lesson 13 administer first aid to a nerve agent casualty

7/30/2019 Lesson 13 Administer First Aid to a Nerve Agent Casualty

1/39

Combat Life SaverCombat Life Saver

LESSON 13LESSON 13

ADMINISTER FIRST AID TO AADMINISTER FIRST AID TO A

NERVE AGENT CASUALTYNERVE AGENT CASUALTY

Compiled and edited by,2LT John C. Miller, PA-C


2/39

LESSON 13

ADMINISTER FIRST AID TO A

NERVE AGENT CASUALTYINTRODUCTION

A soldier showing signs of mild nerveagent poisoning will normally be able totake care of himself. A soldier showingsigns of moderate to severe nerve agent

poisoning, however, will not be able toadequately help himself and must haveassistance.


3/39


NERVE AGENT CASUALTY TASK

Identify the buddy-aid procedures for treatinga nerve agent casualty.

CONDITIONSGiven multiple-choice examination itemspertaining to nerve agent poisoning, buddy-aid treatment, and decontamination.

STANDARDScore 70 or more points on the 100-pointwritten examination.


4/39

TAKE PROTECTIVE

MEASURES Anytime you believe you have been or will

be exposed to a chemical agent, your first

action must be to protect yourself. Youcannot continue with your mission or

administer aid to casualties if you are

overcome by the chemical warfare agent.

Put on your protective mask immediately

and give the alarm.


5/39

TAKE PROTECTIVE MEASURES

If you have signs and symptoms of mildnerve agent poisoning (unexplained runnynose, sudden headache, dizziness,

drooling, tightness in the chest, musculartwitching, stomach cramps, nausea,and/or reduced vision), administer one setof nerve agent autoinjectors to yourself

and decontaminate your exposed skin. Put on the rest of your protective clothing.


6/39

IDENTIFY SIGNS OF SEVERE

NERVE AGENT

POISONING A casualty may progress from mild tomoderate to severe nerve agent poisoningsigns. Signs of severe nerve agent poisoninginclude:

Strange and confused behavior. Coughing, wheezing, and gurgling sounds

while breathing.

Difficulty in breathing. Severely pinpointed pupils. Red eyes with tears present.


7/39

IDENTIFY SIGNS OF SEVERE

NERVE AGENT

POISONING Vomiting. Severe muscular twitching and general

weakness.

Loss of bladder and bowel control. Decreased pulse rate. Convulsion. Paralysis.

Unconsciousness. Respiratory failure (or respiratory arrest)

[casualty stops breathing].


8/39

MASK THE CASUALTY

Put the casualty's mask on him immediately ifhe is not masked. If he is already masked,check the seal.

Position the casualty on his back. Squat, do not kneel, in a chemical environment.

Pressing your knee against the contaminatedground will reduce the protection time afforded byyour protective clothing.

Open the casualty's mask carrier and removehis protective mask.

Hold the mask with the lenses facing you.


9/39

MASK THE CASUALTY

Put your thumbs on the outside of the cheekpouches of the mask and your fingers on theinside of the cheek pouches.

Spread the mask open and position it on the

casualty's chin. Put your thumbs through the two bottom strapsof the head harness.

Cup the casualty's head with the fingers of bothhands and lift his head slightly.

Slide the head harness over the casualty'shead by moving your thumbs toward the backof the casualty's head and down behind hisears.


10/39

MASK THE CASUALTY

Make sure the two bottom straps of the headharness are below the casualty's ears, thetemple straps are above his ears, and the headpad is centered in the middle of the back of hishead.

The head harness should not need to be adjusted.If the straps do need to be tightened, tighten themusing short, firm, jerks.

Check the seal of the mask against thecasualty's face.

If the casualty can follow instructions, have himclear his mask by covering the outlet valve andvoicemitter and exhaling forcefully, then coveringthe inlet valves and inhaling.


11/39

MASK THE CASUALTY

If the casualty cannot follow instructions, cover

the mask's inlet valves. If the mask collapses

when the casualty inhales, it is properly sealed. If

it does not collapse, reseat the mask. If thesoldier is not breathing, you cannot determine

whether the mask is properly sealed.

Make sure the buckles are lying flat and the

straps form a straight line with the tabs. Pull the protective hood over the casualty's

head, neck, and shoulders.

ADMINISTER THREE NERVE


12/39


AGENT

ANTIDOTE KITS AND CANA Select Injection Site The normal injection site is the outer part of

the casualty's thigh at least the width of one

hand below the hip joint and at least the widthof one hand above the knee.

If the casualty is very thin, roll the casualtyonto his stomach or side and select a site on

the upper, outer quadrant of the casualty'sbuttocks. Lift his jacket if it is covering thesite.


13/39


14/39



15/39


AGENT

ANTIDOTE KITS AND CANA Administer Atropine Remove one Mark I nerve agent antidote kit from

the inside pocket of the casualty's mask carrier. If the temperature is near or below freezing, the

autoinjectors may be carried next to the casualty'sbody.

Hold the kit by the clip in your nondominant hand ateye level with the larger (2-PAM chloride)autoinjector on top.

Feel the injection site with your free hand to makesure the site is free from buttons or otherobstructions which could damage the needle.


16/39



17/39


AGENT

ANTIDOTE KITS AND CANA Grasp the body of the lower (smaller) autoinjectorwith the thumb and two fingers of your dominanthand. Do not touch the green (needle) end of the

autoinjector since the pressure could cause theneedle to function.

Pull the atropine autoinjector out of the clip with asmooth motion.

Form a fist around the autoinjector and place the

green end of the autoinjector against the injectionsite (thigh or buttocks) at a 90 degree angle to thesurface of the site.


18/39



19/39


AGENT

ANTIDOTE KITS AND CANA Apply firm even pressure to the autoinjectoruntil the needle functions (clicks), penetratesthe clothing, and automatically injects themedication into the casualty's muscle. Do not use a jabbing motion to inject the antidote

into the muscle. Hold the autoinjector in place for at least 10

seconds. Pull the autoinjector out of the casualty's body

at the same 90 degree angle. Place the used atropine autoinjector betweentwo fingers of the hand holding the kit with theneedle pointing away from your hand.


20/39


21/39


AGENT

ANTIDOTE KITS AND CANA Administer 2-PAM Chloride Grasp the body of the remaining (2-PAM chloride)autoinjector with the thumb and two fingers of yourfree hand.

Pull the autoinjector out of the clip in a smoothmotion. Do not touch the black (needle) end of the autoinjector.

Form a fist around the autoinjector and place theblack end of the autoinjector against the injectionsite at a 90 degree angle.

Apply firm, even pressure until the needlefunctions. Do not use a jabbing motion.


22/39


23/39


24/39



25/39


AGENT

ANTIDOTE KITS AND CANA Hold the autoinjector in place for at least 10seconds.

Pull the autoinjector out of the casualty's body atthe same 90 degree angle.

Drop the empty plastic clip without dropping theautoinjectors.

Lay the used autoinjectors on the casualty's chestor back.

Administer Second and Third Kits Administer the second Mark I kit using the same

procedures as for the first kit.



26/39


AGENT

ANTIDOTE KITS AND CANA Administer the third kit of autoinjectors. There is no waiting period between kits.

If the casualty already administered one set ofinjectors to himself (used autoinjectors attachedto pocket flap), you will only administer the twoadditional Mark I kits.

The CANA is NOT for use as self-aid. If youknow who you are, where you are, and what

you are doing, you do not need CANA. Administer the CANA immediately after the

third MARK I to prevent convulsions.



27/39


AGENT

ANTIDOTE KITS AND CANA Grasp the CANA autoinjector with yourdominant hand with the needle end extendingbeyond your thumb and two fingers.

With your other hand, pull the safety cap off the

autoinjector base. The injector is now armed. DO NOT touch the black (needle) end because

you may accidently inject yourself.

Position the black (needle) end of theautoinjector against the casualty's injection site(thigh or buttocks).


28/39



29/39


AGENT

ANTIDOTE KITS AND CANA Apply firm, even pressure (not a jabbingmotion) to the injector until it pushes the needleinto the casualty's thigh (or buttocks). Make

sure you do not hit the casualty's mask carrieror any objects in the individual's pockets.

Hold the injector firmly in place for at least 10seconds.

Carefully remove the CANA autoinjector fromthe casualty's injection site.

Drop the safety cap. (The cap can be disposedof earlier.)



30/39


AGENT

ANTIDOTE KITS AND CANA Secure Used Autoinjectors Attach used autoinjectors, atropine, PAM

chloride, and CANA to the casualty's

clothing, usually the left pocket flap.


31/39


32/39

DECONTAMINATE EXPOSED

SKIN

Obtain M291 Kit

Obtain the M291 decontamination kit from thecasualty's mask carrier.

The M291 Skin Decontaminating Kit is providedto service members for skin decontamination.This kit may also be used to decontaminateselected individual equipment, such as loadbearing equipment, protective gloves, mask,hood, and weapon.

Seek overhead cover or use a poncho forprotection against further contamination.


33/39


SKIN

Decontaminate Hands Remove one skin decontaminating packet from

the carrying pouch. Tear open quickly at notch. Although any notch

may be used to open the packet, opening atthe TEAR LINE will place applicator pad in aposition that is easier to use.

Remove applicator pad from packet and

discard empty packet. Unfold applicator pad and slip finger(s) intohandle.


34/39


SKIN Thoroughly scrub exposed skin on the

casualty's hands (back of hand, palm, andfingers) until completely covered with blackpowder from the applicator pad.

Decontaminate Face Thoroughly scrub exposed skin of the

casualty's face until completely covered withblack powder from the applicator pad. Have casualty hold his breath, close his eyes.

Grasp his mask beneath chin, and pull hood andmask away from chin enough to allow one handbetween the mask and the face. Hold mask in thisposition until you discard the applicator pad.


35/39


SKIN

Scrub up and down across face beginning at

from of one ear to nose to other ear.

Scrub across face to corner of nose.

Scrub extra stroke at corner of nose. Scrub across nose and tip of nose to other

corner of nose.

Scrub extra stroke at corner of nose. Scrub across face to other ear.


36/39


SKIN Next scrub up and down across face to mouth to

other end of jawbone.

Scrub across cheek to corner of mouth.

Scrub extra stroke at corner of mouth.

Scrub across closed mouth to center of upper lip.

Scrub extra stroke above upper lip.

Scrub across closed mouth to other corner of

mouth. Scrub extra stroke at corner of mouth.

Scrub across cheek to end of jawbone.


37/39


SKIN

Next, scrub up and down across face to chin and toother end of jawbone. Scrub across the under jaw to chin, cupping. Scrub extra stroke at center of chin. Scrub across the under jaw to the end of the jawbone.

Turn your hand out, and quickly wipe the inside of themask that touches the face. Discard applicator pad. Immediately seal mask, clear, and check it. Remove second skin decontaminating packet from

carrying pouch. Tear open quickly at notch. Remove applicator pad from packet and discard empty

packet.


38/39


SKIN Decontaminate Neck

If the casualty was already masked when becomingcontaminated, without breaking the seal between the faceand mask, thoroughly scrub skin of neck and ears untilcompletely covered with black powder.

Redo hands until completely covered with black powder. Discard applicator pad. Put the protective gloves on the casualty. Fasten casualty's hood. Remove powder with soap and water when operational

conditions permit. It does not matter how long the powder

stays on your skin. Bury the used pads and packets if circumstances permit.


39/39


NERVE AGENT CASUALTYCLOSING

Masking the casualty, administering three Mark 1

kits and CANA, and decontaminating exposedskin are initial treatment measures for a nerveagent casualty. The medical phase of the combatlifesaver course presents additional treatmentprocedures for severe nerve agent casualties and

treatment for victims of other types of chemicalagents. This lesson is tested on the writtenexamination.

lesson 13 administer first aid to a nerve agent casualty

Documents