Decontamination Station Organization
In general, the decontamination station, or dirty
area, receives casualties contaminated with a chemical
agent. The arrangement of this area will vary with the
site of the medical unit and the facilities available for
Each ship will have a minimum of at least two
decontamination stations, insofar as the hull design
permits. The dirty areas should be topside or in some
well-ventilated space. Personnel manning these areas
should be provided with protective equipment.
In the dirty area, casualties will be decon-
taminated, undressed, showered, and passed along to
clean areas. Both areas should be clearly marked as either
clean or contaminated, as appropriate. Decontami-
nation kits, protective ointment, and an abundant supply
of soap and water must be provided. In addition, standard
first-aid items should be on hand.
improvise supports (e.g., small boxes, blocks of wood,
etc.) for stretchers to keep them raised off the deck.
Handling of Contaminated Casualties
The spread of contamination to uncontaminated
personnel or to spaces not set aside to receive contami-
nation must be avoided.
clothing, or equipment must be kept out of uncontam-
inated areas since the subsequent decontamination of
such spaces is quite difficult. Contaminated clothing
and gear must be placed in designated dump areas and,
whenever practically possible, kept in metal cans with
tightly fitting covers.
The Medical Officer or Senior Medical Depart-
ment Representative (SMDR) is responsible for
maintaining adequate supplies for decontamination
and treatment of CBR casualties. Medical decon-
tamination supplies are supplied to ships on a
personnel -strength basis, as listed in current Authorized
Medical Allowance List (AMAL).
The decontamination supply cabinets will be kept
locked, and the keys will be in custody of the Damage
Control Assistant (DCA). Cabinets and chests will
b e s t e n c i l e d w i t h a r e d c r o s s a n d m a r k e d
DECONTAMINATION MEDICAL SUPPLIES.
Chemical agents are grouped under several
classifications. The broadest classification we will use
is based on the general effect produced (i.e., severe
casualty, harassment, or incapacitation). Within each
general group, there are further breakdowns, the most
convenient of which (from a medical point of view) is
the classification by physiologic effect.
agents may also be classified as lethal or nonlethal.
Nonlethal agents will not kill you. Lethal agents are
those that result in a 10 percent or greater death rate
They are further classified as
persistent or nonpersistent, depending on the length of
time they retain their effectiveness after dissemination.
In the following paragraphs, we discuss the agents
that produce the greatest number of fatalities and
casualties among personnel who have been exposed to
Nerve agents produce their effect by interfering
with normal transmission of nerve impulses in the
parasympathetic autonomic nervous system.
Physically, nerve agents are odorless, almost colorless
liquids, varying greatly in viscosity and volatility.
They are moderately soluble in water and fairly stable
unless strong alkali or chlorinating compounds are
They are very effective solvents, readily
penetrating cloth either as a liquid or vapor. Other
materials, including leather and wood, are fairly well
Butyl rubber and synthetics, such as
polyesters, are much more resistant.
Pharmacologically, the nerve agents are
cholinesterase inhibitors (interfering with normal
transmission of nerve impulses in the parasympathetic
autonomic nervous system).
Their reaction with
cholinesterase tends to be irreversible, and reaction
time varies with the agent.
SIGNS AND SYMPTOMS OF EXPOSURE.
Nerve-agent intoxication can be readily identified by
its characteristic signs and symptoms.
If a vapor
exposure has occurred, the pupils will constrict,
usually to a pinpoint. If the exposure has been through
the skin, there will be local muscular twitching where
the agent was absorbed. Other symptoms will include
rhinorrhea, dyspnea, diarrhea and vomiting,
convulsions, hypersalivation, drowsiness, coma, and
TREATMENT.Specific therapy for nerve
agent casualties is atropine, an acetylcholine blocker.
When exposed, each member of the Navy and Marine
Corps is issued three 2 mg autoinjectors of atropine
and three 600 mg autoinjectors of 2-PAM Cl.