Casualty management

Decontaminate the casualty ensuring that all nerve agents have been removed. If nerve agents have gotten into the eyes, irrigate the eyes with water or 0.9% saline solution for at least 15 minutes. Irrigate open wounds with water or 0.9% saline solution for at least 10 minutes. However, do not delay treatment if thorough decontamination cannot be 

Once the casualty has been decontaminated, including the removal of foreign matter from wounds, medical personnel do not need to wear a chemical-protective mask. 

Ventilate the patient. There may be an increase in airway resistance due to constriction of the airway and the presence of secretions. If breathing is difficult, administer oxygen. As soon as possible administer of atropine alone or in combination with pralidoxime chloride (2-PAMC1) or other appropriate oxime. Diazepam may be required to prevent or control severe convulsions. If diazepam is not administered within 40-minutes postexposure, then its effectiveness at controlling seizures is minimal. 

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Medical [Centers for Disease Control and Prevention (CDC), case definition, differential diagnosis, signs and symptoms, mass-casualty triage recommendations, casualty management, fatality management]... 

Training of emergency responders (firefighters, police, and emergency medical services) for responding to weapons of mass destruction should emphasize critical concepts for self-preservation and effective casualty management. Training should include both classroom instructions on basic concepts and principles, hands-on demonstrations of required skills, and drills to reinforce basic procedures. The recommended topics to be covered include ... 

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