Establishing a patient airway (for example, with a cricothyroidotomy or endotracheal tube) and administering assisted ventilation, if required. Only qualified personnel can perform these procedures. You should use oxygen if available.
Atropine sulfate and 2 PAM Cl remain essential drugs in the treatment of nerve agent poisoning. When exposed, each member of the Navy and Marine Corps is issued three 2 mg auto injectors of atropine and three 600 mg auto injectors of 2 PAM Cl (fig. 13-30). Do not give nerve agent antidotes for preventive purposes before contemplated exposure to a nerve agent.
The atropine auto injector consists of a hard plastic tube containing 2 mg (0.7 ml) of atropine in solution. It has a pressure activated coiled spring mechanism that triggers the needle for injection of the antidote solution. The 2 PAM Cl auto injector is a hard plastic tube, which dispenses 600 mg of 2 PAM Cl (300 mg/ml) solution when activated. It also has a pressure activated coiled spring mechanism identical to that in the atropine auto injector. Diazepam (CANA) is administered as a single-dose 10 mg autoinjector.
Certain general usage principles should be followed in the administration of nerve agent antidotes. Complete instructions for the administration of nerve agent antidotes are found on the auto injectors and also in the Navy NAVMED P-5041.
SELF-AID. - If you experience most or all of the mild symptoms of nerve agent poisoning, you should IMMEDIATELY hold your breath (without first inhaling) and put on your protective mask. Then, administer one set of (atropine and 2 PAM Cl) injections into your lateral thigh muscle or buttocks as illustrated in figures 13-31 and 13-32. Position the
Figure 13-31. - Thigh injection site.
needle end of the atropine injector against the injection site and apply firm, even pressure (not jabbing motion) to the injector until it pushes the needle into your thigh (or buttocks). Make sure you do not hit any buttons or other objects. Using a jabbing motion may result in an improper injection or injury to the thigh or buttocks.
Figure 13-32. - Buttocks injection sites.
Figure 13-30. - Nerve agent antidotes.Continue Reading