NOT give nerve agent antidotes for preventivepurposes before contemplated exposure to a nerveagent.The atropine autoinjector consists of a hard plastictube containing 2 mg (0.7 ml) of atropine in solutionfor intramuscular injection. It has a pressure-activatedcoiled-spring mechanism that triggers the needle forinjection of the antidote solution. These injectors aredesigned to be used by individuals on themselves whensymptoms appear. For medical personnel, the requiredtherapy is to continue to administer atropine at15-minute intervals until a mild atropinization occurs.This can be noted by tachycardia and a dry mouth.Atropine alone will not relieve any respiratory musclefailure. Prolonged artificial respiration may benecessary to sustain life.A second autoinjector containing oxime therapy(using pralidoxime chloride, or 2-PAM Cl) can also beused for regeneration of the blocked cholinesterase.Since 2-PAM Cl is contained in the kit of autoinjectors,additional oxime therapy is not generally medicallyrecommended for those who have already receivedtreatment by autoinjection. The 2-PAM Clautoinjector 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-springmechanism identical to that in the atropineautoinjector.Self-Aid.—If you experience the mild symptomso f 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 dIMMEDIATELY hold your breath and put on yourprotective mask. Then, administer one set of (atropineand 2-PAM Cl) injections into your lateral thighmuscle or buttocks, as illustrated in figures 8-4 and8-5. Position the needle end of the atropine injectoragainst the injection site and apply firm, even pressure(not jabbing motion) to the injector until it pushes theneedle into your thigh (or buttocks). Make sure you donot hit any buttons or other objects. Using a jabbingmotion may result in an improper injection or injury tothe thigh or buttocks.Hold the atropine injector firmly in place for atleast 10 seconds. The seconds can be estimated bycounting “one thousand one, one thousand two,” andso forth. Firm pressure automatically triggers thecoiled mechanism and plunges the needle through theclothing into the muscle and at the same time injectsthe atropine antidote into the muscle tissue.Next, inject yourself in the same manner with the2-PAM Cl injector, using the same procedure as youdid for the atropine. This will now complete one set ofnerve-agent antidotes. Attach the used injectors toyour clothing (fig. 8-6) (to indicate the number ofinjections you have already received).After administering the first set of injections, wait10 to 15 minutes (since it takes that long for theantidote to take effect) before administering a secondset, if needed. If the symptoms have not disappearedwithin 10 to 15 minutes, give yourself the second set ofinjections. If the symptoms still persist after anadditional 15 minutes, a third set of injections may begiven by nonmedical personnel.After administering each set of injections, youshould decontaminate your skin, if necessary, and puton any remaining protective clothing.8-6HIPBONELATERALTHIGHMUSCLEINJECTIONSITEHM3F0804Figure 8-4.—Thigh injection site.INJECTIONSITEINJECTIONSITEMAINNERVEHM3F0805Figure 8-5.—Buttocks injection site.
Integrated Publishing, Inc. - A (SDVOSB) Service Disabled Veteran Owned Small Business