DEFENSE AGAINST CBR WARFARE

As members of the healthcare team, Dental Technicians are trained in the recognition and treatment of chemical, biological, and radiological (CBR) hazards. The purpose of CBR warfare is to produce casualties, disable, or kill the enemy. In the event that an enemy uses any CBR warfare, U.S. forces must be trained to survive. The enemy's aim is to force U.S. forces into protective gear, restrict 'our capability to perform our mission, and contaminate our combat systems. To survive, it is essential that all Navy personnel have a good working knowledge of all aspects of CBR defense. All personnel should be familiar with self-protection and treatment procedures. We will explain how to recognize CBR agents and to treat casualties.

CHEMICAL WARFARE

Chemical warfare (CW), or "gas warfare," is the deliberate use of a variety of chemical agents in gaseous, solid, or liquid state. These agents are toxic (poisonous) chemicals that can produce death, injury, or irritating effects.

All service members must take every precaution against becoming chemical casualties. Medical personnel must apply the principles of first aid, treatment, and decontamination to increase their's and their patients' chances of survival.

This section of chemical warfare outlines the basic recognition and treatment principles. For specific detailed treatment, refer to Navy NAVMED P-5041,

Treatment of Chemical Agent Casualties and Conventional Military Injuries.

Chemical agents attack the body and produce specific damage depending upon the nature of the agent used. The most common types of agents are listed below:

Nerve agents

Blister agents (vesicants)

Incapacitating agents (psychochemical agents)

Blood agents (cyanogens)

Choking agents

Vomiting and tear agents (sternutators and lacrimators, respectively)

NERVE AGENTS

Nerve agents are among the deadliest of chemical agents and may produce rapid symptoms. They include the G and V agents. Examples of G agents are Tabun (GA), Sarin (GB), Soman (GD), and VX.

Nerve agents can be dispersed by artillery shell, mortar shell, rocket, land mine, missile, aircraft spray, and aircraft bomb.

Physical Properties

Nerve agents are colorless to light brown liquids. Most nerve agents are essentially odorless; however, some have a faint fruity or paint odor. In toxic amounts, aqueous solutions of nerve agents are tasteless.

Protection Against Absorption of Nerve Agents

Nerve agents may be absorbed through any body surface. When dispersed as a spray or aerosol, droplets can be absorbed through the skin, eyes, and respiratory tract. When dispersed as a vapor, it is primarily

absorbed through the respiratory tract. Liquid nerve agents may also be absorbed through the skin, eyes, mouth, and membranes of the nose. Nerve agents may also be absorbed through the stomach when ingesting contaminated food or water.

A protective mask and hood should be used to protect the face and neck, eyes, mouth, and respiratory tract against nerve agent spray, vapor, and aerosol. To prevent inhaling an incapacitating or lethal dose, you should hold your breath and put on the mask within 9 seconds of the first warning of a nerve agent presence.

Liquid nerve agents penetrate ordinary clothing rapidly. However, significant absorption through the skin requires a period of minutes. The effects may be reduced by quickly removing contaminated clothing and neutralizing liquid nerve agent on the skin by washing off, blotting, or wiping away. Prompt decontamination (decon) of the skin is imperative. Decon of nerve agents on the skin within 1 minute after contamination is perhaps 10 times more effective than it would be if delayed 5 minutes. A nerve agent on the skin can be removed effectively by using the M291 skin decontamination kit (fig. 13-28). The M291 skin decontamination kit is replacing the M258A1 (fig. 13-29). Upon receipt of the M291, discontinue use of the M258A1 on the skin. Detailed instructions on the use of skin decontamination kits can be found in Navy NAVMED P-5041 and in the kit itself. Liquid nerve agent in the eye is absorbed faster than on the skin and is extremely dangerous; immediately irrigate the eye with an abundant amount of water.

Diagnosis of Nerve Agent Poisoning

Nerve agent poisoning may be identified from the characteristic signs and symptoms. It is important that all service members know the following mild and severe signs and symptoms of nerve agent poisoning. Service members who have most or all of the symptoms listed must immediately receive first aid (self-aid or buddy aid).

Self-aid is provided by the person affected by chemical agents. They know who they are, where they are, and what they are doing. They are able to move around freely without assistance. Buddy aid is provided when individuals cannot care for themselves and require assistance.