Viral Hemorrhagic Fevers (VHF)

Viral Hemorrhagic Fevers (VHF) Diagnosis 1. Early: severe febrile illness, decr’d blood pressure, postural hypotension, petechiae, easy bleeding, flushing of face and chest, non-dependent edema 2. Late: headache, photophobia, pharyngitis, cough, N/V/D, abd pain, G.I. bleeding, hyperesthesia, dizziness, confusion, tremor, malaise, myalgias 3. Labs: thrombocytopenia (exception: Lassa) and leukopenia (exception: Lassa, Hantaan, some severe CCHF […]

Primary Blast Injury (PBI)

Primary Blast Injury (PBI) General Management Respiratory System Arterial Air Emboli G.I. System Auditory System General Management 1. Initiate life support 2. Hx: distance from explosion, underwater or in enclosure 3. PE: ruptured tympanic membrane; retinal air emboli; SQ emphysema; ecchymoses 4. CBC, CXR, CT chest, abdomen, head if H&P suggests pathology 5. Limit physical […]

Radiation Exposure

Radiation Exposure Exposure Levels Exposure Risks Management Specimen Collection Decontamination Exposure Levels 1. Rad (radiation absorbed dose): special unit of absorbed dose 2. Rem (roetgen equivalent man): Biologic effect of radiation Unit of radiation dose equivalent Equal to absorbed dose in rads x relative biologic effectiveness of radiation in question 3. Gy: measures absorbed dose […]

Chemical Agent ID/Detection

Chemical Agent ID/Detection M8 M9 M256A1 CAM M8A1 M272 M258A1 M291 M295 Paper, CM Agent Detector: M8 1. Identifys type of agent present in liquid form on battlefield 2. Takes 30 secs; false positive with insecticides, petroleum, antifreeze Paper, CM Agent Detector: M9 1. Detects presence of liquid agent, but doesn’t identify specific agent or […]

Riot Control Agents (CS, CN)

Riot Control Agents (CS, CN) Diagnosis 1. Burning and pain on mucous membranes and skin, eye pain and tearing, tingling of exposed skin 2. Burning in nostrils, respiratory discomfort, bronchospasm (may be delayed 36 hrs) 3. No detection method 4. No specific lab tests History 1. Used in France before WWI; first chemical agents deployed […]

Chemical Decontamination

Chemical Decontamination General Physical Chemical Wound Contamination General 1. M291 Kit is best universal dry decontaminant for skin 2. Fresh 0.5% hypochlorite soln with alkaline pH is best universal liquid agent 3. Hypochlorite soln for use on skin and soft tissue wounds only 4. Do not use hypochlorite in abdominal wounds, open chest wounds, on […]

Incapacitating Agents (BZ, Agent 15)

Incapacitating Agents (BZ, Agent 15) Diagnosis 1. 3-quinuclidinyl benzilate (BZ) 2. Mydriasis, dry mouth, dry skin 3. Incr’d DTRs; decr’d LOC; confusion; disorientation 4. Illusions and/or hallucinations; denial of illness; short attention span; impaired memory 5. Stage 1 (0-4 hrs): parasympathetic blockade and mild CNS effects 6. Stage 2 (4-20 hrs): stupor with ataxia and […]

Nerve Agents (GA, GB, GD, GF, VX) Tabun (GA), Sarin (GB), Soman (GD)

Nerve Agents (GA, GB, GD, GF, VX) Tabun (GA), Sarin (GB), Soman (GD) Diagnosis 1. Vapor; small exposure: miosis (takes up to 2 mths to normalize), rhinorrhea, mild difficulty breathing 2. Liquid on skin; small to moderate exposure: localized sweating, nausea, vomiting, feeling of weakness 3. Large exposure (vapor or skin): loss of consciousness, convulsions […]


Ethyldichloroarsine (ED) Diagnosis 1. Dermal and ocular toxicity 2. Erythema, eye pain, photophobia, shivering, thirst, muscle weakness, hemolysis with hemoglobinuria and jaundice 3. Nasal and throat toxcity < 1 min 4. Odor of gas: fruity, but biting & irritating 5. Garlicky breath odor History 1. Made by Germans in 1918 Pathophysiology 1. Rapid hydrolysis; short […]

Phosgene Oxime

Phosgene Oxime (CX) Diagnosis 1. Burning, irritation, wheal-like skin lesions, eye and airway damage 2. Conjunctivitis, lacrimation, lid edema, blepharospasm 3. Pleasant smell of freshly mown hay 4. No distinct lab findings History 1. Used in WWI gas warfare 2. Developed by Russia and Germany before WWII 3. Military interest as CX penetrates garments and […]