CAS RN:77-81-6

Other Preventive Measures

Any chemical release will have its maximum harmful effect against unprotected individuals, so those who self-evacuate and the rapidly rescued will generally have the best survival and recovery prospects. Planners and incident commanders should bear in mind that by the time rescue efforts are mounted survivors are generally unlikely to be found in environments or circumstances that demand the wearing of self-contained respiratory protection. Health plans should also recognize that the level of meaningful assessment or treatment that can be carried out in the ... hot zone... will be very limited. ... Rapid rescue from the hot zone represents the most practical and effective operational approach and in most major releases the most effective health response is likely to be focused in the more lightly contaminated ("warm") and uncontaminated ("cold") zones. There - and at receiving hospitals - the main emphasis should be on providing the type of respiratory and physical protection for staff so that secondary contamination is prevented. Unprotected staff should not come into contact with undecontaminated patients. /Chemical warfare agents/
Identifying the chemical(s) involved and measuring its concentration would obviously be helpful... but may not prove possible until more specialist support arrives and so responders are likely to be reliant on environmental indicators and/or the signs and symptoms displayed by victims. In practice, information gathered during clinical examination may be most useful. /Chemical warfare agents/
Decontaminating "non-ambulatory" patients is very staff-intensive and time-consuming but should generally be the primary focus of health effort at the scene. ... Dealing with those who are "ambulatory" is a quicker process as they should normally be able to carry out their own decontamination under supervision ... /Chemical warfare agents/
Current recommendations for decontamination of civilians exposed to chemicals as a result of release of such substances by terrorists. ... decontamination of the entire body - not just, for example, the hands and face, should be undertaken. All clothing should be removed and placed in sealed polythene bags. Jewelry, watches, money and other personal possessions should be collected and placed in labeled polythene bags. Two approaches to decontamination are feasible: the "bucket and sponge" method taking one patient at a time, or the mass decontamination approach with attendants supervising the passage of a queue of people through some communal shower unit. Patients who have been injured or are unable to help themselves should be decontaminated by trained attendants using a system in which a stretcher is placed on a table equipped with rollers that allows transfer of the decontaminated patient to a clean stretcher, and ambulance and to hospital. Some authorities have argued for the addition of liquid soap to the water used in automated decontamination units. This will speed the process of material but the interaction of water and soap leading to foaming when passed through a jet should be considered. Whatever means of decontamination are used it should be thorough. This means that each patient will need some minutes of attention: up to 15 or so minutes may be needed to deal with an incapacitated patient. Whatever system is used, plans for dealing with waste water and any decontaminants used should be devised and practiced in advance of an incident occurring. Waste water may be collected inside an area protected by inflatable "bunds". ...If waste water is to be allowed to run into drains, the local water company should be informed. ...Suitable towels and clothing must be provided, modesty should be preserved and consideration given to how people are to make their way home. /Chemical warfare agents/
SRP: Contaminated protective clothing should be segregated in such a manner so that there is no direct personal contact by personnel who handle, dispose, or clean the clothing. Quality assurance to ascertain the completeness of the cleaning procedures should be implemented before the decontaminated protective clothing is returned for reuse by the workers. Contaminated clothing should not be taken home at end of shift, but should remain at employee's place of work for cleaning.
Victims whose skin or clothing is contaminated with liquid nerve agent can contaminate rescuers by direct contact or through off-gassing vapor ... Hot Zone responders should be trained and appropriately attired before entering the Hot Zone. If the proper personal protective equipment (PPE) is not available, or if the rescuers have not been trained in its use, call for assistance in accordance with local Emergency Operational Guides (EOG). ... Rescue Personnel should continue to wear the same level of protection /in the Decontamination Zone./ /Nerve agents/
Rescuer Protection: Respiratory protection: Pressure-demand, self-contained breathing apparatus (SCBA) is recommended in response situations that involve exposure to any nerve agent vapor or liquid. Skin protection: Chemical-protective clothing and butyl rubber gloves are recommended when skin contact is possible because nerve agent liquid is rapidly absorbed through the skin and may cause systemic toxicity. /Nerve agents/
Nerve Agent Effects. Vapor Exposure. Mild: Eyes - Small pupils (miosis), Dim vision; Headache; Nose - Runny nose (rhinorrhea); Mouth - salivation; lungs - tightness in the chest. Time of onset: seconds to minutes after exposure. Self-aid: 1 MARK I Kit. Buddy-aid: stand by. Severe: all of the above, plus Severe breathing difficulty or cessation of respiration; generalized muscular twitching, weakness, or paralysis; convulsions; loss of consciousness; Loss of bladder, bowel control. Time of onset: seconds to minutes after exposure. Self-aid: none; soldier will be unable to help himself . Buddy-aid: three MARK I Kits and diazepam immediately. Liquid on Skin. Mild/Moderate: muscle twitching at site of exposure; sweating at site of exposure; nausea, vomiting; feeling of weakness. Time of onset: 10 minutes to 18 hours after exposure. Self-aid: 1-2 MARK I Kits, depending on severity of symptoms. Buddy-aid: stand by. Severe: all of the above, plus breathing difficulty or cessation of breathing; generalized muscular twitching, weakness, or paralysis; convulsions; loss of consciousness; loss of bladder and bowel control. Time of onset: minutes to an hour after exposure. Self-aid: none; soldier will be unable to help himself. Buddy-aid: three MARK I Kits and diazepam immediately. The most important care the casualty receives is the care given within the first several minutes after exposure (self-aid, buddy-aid). Immediate care, including administration of antidotes, can mean the difference between survival and death in a soldier exposed to a nerve agent. /Nerve agents in war/
The doctrine for self-aid for nerve agent intoxication states that if an individual has effects from the agent, he/she should selfadminister one MARK I Kit. If there is no improvement in 10 minutes, he/she should seek out a buddy to assist in the evaluation of his/her condition before further MARK I Kits are given. If a buddy finds an individual severely intoxicated (e.g., gasping respirations, twitching, etc.) so that the individual cannot self-administer a MARK I Kit, the buddy should administer three MARK I Kits and diazepam immediately.
PRECAUTIONS: Prevent contamination to uncontrolled areas. Do not breathe fumes. Avoid skin contact at all times. Hold breath until mask in place. Fire fighting personnel should wear full protective clothing and breathing apparatus. Wear protective rubber gloves. Wear chemical goggles or face shield if available. Once a case is suspected, the local health authorities must be informed immediately.
Although resistant to liquid chemical agents, impermeable protective clothing may be penetrated after a few hr of exposure to heavy concn of agent. Consequently, liquid contamination on the clothing must be neutralized or removed as soon as possible. /Chemicals in war/
Collective protection involves primarily the use of shelters where personnel can work or rest. Such shelters must be airtight to prevent the inward seepage of chemical agents and, thus, require a means of providing uncontaminated air. Such an air supply can be obtained by two methods. In small shelters a filter material called diffusion board can be incorporated into the construction or used as a liner in existing structures. ... For large shelters, a mechanical collective protector can be used. /Chemicals in war/
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