Chemical Agents and Treatment Protocols Flashcards
what is a chemical attack
The purposeful use of chemical substance to harm people, cause economic or property damage or instill fear or panic.
severity of a chemical attack
- toxicity + concentration
- concentration variable
- chemicals that vaporize are less toxic
- wind
- volatility
decontamination
-you must make sure the patient is decontaminated before treatment
-remove all chemicals and clothing
-
if you see something say something
-someone should investigate
personal protection
- time- spend the least amount of time in the area -> less exposure
- distance- put distance between you and incident or have PPE -> less exposure
- shielding- wear the appropriate PPE
accidental exposure
- blot- blot off the agent
- strip- removing all clothing (80% of decontamination)
- flush- flush the affected area with large amount of water
- cover- cover the affected area- reduce exposure or infection
physiological effect of chemical warfare
- overstimulation- seizures, twitching -> confusion
- unaware of surroundings
- dizzy
- nervous system is affected
- can last for 2-6 weeks
- constriction of airways - you can get air in but no air out -> trouble breathing, high blood pressure
- excessive mucus -> suction
affects on vagus nerve
- simulates vagus nerve -> lowers heart rate
- cardiac arrest
- brain damage within 5 minutes
- lowered blood pressure
choking agent
-chlorine gas
-prevent breathing
-pulmonary edema - fluid in lungs
-
herbicide
- agent orange
- used to damage vegetation
- vietnam war- damage the foliage
- no hiding
blister agents
- causes blisters
- can be in the airways too
- eyes can be affected
- can last 2 hours
riot control
- law enforcement
- irritates eyes
- not meant to cause severe damage
- pepper spray
- if you spray someone with COPD or asthma it can be serious
- tear gas
blood agents
- cyanide- organ cells cant take up the oxygen
- affects the way the body can use oxygen
- affects the hemoglobin -> cant pick up oxygen
- CO poisoning - hemoglobin cant pick up oxygen
nerve agents
- chlorine gas
- sarin gas
- blisters
- difficulty breathing
- fluids coming out everywhere- SLUDGEM
- tabun
- soman
- cyclosarin
- seizures
- paralysis
- confusion
- vomiting
- pinpoint pupils **
SLUDGEM
- salvation - fluids
- lacrimation
- urination
- defecation
- gastroenteritis
- emesis- vomiting
- miosis- pupil constriction
pathophysiology of nerve agents
- agent binds with ACh
- ex. sarin binds with ACh constantly
- Acetylcholine releases constantly -> overstimulation -> Seizures, secretion of fluids
tokyo subway attack
- leader created his own religion
- when you joined you sign off your wealth -> rich
- experiments with nerve agents
- used sarin gas in bags in the subway
- use umbrellas to puncture the bags
- 13 people died
- this disrupts the economy, the public, in mass amounts
- so easily available and yet instills fear, death, pain
treatment: nerve agents
- decontamination
- ventilation
- administration of antidotes
- supportive therapy
nasal cannula
- 1-6 LPM (liters per minute)
- delivers 24-40% oxygen
nonrebreather mask
- 8-15 LPM
- delivers 90% of oxygen
- more difficulty of breathing-
bag mask valve (BVM)
- 15 LPM
- delivers up to 100% oxygen
- when someone cannot ventilate themselves
- lung size depends on height
- issue comes in when you start over inflating -> pneumothorax
- meant to be used by two people- bc cramping
- add a filter to decrease spread of germs
- put on mask then attach bag
peep valve
- red cap on a BVM
- increases pressure so when you squeeze the bag it keeps pressure within the system (if you have a good seal)
- when you have built up fluid the alveoli will open up and STAY open*
- helps with bringing oxygen in when fluid is present
- o2 doesn’t move easily in fluid but CO2 does
continuous positive airway passage mask (CPAP)
- asthma attack
- opens the airways
- used on someone is exposed to a chemical
- maintains the pressure
- opens alveoli
Bilevel positive airway pressure (BiPAP)
- for people that are tired
- tired of breathing