First Aid and Emergency Information

1 Fundamental Criteria for First Aid
2 Basic Measures for First Aid
3 First Aid for Special Wounds
4 First Aid for Fractures
5 First Aid for Climatic Injuries
6 First Aid for Bites and Stings
7 First Aid in Toxic Environments
8 First Aid for Psychological Reactions

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Chapter 7 - First Aid in Toxic Environments

American forces have not been exposed to high levels of toxic substances on the battlefield since World War I. In future conflicts and wars we can expect the use of such agents. Chemical weapons will degrade unit effectiveness rapidly by forcing troops to wear hot protective clothing and by creating confusion and fear. Through training in protective procedures and first aid, units can maintain their effectiveness on the integrated battlefield.

7-1. Toxic Substances

a. Gasoline, chlorine, and pesticides are examples of common toxic substances. They may exist as solids, liquids, or gases depending upon temperature and pressure. Gasoline, for example, is a vaporizable liquid; chlorine is a gas; and Warfarin, a pesticide, is a solid. Some substances are more injurious to the body than others when they are inhaled or eaten or when they contact the skin or eyes. Whether they are solids, liquids, or gases (vapors and aerosols included), they may irritate, inflame, blister, burn, freeze, or destroy tissue such as that associated with the respiratory tract or the eyes. They may also be absorbed into the bloodstream, disturbing one or several of the body’s major functions.
b. You may come in contact with toxic substances in combat or in everyday activities. Ordinarily, brief exposures to common household toxic substances, such as disinfectants and bleach solutions, do not cause injuries. Exposure to toxic chemical agents in warfare, even for a few seconds, could result in death, injury, or incapacitation. Remember that toxic substances employed by an enemy could persist for hours or days. To survive and operate effectively in a toxic environment, you must be prepared to protect yourself from the effects of chemical agents and to provide first aid to yourself and to others.

7-2. Protective and First Aid Equipment
You are issued equipment for protection and first aid treatment in a toxic environment. You must know how to use the items described in a through e. It is equally important that you know when to use them. Use your protective clothing and equipment when you are ordered to and when you are under a nuclear, biological, or chemical (NBC) attack. Also, use your protective clothing and equipment when you enter an area where NBC agents have been employed.
a. Field Protective Mask With Protective Hood. Your field protective mask is the most important piece of protective equipment. You are given special training in its use and care.
b. Field Protective Clothing. Each soldier is authorized three sets of the following field protective clothing:
• Overgarment ensemble (shirt and trousers), chemical protective.
• Footwear cover (overboots), chemical protective.
• Glove set, chemical protective.
c. Nerve Agent Pyridostigmine Pretreatment (NAPP). You will be issued a blister pack of pretreatment tablets when your commander directs. When ordered to take the pretreatment you must take one tablet every eight hours. This must be taken prior to exposure to nerve agents, since it may take several hours to develop adequate blood levels.

Normally, one set of protective clothing is used in acclimatization training that uses various mission-oriented protective posture (MOPP) levels.

d. M258A1 Skin Decontamination Kit. The M258A1 Skin Decontamination (decon) Kit contains three each of the following:
• DECON-1 packets containing wipes (pads) moistened with decon solution.
• DECON-2 packets containing dry wipes (pads) previously moistened with decon solution and sealed glass ampules. Ampules are crushed to moisten pads.

The decon solution contained in both DECON-1 and DECON-2 packets is a poison and caustic hazard and can permanently damage the eyes. Keep wipes out of the eyes, mouth, and open wounds. Use WATER to wash toxic agent out of eyes and wounds and seek medical aid.

e. Nerve Agent Antidote Kit, Mark I (NAAK MKI). Each soldier is authorized to carry three Nerve Agent Antidote Kits, Mark I, to treat nerve agent poisoning. When NAPP has been taken several hours (but no greater than 8 hours) prior to exposure, the NAAK MKI treatment of nerve agent poisoning is much more effective.

7-3. Classification

a. Chemical agents may be classified according to the primary physiological effects they produce, such as nerve, blister, blood, choking, vomiting, and incapacitating agents.
b. Biological agents may be classified according to the effect they have on man. These include blockers, inhibitors, hybrids, and membrane active compounds. These agents are found in living organisms such as fungi, bacteria and viruses.

Ingesting water or food contaminated with nerve, blister, and other chemical agents and with some biological agents can be fatal. NEVER consume water or food which is suspected of being contaminated until it has been tested and found safe for consumption.

7-4. Conditions for Masking Without Order or Alarm
Once an attack with a chemical or biological agent is detected or suspected, or information is available that such an agent is about to be used, you must STOP breathing and mask immediately. DO NOT WAIT to receive an order or alarm under the following circumstances:
• Your position is hit by artillery or mortar fire, missiles, rockets, smokes, mists, aerial sprays, bombs, or bomblets.
• Smoke from an unknown source is present or approaching.
• A suspicious odor, liquid, or solid is present.
• A toxic chemical or biological attack is present.
• You are entering an area known or suspected of being contaminated.
• During any motor march, once chemical warfare has begun.
• When casualties are being received from an area where chemical or biological agents have reportedly been used.
• You have one or more of the following symptoms:
º An unexplained runny nose.
ºA feeling of choking or tightness in the chest or throat.
ºDimness of vision.
ºIrritation of the eyes.
ºDifficulty in or increased rate of breathing without obvious reasons.
ºSudden feeling of depression.
ºDread, anxiety, restlessness.
ºDizziness or lightheadedness.
ºSlurred speech.
• Unexplained laughter or unusual behavior is noted in others.
• Numerous unexplained ill personnel.
• Buddies suddenly collapsing without evident cause.
• Animals or birds exhibiting unusual behavior and/or sudden unexplained death.
For further information, see FM 3-4.

7-5. First Aid for a Chemical Attack (081-831-1030 and 081-831-1031)
Your field protective mask gives protection against chemical as well as biological agents. Previous practice enables you to mask in 9 seconds or less or to put on your mask with hood within 15 seconds.
a. Step ONE (081-831-1030 and 081-831-1031). Stop breathing. Don your mask, seat it properly, clear and check your mask, and resume breathing. Give the alarm, and continue the mission. Keep your mask on until the “all clear” signal has been given.

Keep your mask on until the area is no longer hazardous and you are told to unmask.

b. Step TWO (081-831-1030). If symptoms of nerve agent poisoning (paragraph 7-7) appear, immediately give yourself a nerve agent antidote. You should have taken NAPP several hours prior to exposure which will enhance the action of the nerve agent antidote.

Do not inject a nerve agent antidote until you are sure you need it.

c. Step THREE (081-831-1031). If your eyes and face become contaminated, you must immediately try to get under cover. You need this shelter to prevent further contamination while performing decon procedures on areas of the head. If no overhead cover is available, throw your poncho or shelter half over your head before beginning the decon process. Then you should put on the remaining protective clothing. (See Appendix F for decon procedure.) If vomiting occurs, the mask should be lifted momentarily and drained—while the eyes are closed and the breath is held—and replaced, cleared, and sealed.
d. Step FOUR. If nerve agents are used, mission permitting, watch for persons needing nerve agent antidotes and immediately follow procedures outlined in paragraph 7-8 b.
e. STEP FIVE. When your mission permits, decon your clothing and equipment.

Continue to Nerve Agents


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