NOT give nerve agent antidotes for preventive
purposes before contemplated exposure to a nerve
The atropine autoinjector consists of a hard plastic
tube containing 2 mg (0.7 ml) of atropine in solution
for intramuscular injection. It has a pressure-activated
coiled-spring mechanism that triggers the needle for
injection of the antidote solution. These injectors are
designed to be used by individuals on themselves when
symptoms appear. For medical personnel, the required
therapy is to continue to administer atropine at
15-minute intervals until a mild atropinization occurs.
This can be noted by tachycardia and a dry mouth.
Atropine alone will not relieve any respiratory muscle
Prolonged artificial respiration may be
necessary to sustain life.
A second autoinjector containing oxime therapy
(using pralidoxime chloride, or 2-PAM Cl) can also be
used for regeneration of the blocked cholinesterase.
Since 2-PAM Cl is contained in the kit of autoinjectors,
additional oxime therapy is not generally medically
recommended for those who have already received
treatment by autoinjection.
The 2-PAM Cl
autoinjector is a hard plastic tube that, when activated,
dispenses 600 mg of 2-PAM Cl (300 mg/ml) solution.
It also has a pressure-activated coiled-spring
mechanism identical to that in the atropine
Self-Aid.If you experience the mild symptoms
n e r v e - a g e n t
p o i s o n i n g ,
y o u
s h o u l d
IMMEDIATELY hold your breath 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 8-4 and
8-5. Position the 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.
Hold the atropine injector firmly in place for at
least 10 seconds. The seconds can be estimated by
counting one thousand one, one thousand two, and
Firm pressure automatically triggers the
coiled mechanism and plunges the needle through the
clothing into the muscle and at the same time injects
the atropine antidote into the muscle tissue.
Next, inject yourself in the same manner with the
2-PAM Cl injector, using the same procedure as you
did for the atropine. This will now complete one set of
nerve-agent antidotes. Attach the used injectors to
your clothing (fig. 8-6) (to indicate the number of
injections you have already received).
After administering the first set of injections, wait
10 to 15 minutes (since it takes that long for the
antidote to take effect) before administering a second
set, if needed. If the symptoms have not disappeared
within 10 to 15 minutes, give yourself the second set of
If the symptoms still persist after an
additional 15 minutes, a third set of injections may be
given by nonmedical personnel.
After administering each set of injections, you
should decontaminate your skin, if necessary, and put
on any remaining protective clothing.
Figure 8-4.Thigh injection site.
Figure 8-5.Buttocks injection site.