absorbed through the respiratory tract. Liquid nerve agents may also be absorbed through the skin, eyes, mouth, and membranes of the nose. Nerve agents may also be absorbed through the stomach when ingesting contaminated food or water.

A protective mask and hood should be used to protect the face and neck, eyes, mouth, and respiratory tract against nerve agent spray, vapor, and aerosol. To prevent inhaling an incapacitating or lethal dose, you should hold your breath and put on the mask within 9 seconds of the first warning of a nerve agent presence.

Liquid nerve agents penetrate ordinary clothing rapidly.

However, significant absorption through the skin requires a period of minutes. The effects may be reduced by quickly removing contaminated clothing and neutralizing liquid nerve agent on the skin by washing off, blotting, or wiping away. Prompt decontamination (decon) of the skin is imperative. Decon of nerve agents on the skin within 1 minute after contamination is perhaps 10 times more effective than it would be if delayed 5 minutes. A nerve agent on the skin can be removed effectively by using the M291 skin decontamination kit (fig. 13-28). The M291 skin decontamination kit is replacing the M258A1 (fig. 13-29). Upon receipt of the M291, discontinue use of the M258A1 on the skin. Detailed instructions on the use of skin decontamination kits can be found in Navy NAVMED P-5041 and in the kit itself. Liquid nerve agent in the eye is absorbed faster than on the skin and is extremely dangerous; immediately irrigate the eye with an abundant amount of water.

Diagnosis of Nerve Agent Poisoning

Nerve agent poisoning may be identified from the characteristic signs and symptoms. It is important that all service members know the following mild and severe signs and symptoms of nerve agent poisoning. Service members who have most or all of the symptoms listed must immediately receive first aid (self-aid or buddy aid).

Self-aid is provided by the person affected by chemical agents. They know who they are, where they are, and what they are doing. They are able to move around freely without assistance. Buddy aid is provided when individuals cannot care for themselves and require assistance.

MILD POISONING (SELF-AID). - Casualties with mild poisoning may experience most or all of the following symptoms:

Unexplained runny nose

Unexplained sudden headache

Sudden drooling

Difficulty in seeing

Tightness in the chest or difficulty in breathing

Wheezing and coughing

Localized sweating and muscular twitching in the area of the contaminated skin

Stomach cramps

Nausea with or without vomiting

Tachycardia followed by bradycardia

Figure 13-28. - M291 skin decontamination kit.