{"id":5055,"date":"2011-07-14T20:22:59","date_gmt":"2011-07-14T20:22:59","guid":{"rendered":"http:\/\/crashtext.org\/misc\/5055.htm\/"},"modified":"2011-10-02T20:21:04","modified_gmt":"2011-10-02T20:21:04","slug":"chemical-weapons-mass-destruction","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/ems-disaster\/chemical-weapons-mass-destruction.htm\/","title":{"rendered":"Chemical Weapons of Mass Destruction"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>PPE if possibility of contamination<\/p>\n<p>A-SCBA c TECP (Totally-encpasulated Chemical Protection) Suit<\/p>\n<p>B-SCBA or SAR (supplied air respirator) and non-encapsulated chemical resistant suit<\/p>\n<p>C-Skin protection of B c respirator<\/p>\n<p>D-Universal Precautions<\/p>\n<p>&nbsp;<\/p>\n<p>Liquid Exposure requires Decon, vapor does not.\u00a0 Decon c water then soap then 0.5% hypochlorite solution, conveniently prepared by mixing 1 part 5% hypochlorite (household bleach) with 9 parts water.\u00a0 Do not use hot water, aids in absorbtion<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Nerve_Agents\"><\/span>Nerve Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>G Series for German<\/p>\n<p>Tabun (GA)-13 hour aging<\/p>\n<p>Sarin (GB)-5 hour aging, most volatile<\/p>\n<p>Soman (GD)-2 minute aging<\/p>\n<p>Cyclosarin (GF)<\/p>\n<p>V Series<\/p>\n<p>VX-most lethal, low volatility, very lipophilic.Oily liquid designed to remain on clothes and surfaces much longer than other agents.\u00a0 48 hour aging<\/p>\n<p>Binary-just means stored as 2 components to limit handling risk<\/p>\n<p>GB2<\/p>\n<p>VX2<\/p>\n<p>&nbsp;<\/p>\n<p>All agents penetrate through skin and clothing, heavier than air<\/p>\n<p>Liquid or Vapor Exposure<\/p>\n<p>Liquid-sx in 30 minutes to 18 hours depending on degree of exposure<\/p>\n<p>Vapor-sx in seconds to minutes<\/p>\n<p>&nbsp;<\/p>\n<p>Resp-hypersecretion and in higher doses respiratory shutdown<\/p>\n<p>CV-tachycardia or bradycardia depending on nicotinic or muscarinic predominance<\/p>\n<p>CNS-decreased LOC and seizures<\/p>\n<p>Musculoskeletal-weakness then fasiculations then paralysis<\/p>\n<p>Ocular-tearing and in vapor exposure, miosis<\/p>\n<p>Lab tests-Plasma and RBC cholinesterase (more specific), not great tests<\/p>\n<p>Treatment<\/p>\n<p>Atropine for muscarinic 2 mg IV\/IM q 2-5 (will not need as high doses as organophosphates).\u00a0 If severe sx make dose 5 mg<\/p>\n<p>Oximes: 2-Pam 1-2 grams IV\/IM Q hour (15-25 mg\/kg in kids) administered slowly, will not work if aging has occurred<\/p>\n<p>Mark I Kit-2 mg of Atropine and 600 mg of 2-Pam in autoinjectors.\u00a0 Usually need 3 kits per person<\/p>\n<p>If you need to intubate, do not use sux as will get prolonged paralysis<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Blistering_Agents\"><\/span>Blistering Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Mustards (HD)<\/p>\n<p>Sulfur mustard penetrates into cells causing alkalation of DNA.\u00a0 Effective in warm, moist tissues (regardless of covering by clothes, so suspect if blisters in groin or axilla)<\/p>\n<p>Volatile at higher temps and most effective in vapor form<\/p>\n<p>Sx 4-24 hours post exposure c bullae and especially ocular effects<\/p>\n<p>If not deconed in 2 minutes post-exposure, irreversible binding.\u00a0 Use water then soap then bleach solution<\/p>\n<p>Lewisite (L)<\/p>\n<p>Smells like geraniums<\/p>\n<p>Immediate blisters<\/p>\n<p>Lewisite shock from thirdspacing of fluids<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Choking_Agents\"><\/span>Choking Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Cyanides\"><\/span>Cyanides<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Incapacitating_Agents\"><\/span>Incapacitating Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Lacrimating_Agents\"><\/span>Lacrimating Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Vomitting_Agents\"><\/span>Vomitting Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Irritant_Agents\"><\/span>Irritant Agents<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Phosgene (CG)<\/p>\n<p>Smells like freshly cut hay<\/p>\n<p>Denser than air<\/p>\n<p>Pulmonary toxicity prevails along c hemolysis<\/p>\n<p>Decon, steroids, NAC<\/p>\n<p>Chlorine<\/p>\n<p>First eye and oropharynx symptoms (tearing, sore throat, runny nose) then pulmonary toxicity<\/p>\n<p>Nebulized Bicarb (2.5 cc Syringe Bicarb diluted 1:1 with saline) and steroids<\/p>\n<p>&nbsp;<\/p>\n<p>|\u00a0\u00a0 \u00a0\u00a0 |\u00a0\u00a0 \u00a0\u00a0 |<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[13],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Chemical Weapons of Mass Destruction - Crashing Patient<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crashingpatient.com\/ems-disaster\/chemical-weapons-mass-destruction.htm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta 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