use if you become a nerve-agent casualty. Theautoinjectors will be discussed later in this chapter.Familiarize yourself with your equipment. Know howit works before you need it.DECONTAMINATIONThe guiding principle in personnel decontam-ination is to avoid spreading contamination to cleanareas and to manage casualties without aggravatingother injuries.Casualty PrioritiesIt will often be necessary to decide whether tohandle the surgical condition or the chemical hazardfirst. If the situation and the condition of the casualtypermit, decontamination should be carried out first.The longer the chemical remains on the body, the moresevere will be the danger of spreading the chemical toother personnel and equipment.The following order of priority for first aid anddecontaminating casualties is recommended:1. Control of massive hemorrhage2. First aid for life-threatening shock and wounds3. Decontamination of exposed skin and eyes4. Removal of contaminated clothing anddecontamination of body surfaces (if not in atoxic environment)5. Adjustment of patient’s mask, if mask isnecessary6. First aid in less severe shock and woundsThe basic steps in sorting and handling casualtiesare indicated in figure 8-3. This plan should bemodified to fit specific needs.8-4BEDHM3F0803DIRTYCLEANWOUNDEDCLEANCLEANCLEANTREATMENTADDITIONAL MEDICAL AID.AWAITING EVACUATION.CONTAMINATEDEMERGENCYDIRTYIMPROVISED AREA ORSPECIALLYDESIGNATEDFACILITY FOR EMERGENCYOPERATIONS ON CONTAMI-NATED WOUNDED WHO AREDECONTAMINATED WHENINDICATED.CLEANCONTAMINATEDCONTAMINATED EMERGENCYCONTAMINATEDWOUNDEDFREE VENTILATION; SOME COVER.REMOVE CONTAMINATED OUTERCLOTHING, GEAR, AND BLANKETS.SPEED IN UNDRESSING DESIRABLE.CHANGE TO CLEAN LITTER, BLAN-KETS. SKIN PENCIL AREAS OFCONTAMINATION. UNDRESSERS,BEARERS MASKED AND PROTECTED.DIRTYSENTRYMAY BE WARMED. UNDERCLOTHESREMOVED AND PASSED FORWARD ORPLACED IN FREQUENTLY EMPTIEDSACKS OR BINS. OINTMENT OR SOAPAND WATER TO SKIN AREAS BELIEVEDEXPOSED. WASHING FACILITIES.ATTENDANTS MASKED, PROTECTED.ALL CASESANDRECORDS RECEIVED.Figure 8-3.—Basic steps in sorting and handling casualties.
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