For decontaminating skin, each Seabee receives the M258A1 kit in a hard plastic case. Avoid getting decontaminants into eyes, open wounds, or mouth. If contaminants enter these areas, flush them with water. If symptoms appear, seek medical attention as soon as possible. The kit is normally attached to the protective mask carrier or the load-bearing equipment (LBE). It contains three sets of foil-packaged towelettes saturated with different decontaminating solutions. These solutions neutralize most nerve and blister agents. Protect the kit from temperatures above 110F (43C) and below 32F (0C). The solutions are flammable and unstable in storage at temperatures above 110F (43C) or for prolonged periods of time in sunlight.

Shelter is necessary to prevent further contamination during the decontamination process. If no overhead cover is available, throw a poncho or shelter half over your head before beginning decontamination.

CAUTION

Do not let the solution from the M258A1 kit get in your eyes!

NERVE AGENTS.- If you are told that your pupils are getting very small or if you are having trouble breathing and your chest feels tight, use the atropine nerve agent antidote kit (NAAK), Mark I. The injectors contain medications to treat the initial symptoms of nerve agent poisoning. But, most importantly, it will check the more serious effects of nerve agent sickness. The injectors are antidotes, not a preventive device; therefore, only use the injectors when you actually experience symptoms of nerve agent poisoning. (See fig. 9-3.) The directions for use are as follows:

1. Put on the protective mask.

Figure 9-3.-Nerve agent antidote kit (NAAK), Mark I.

2. Remove a (NAAK), Mark I, from the protective mask carrier.

3. Inject the thigh with the first injector from the kit (atropine, small autoinjector). (See fig. 9-4.) Hold the injector against the thigh for at least 10 seconds. Remove the injector.

4. Follow immediately with the second injector (2-PAM chloride, large injector) and inject the thigh. Hold the injector against the thigh for at least 10 seconds.

5. Remove the injector and place each injector needle through the pocket flap of the overgarment. Bend each needle to form a hook.

6. Massage the injection site, if time permits.

7. The interval between injecting each set of auto-injectors is 10 to 15 minutes when symptoms persist or recur. A Seabee must not administer more than three NAAK sets. The administration of more than three sets must be authorized by medical support personnel.

WARNING

If within 5 minutes after the administration of any set of injections your heart beats very rapidly AND your mouth becomes very dry, DO NOT give yourself another set of injections. When an individual experiences severe symptoms from nerve agent poisoning and is unable to administer self-aid, a buddy must perform the following aid measures:

1. Mask the casualty.

2. Using the NAAK belonging to the victim, administer three sets of injections immediately and in rapid succession in the thigh muscle of the leg.

3. Hook the expended autoinjectors to the overgarment pocket flap of the victim.

4. Administer the back pressure arm-lift method of artificial ventilation if breathing is difficult or has ceased.

5. Seek medical attention as soon as possible.

Continue to perform your duties if you feel relief from the atropine and can breathe freely again. Dryness of the mouth is a good sign. It means that you have had enough atropine to overcome the dangerous effects of the nerve agent.

Figure 9-4.-Instructions for use of NAAK, Mark I.

If you should get a splash of liquid nerve agent in your eyes, instant action is necessary to avoid serious injury. Obtain water as fast as possible, tilt your head back so your eyes look straight upward, slowly pour water into the your eyes, and flush them out. Hold your eyes open with your fingers, if necessary. Pour the water slowly so the irrigation lasts not less than 30 seconds. This irrigation must be done in spite of the danger of breathing nerve gas vapor. Don your mask quickly after irrigation is complete. Then, if the symptoms of nerve gas poisoning develop, give yourself an injection from the NAAK, Mark I.

If liquid nerve gas gets on your skin or clothing, fast action is needed to get rid of it. Immediately use the M258A1 decontamination kit. Then carry on with your combat duties. Meanwhile, watch for muscles twitching in the contaminated area. If twitching does not develop in the next half hour and there is no tightness in your chest, you have been decontaminated successfully.

If twitching of the muscles in the area of contamination does develop, do not wait for other symptoms to appear. Give yourself the injections from the NAAK, Mark I, at once. If no other symptoms develop, one series of injections is enough. The atropine does not relieve the local twitching of muscles, but this twitching is not dangerous.

Avoid water and food that may be contaminated with nerve agents. Let the medical personnel check the food and water for safety before you consume them. If you have swallowed contaminated food or water and all of the following symptoms occur-increased flow of saliva, nausea, pains in the stomach, and tightness in the chest-give yourself the injections from the NAAK, Mark I.