SELF AID AND FIRST AID

You or your shipmates may be injured or become contaminated with radiological, biological, or chemical agents during an attack. If so, you can increase your chances of survival if you immediately administer certain self aid and first aid. Self aid consists of those measures which you can apply to help yourself. First aid is the help rendered by nonmedical personnel to a casualty until medical help arrives.

Radiation Injuries

The blast and heat injuries from a nuclear explosion are treated the same as those from high explosive bombs, incendiary weapons, and mechanical accidents. Fractures, concussions, lacerations, contusions, hemorrhages, burns, shock, and exposure are treated with standard self-aid and first-aid measures.

There is nothing that needs to be done immediately for nuclear radiation sickness. Remember that you can receive a dose of radiation even though you are NOT contaminated with radioactive particles. If there is the possibility y that you have been exposed to nuclear radiation, be sure you are checked and treated by medical personnel.

If directed, proceed to a personnel decontamination station. Discard your clothing and equipment and take a shower using plenty of soap and warm water. In washing, pay close attention to the hairy parts of your body, body creases, and fingernails, where dirt tends to gather. Radiation concentrates in those places.

Biological Agent Injuries

Since symptoms caused by pathogenic biological agents may not appear for some time, you may not know that a biological attack has occurred. However, if you suspect biological contamination, put on your protective mask and observe the basic principles of preventive medicine. These include individual hygiene, sanitation, and physical checkups. Report any illness to medical authorities immediately.

If there is a possibility that you have been contaminated by biological agents, take the following actions: Carefully remove your clothes to avoid spreading any contamination, and take

a thorough soap and water shower as soon as possible. Change your clothes and dispose of contaminated clothing as directed. Pay carefully attention to your face and hands. Use a fingernail brush to remove dirt under your nails. Brush your teeth and gums frequently, including the roof of your mouth and your tongue.

Some biological agents take effect with great speed. You should apply first aid or self aid immediately if you think you may have been exposed.

Chemical Agent Injuries

At the first sign of a chemical agent in the atmosphere, put on your protective mask immediately. You must hold your breath until the mask is on and properly adjusted. Wear the mask constantly until you are sure there is no chemical agent in the air and the all-clear signal is given.

If a liquid nerve or blister agent gets on your skin or clothing, take immediate action. If your clothing is contaminated, find a place away from the source of contamination where you can remove and discard the clothing. Put on new clothing and continue your duties. If you believe your skin may be contaminated, treat yourself with the M258A1 skin decontaminating kit. DO NOT GET ANY OF THE CHEMICALS FROM THE KIT IN YOUR EYES OR MOUTH. The treatment requires the use of two packets: DECON 1 WIPE and DECON 2 WIPE, which are found in the kit. Use these packets according to the instructions on the M258A1 carrier.

After you use the packets, you should occasionally examine the contaminated areas for local sweating and muscular twitching. If none develops in the next half hour and you have no tightness in your chest, your self aid was successful and you can forget it. If these symptoms do occur, immediately use your atropine and 2 pare-chloride injectors. These injections should be self-administered, through your clothing and into the outside of your thigh. If no other symptoms develop, one injection each of atropine and 2 pare-chloride is enough. Dryness of the mouth is a good sign indicating that you have had enough atropine.

If nerve agent symptoms persist, you may give yourself up to two more injections of atropine and 2 pare-chloride at 10-15 minute intervals. More than three injections may be given only under the direct supervision of medical personnel or under direction of the petty officer or officer in charge of the battle station.

If a drop or splash of liquid nerve agent should get into your eye, take instant action to avoid serious symptoms. Quickly open a container of uncontaminated water, tilt your head back so that your eyes look straight upward, and flush your eye for not less than 30 seconds. This must be done in spite of the presence of nerve agent vapor. Hold your breath as much as possible during this procedure. If you cannot hold your breath for 30 seconds, rinse for as long as you can hold your breath, but put on the mask before breathing. After taking several breaths with the mask on, remove the mask and then complete decontamination. As soon as the flushing is completed, put the protective mask back on at once. Watch the pupil of the contaminated eye during the next minute. Use a mirror if one is available or have someone nearby do it. If the pupil gets rapidly smaller, inject one of your atropine automatic injectors at once into the outside of your thigh. If the pupil does not get smaller, the eye was not contaminated by the nerve agent. Do not use atropine until you are sure that the symptoms are those of nerve agent poisoning.

Exposure to high concentrations of nerve agents may bring on a lack of coordination, mental confusion, and collapse so fast that you may not be able to perform self-aid measures. If this happens, the nearest person should apply first aid.

Severe nerve agent exposure may rapidly cause unconsciousness, muscular paralysis, and loss of breathing. When this occurs, atropine and 2 pamchloride alone will not save a life. Start artificial respiration immediately and continue until either natural breathing is restored or the casualty can be taken over by medical personnel. An atropine injection increases the effectiveness of artificial respiration. It should be administered as soon as possible, preferably by someone who is not performing the artificial respiration.

Whenever liquid or vaporized blister agents are known to be present, be sure to wear the protective mask. Liquid blister agents in the eyes or on the skin must be dealt with immediately by the individual concerned.

If liquid blister agent in the eye does not cause immediate pain, decontaminate by flushing the eye with water for at least 30 seconds. Try to regulate the flow of water so that flushing lasts not less than 30 seconds and not more than 2 minutes. Since decontamination with water effectively removes mustard, this procedure is now standard for all agents.

The risk of leaving blister agents in the eye is much greater than the risk of exposure to blister agent vapors. Therefore, the decontamination procedure MUST be performed in spite of the presence of vapor.

Phosgene oxime (blister agent) reacts rapidly with tissue. Therefore, decontamination will not be entirely effective after pain has started. Nevertheless the contaminated area should be flushed as rapidly as possible with large amount of water to remove any phosgene oxime that has not yet reached the tissue.

In the case of blood agents, speed in first aid is absolutely essential. If you notice any stimulation of breathing, an odor of bitter almonds, or any irritation of the eyes, nose or throat, mask at once. Blood agents act rapidly. Within a few seconds after exposure, you probably will not be able to put on the mask by yourself. Try to hold your breath until the mask is on your face, if at all possible. This may be very difficult, since blood agents strongly stimulate respiration.

There is currently no self-aid or buddy-aid treatment for blood-agent symptoms. Affected personnel should seek medical attention immediately.

Irritation of the eyes or a change in the taste of a cigarette might indicate the presence of phosgene, a choking agent. Smoking may become tasteless or offensive in taste. If any one of the signs occur, hold your breath and put on your protective mask at once. Unless you have difficulty in breathing, have nausea or vomiting, or more than the usual shortness of breath on exertion, continue your normal combat duties. If any of these symptoms occur, you should rest quietly until you are evacuated by medical personnel.