CANA injectors

The atropine works quickly to block the receptor site for the nerve transmitter acetylcholine. This helps prevent the constant firing of the nerves and gives relief of the symptoms. The 2-PAM is a true antidote and it breaks the bond that has formed between the nerve agent and the enzyme acetylcholinesterase. This allows the enzyme to break down the acetylcholine. Some kits also include a CANA (con-vulsants antidote for nerve agent) injector for treatment of seizures. CANA injectors... 

Patients with severe symptoms (seizing, apnea, cyanosis, unconsciousness) should immediately receive three NAAKs plus diazepam (CANA injector). The autoinjectors will work through two layers of clothes or a chemical suit. 

DuoDote has both the atropine and 2-PAM in the same syringe. DuoDote has only recently been made available to civilians. Some kits may also contain a diazepam or CANA injector (Figure S3.2). You must be able to identify the symptoms and signs that require use of the NAAK, select the appropriate dosage, and administer the atropine, pralidoxime, and diazepam as required. 

It must be remembered that for immediate field treatment most soldiers are equipped with only three 2 mg autoinjectors of atropine (as well as oxime, and possibly anticonvulsant injectors) for administration by themselves or a buddy . Most medical treatment doctrines call for oxime administration only with the first three autoinjectors of atropine. Additional oxime beyond this initial treatment will be administered under direction of a physician at a medical treatment facility. Additional atropine and anticonvulsant treatment is carried by the medic/corpsman in most West-em/NATO forces and will be absolutely required in cases of severe poisoning. US medical treatment guidelines call for the administration of the first CANA anticonvulsant (10 mg of diazepam)... 

Convulsive Antidote Nerve Agent (CANA) is a convulsion antidote for nerve agents. CANA is an auto-injector that contains 2ml of diazepam (more commonly known as Valium) as the anticonvulsant. Diazepam is fully approved for this application by the USFDA. It is used only as buddy-aid, never self injected. CANA is a note Q item requiring vault or safe storage. Additionally, this item must be stored at a controlled room temperature of 59-86 degrees Fahrenheit. The shelf life is two years. 

If there is a potential threat from a nerve agent attack, public safety responders should carry the NAAK and hospitals should stock the kits. Those areas most likely to be threatened are metropolitan areas, areas near military storage sites for nerve agents, and areas near chemical weapons transportation routes. Each rescuer should he issued three MARK I kits (NAAK) with the atropine and prahdoxime injectors and with the consideration of issuing one CANA diazepam injector. 

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