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Deliver
Prompt Medical Treatment
The toxic effects of some classes of
CW agents can be reversed
or slowed through the prompt administration of antidotes and other
drugs. Antidotes are available for only a few types of CW agents,
however, and the time window for effective treatment is extremely
narrow. Until the specific agent has been identified, medical
practitioners should treat exposed persons symptomatically—treating the
victim's physical reaction (the symptoms) rather than the cause of the
ailment. The appropriate treatment for victims of chemical terrorism
depends on the type of toxic agent used in the attack:
-
Nerve Agents:
If a nerve agent such as
sarin or
VX is used in an attack,
the administration of antidotes within minutes would be required to
save lives. Victims who were exposed to lower doses of agent on the
periphery of an attack could be treated somewhat later. The nerve
agent antidotes stockpiled by the U.S. military are atropine, 2-PAM
chloride, and diazepam to prevent seizures, but such drugs may be in
short supply in states and localities. Most ambulances carry
atropine for treating heart attacks, but in doses less than
one-tenth of what a nerve gas victim requires. Thus, each major city
should acquire and maintain a stockpile of nerve agent antidotes.
-
Hydrogen Cyanide:
Immediate treatment with antidotes that bind cyanide ions in the
blood can accelerate detoxification.
-
Choking Agents:
No antidotes exist for choking agents such as ammonia, chlorine, or
phosgene, so exposures must be treated symptomatically. Inhalation
of choking agents typically results in swelling of the lung tissue,
which can be managed by administering oxygen, cortisone, and a drug
to widen the bronchial tubes. Mechanical ventilators may be required
to keep victims breathing while their damaged lungs recover.
- Blister Agents: No
antidotes currently exist for blister agents, which must be treated
symptomatically.
The Department of Health and Human
Services has developed "push-packs" with enough antidotes and
ventilators to treat 5,000 victims of a chemical attack. At least in
theory, one such container could be made ready within hours to be flown
to the site of a terrorist event, and more would be en route the
following day. In a serious incident of chemical terrorism, however, the
only option may be “triage”: giving treatment priority to patients with
the best chance of survival, in view of the available resources.
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