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.
NERVE AGENT ANTIDOTES
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.
General Usage Principles for Nerve
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.