In the HM 3 & 2 Rate Training Manual you were indoctrinated in the recognition and treatment of chemical, biological, and radiological (CBR) hazards. In this chapter we will discuss the Medical Departments role in meeting the medical aspects of CBR defense, which includes protection from CBR hazards, mass casualty decontamination, decontamination stations, and supplies for decontamination.
To appreciate the importance of defense against chemical agents, one only has to study the disastrous experience of unprepared and improperly indoctrinated troops in World War I. The importance of planning and training for defense against chemical agents cannot be underestimated.
Chemical agents may be dispersed by modern weapons for strategic as well as tactical purposes; the areas of their employment are limited by the range of the weapons or aircraft used by the combatant force. The chances of surviving a chemical attack are increased as knowledge of the nature of the agents and of the use of correct protective measures is increased.
A naval unit afloat finds itself in a unique situation insofar as defending against toxic chemical agents is concerned. Because agents can be released as clouds of vapor or aerosol, they can envelop the exterior of a vessel and may penetrate within the hull due to the extensive use of artificial ventilation aboard ship. Therefore, extensive contamination may result from such an attack. As the ship, in most cases, cannot be abandoned, it must be decontaminated while the personnel manning it continue to eat, sleep, live, and fight on board.
The medical officer or the hospital corpsman on independent duty must organize the Medical Department to meet the medical needs of defense against chemical agents well in advance of actual need. All hands must be indoctrinated in the use of protective equipment and self-aid procedures. Close liaison and planning must be maintained with damage control personnel responsible for area decontamination, and all medical personnel must be informed of the approved methods currently available for treatment of casualties resulting from the use of chemical agents.
In a chemical attack, the first priority is to ensure your own survival so that you may then treat casualties. There are several items available to help you survive a chemical attack, and you should know how to use them. Along with protective clothing, they include a protective mask, which should be put on at the first indication of a chemical attack. The mask will filter out all known chemical agents from the air and allow you to work in a chemically contaminated area. In addition, there is the M258 personal decontamination kit, which is to be used to chemically neutralize any toxic chemical agent you may have on your clothing or skin. Finally, there are two types of antidote autoinjectors, atropine and 2-PAM C1, for your own use if you become a nerve agent casualty. Familiarize yourself with your equipment. Know how it works when you need it.
The guiding principle in personnel decontamination is to avoid spreading contamination to clean areas and to manage casualties without aggravating other injuries.
It will frequently be necessary to decide whether to handle the surgical condition or the chemical hazard first. If the situation and the condition of the casualty permit, decontamination should be carried out first, for the longer the chemical remains on the body the more severe