Chemical agent exposure

Procedure:

- Ensure personal safety.

- Separate patient from causative agent.

- Victim’s clothing should be removed and isolated by personnel wearing proper PPE.

- Victims should be decontaminated prior to transport whenever possible.

- For severely affected patients, perform rapid decontamination and provide treatment.

- ABCs / monitor cardiac rhythm.

- Check pupil size.  Spinal immobilization if indicated.  IV access, rate titrated to perfusion as needed.

 

Suspected Nerve Agent Exposure:

Duo Dotes (Atropine 2 mg auto-injector and Pralidoxime 600 mg auto-injector)

 

MILD / MODERATE SYMPTOMS:  (Patients 14 - 65 years old)

- 1 to 2 Duo Dotes, IM at 10 minute intervals.  Maximum 3 Duo Dotes.

 

If Duo Dotes are not available:

- Atropine: 2 - 4 mg IM/IV at 10 minute intervals as needed.

 

SEVERE RESPIRATORY SYMPTOMS:  (Patients 14 - 65 years old)

- 3 Duo Dotes or Mark 1 kits, IM in rapid succession.

If Duo Dotes are not available:

- Atropine: 6 mg IM/IV repeat as needed.

 

Elderly Patients ( > 65 years) or Patients with underlying cardiovascular or renal disease:

- Atropine 1 mg IM.  Repeat doses may be given at BH direction; IM or IV.

- Pralidoxime  (2-PAM, Protopam) 7.5 mg/kg IM, to a maximum of 600 mg (one auto-injector) per dose.

- Elderly patients must weigh at least 80 kg to receive 1 auto-injector of Pralidoxime IM.

 

PEDS: (< 12 years): 

Dose:

Atropine:     

IV:            0.1 mg/kg IVP, minimum of 0.1 mg repeat once as needed (Max single dose 0.5mg) 

IM:           0.1mg/kg IM repeat once as needed (Max single dose 0.5 mg)

 

Pralidoxime:

IV / IM:    20 mg/kg IM or IVP (must weigh at least 30 kg to receive 1 auto-injector IM)

 

If Prolidoxime powder 1 Gm for reconstitution is available:

Reconstitute as directed by BH or 20 mL sterile water w/o preservative to produce a concentration of 50 mg/ml.

 

Adult Patients:     1 Gm over 30 minutes IV or 600 mg - 1 Gm IM in divided injections if necessary.

 

Elderly Patients:   0.5 mg/kg IM or IV. Max IV dose is 1 Gm over 30 minutes.  May repeat once in one hour.

 

PEDS:     20 mg/kg IM or IV. Max IV dose is 1 Gm over 30 minutes.  May repeat once in one hour.

Call

M: 949-769-1162

  • facebook
  • Twitter Clean