New Mexico CHEMPACK Program Mark 1 Kit Training - PowerPoint PPT Presentation

1 / 39
About This Presentation
Title:

New Mexico CHEMPACK Program Mark 1 Kit Training

Description:

Store at room temperature. approximately 25 C. KEEP FROM. FREEZING. Mark 1 Kit Dosing ... US Army Medical Research Institute of Chemical Defense ... – PowerPoint PPT presentation

Number of Views:137
Avg rating:3.0/5.0
Slides: 40
Provided by: loretta3
Category:

less

Transcript and Presenter's Notes

Title: New Mexico CHEMPACK Program Mark 1 Kit Training


1
New MexicoCHEMPACK Program Mark 1 Kit Training
Ambulance Service and Other First Responder
Training
2
CHEMPACK
CHEMPACK is a Federal program. Pre positioned
packages of antidotes for nerve agents are
available across New Mexico for public safety
personnel and emergency department employees.
3
CHEMPACK In New Mexico
  • There are two variations of the CHEMPACK -- one
    for EMS and one for hospitals.
  • The EMS container will treat approximately 454
    victims.
  • The hospital container will treat approximately
    1000 victims.

4
CHEMPACK In New Mexico
  • Hospital Container
  • Treats approximately 1000 victims.
  • 480 Mark 1 Kits in container.
  • Packaged - 2 cases of 240 Mark 1 Kits.
  • Each case - 8 boxes with 30 Mark 1 Kits.
  • New Mexico has only hospital containers.

5
Access to CHEMPACK
6
Indications of Nerve Agent Exposure
  • Signs symptoms of nerve agent toxicity or
    organophosphate poisoning
  • Unexplained multi-casualty incident (MCI).
  • Make proper notification to Incident Commander
    (IC) or Dispatch Center
  • of suspected nerve agent exposure.

7
Nerve Agent Actions
  • Causes Central Nervous System problems by
    interrupting the process of chemical signaling at
    the receptor level.
  • Physical symptoms are due to excessive
    stimulation of body organs.

8
Types of Nerve Agent Exposure
  • VAPOR
  • Usually more severe with faster onset of
    symptoms.
  • LIQUID
  • Slower onset of symptoms
  • Will penetrate clothing.
  • Absorbed through the skin.
  • Consider vapor exposure with liquid exposure.

9
Nerve Agent Effects
  • Pulse
  • Slow, normal or fast depending on the nerve
    agent and degree of exposure.
  • Blood Pressure
  • Low, normal or elevated depending on the
    nerve agent and degree of exposure.

10
Nerve Agent Effects
  • S Salivation (excessive drooling)
  • L Lacrimation (tearing)
  • U -Urination
  • D Defecation/Diarrhea
  • G Gastrointestinal
  • E Emesis (vomiting)
  • M Miosis (pinpoint pupils)
  • R Respiratory (distress)
  • A Agitation (CNS symptoms)

11
EXPOSURE Signs SymptomsMild to Severe
  • Unexplained runny nose
  • Tightness in the chest
  • Difficulty Breathing
  • Bronchospasm
  • Pinpoint pupils, blurred vision
  • Drooling
  • Excessive sweating
  • Nausea and/or vomiting
  • Abdominal cramps
  • Involuntary urination and/or defecation
  • Jerking, staggering twitching
  • Headache
  • Drowsiness
  • Coma
  • Convulsions
  • Apnea

12
NERVE AGENT EXPOSURESigns Symptoms
  • MILD Rhinorrhea (runny nose) and Miosis
    (pinpoint pupils)
  • MODERATE Key finding are respiratory distress,
    excess secretions and pinpoint pupils.
  • S-Salivation, L-Lacrimation, U-Urination,
    D-Defecation/Diarrhea,
  • G-Gastrointestinal, E-Emesis,
    R-Respirations, A-Agitation
  • SEVERE Key findings are respiratory distress,
    excessive secretions, pinpoint pupils, loss of
    consciousness, seizures apnea.
  • S-Salivation, L-Lacrimation, U-Urination,
    D-Defecation/Diarrhea,
  • G-Gastrointestinal, E-Emesis,
    R-Respirations, A-Agitation

13
MARK 1 Kit Use
  • Indicated for immediate treatment of moderate to
    severe vapor and/or liquid exposures to nerve
    agents.
  • Primarily for self aid or buddy aid. (Treat
    yourself, your crew then treat the victims.)
  • Victims should be treated when CHEMPACK cache
    supplies are available responders have been
    treated.

14
Nerve Agent Antidote KitMark 1 Kit
  • Atropine auto injector (2 mg in 0.7 cc)
  • Pralidoxime chloride auto injector 2 PAM (600mg
    in 2cc)

15
Mark 1 Kits
  • The Mark 1 Kit comes in a foam case. The case is
    marked with the expiration date. ALWAYS CHECK
    THE EXPIRATION DATE!!
  • The small injector, marked 1 is atropine 2 mg
    and should be given first.
  • The larger injector, marked 2, is 2 PAM 600 mg
    and is given after the atropine.

TIP Store at room temperature
approximately 25 C KEEP FROM FREEZING
16
Mark 1 Kit Dosing
Mild Exposure Symptoms
  • Rhinorrhea (runny nose) and Miosis (pinpoint
    pupils)
  • NO Mark 1 Kit administered for mild exposure
    symptoms

17
Mark 1 Kit Administration
Moderate Exposure Symptoms
  • Respiratory distress, excess secretions, pinpoint
    pupils. (SLUDGEMRA)
  • Symptoms related to moderate nerve agent exposure
    should be treated by administering up to 2 Mark 1
    Kits in 5-20 minute intervals.
  • Repeat administration at 5-10 minute intervals
    until improvement or signs of atropinization
    (tachycardia dry mouth) are noted.

18
Mark 1 Kit Administration
Severe Exposure Symptoms
  • Respiratory distress, excess secretions, pinpoint
    pupils, loss of consciousness, seizures apnea.
    (SLUDGEMRA)
  • Severe symptoms should be treated by
    administering up to 3 Mark 1 Kits in 3-5 minute
    intervals.
  • Repeat administration in 3-5 minute intervals
    until improvement is noted or sign of
    atropinization (tachycardia dry mouth) are
    noted.
  • ALS Treat seizures with valium per standing
    orders.
  • DO NOT ADMINISTER MORE THAN 3 DOSES OF 2PAM
    (hypertensive effects). ALS titrate atropine
    as needed to alleviate sings symptoms or until
    atropinization is noted.

19
  • PROCEDURES FOR ADMINISTERING MARK 1 KITS
  • NERVE AGENT EXPOSURE

20
Mark 1 Kit
  • Spring powered injector containing
  • Atropine, 2 mg/0.7 ml
  • Pralidoxime Chloride, 600 mg/2 ml (2-PAM)

21
TREATMENTVapor or Liquid Exposure
Moderate Exposure Symptoms
  • Treatment
  • (Including mild respiratory distress)
  • Self Aid Up to 2 Mark 1 Kits
  • Buddy Aid Up to 2 Mark 1 Kits
  • Victims When supplies are available, up to 2
    Mark 1 Kits
  • If you must administer the Mark 1 Kit to
    yourself, you will be out of commission. You
    must report self administrations to the Incident
    Commander.

22
TREATMENTVapor or Liquid Exposure
Severe Exposure
  • (Including severe respiratory distress, altered
    mental status, seizure, coma, apnea)
  • Self Aid
  • Will be unable to help self.
  • Buddy Victim Aid
  • Up to 3 Mark 1 Kits
  • ALS 1 Diazepam
  • Victim Aid When supplies are available
  • TREATMENT MUST BE IMMEDIATE !!!!!

23
ADDITIONAL TREATMENTLiquid or Vapor Exposure
  • Maintain an open airway and suction as necessary.
  • Administer high flow oxygen if available.

24
Mark 1 Kit Administration Procedures Atropine 1
Pull small injector out of plastic holder
25
GRASPING THE ATROPINE AUTOINJECTOR
  • Use Appropriate Body Substance Isolation (BSI)!
  • With your dominant hand grasp the Atropine
    auto-injector (the smaller of the two) with the
    thumb and first two fingers.
  • DO NOT cover or hold the needle end with your
    hand, thumb, or fingers. You might accidentally
    inject your self.
  • An accidental injection into the hand WILL NOT
    deliver an effective dose of the antidote,
    especially if the needle goes through the hand.

26
REMOVING THE ATROPINE AUTO INJECTOR
  • Pull the injector out of the clip with a smooth
    motion.
  • Ensure that the yellow safety cap has been
    removed. (The cap should remain in the clear
    plastic clip see Figure 1.)
  • The auto injector is now armed !!!

27
Mark 1 Kit Administration ProceduresInjection
Procedure
  • Place green end against your outer thigh and push
    hard until you feel the injector function.
  • The needle will penetrate clothing.
  • Make sure that pockets are empty or that nothing
    is blocking the injection site.
  • Hold firmly for 10 seconds.
  • Use the secondary site if primary site is not
    accessible.

28
Mark 1 Kit Administration ProceduresInjection
Procedure
Secondary Sites
29
Intramuscular Injection Procedure
  • Apply firm, even pressure (not jabbing motion) to
    the injector until it pushes the needle onto the
    injection site. Using a jabbing motion may
    result in an improper injection or injury to the
    thigh or buttocks.
  • Hold the injector firmly in place for at least 10
    seconds.
  • Firm pressure automatically triggers the coiled
    spring mechanism. This plunges the needle
    through clothing into the muscle and at the same
    time injects the antidote into the muscle tissue.
  • Carefully remove the auto injector from the
    injection site.

30
INTRAMUSCULAR INJECTION SITE ON THE BUTTOCKS
31
Used Atropine Injector
  • Place the used atropine injector carefully
    between your little finger and the ring finger of
    the hand holding the remaining auto injector and
    clip.
  • Watch out for the needle!!

32
Mark 1 Kit Administration ProceduresPralidoxim
e Chloride (2PAM)2
Pull the large injector out of the plastic holder.
33
Removing the 2-PAM Auto Injector
34
Mark 1 Kit Injection Procedure2-PAM
  • Use appropriate Body Substance Isolation
    precautions!
  • Place black end against outer thigh and push hard
    until you feel the injector function.
  • The needle will penetrate clothing.
  • Make sure that pockets are empty or that nothing
    is blocking the injection site.
  • Hold firmly for at least 10 seconds.
  • Use secondary site if primary site in not
    accessible.

35
INTRAMUSCULAR INJECTION SITE ON THE BUTTOCKS
36
Decontamination
  • Consider victim decontamination as soon as
    possible after the initial Mark 1 Kit treatment
    has been administered.
  • Decontamination Procedure
  • Immediately remove clothing.
  • Wash victim using large amounts of water, with
    soap if available.

37
Nerve Agent Exposure Overview
  • If you, as well as personnel in your immediate
    area, present with signs and symptoms of a
    moderate to severe Nerve Agent Injury,
    immediately administer up to two (2) Mark 1 Kits
    in 5-10 minute intervals (Moderate Symptoms),
    administer up to three (3) Mark 1 Kits in 3-5
    minute intervals (Severe Symptoms).
  • The effect of atropine administration on moderate
    or severe cases of nerve agent poisoning may help
    confirm the diagnosis.
  • When in doubt, err on the side of caution when
    presented with signs and symptoms of nerve agent
    poisoning.

38
Nerve Agent Exposure Overview
Are you seeing any of these signs and symptoms?
39
Nerve Agent Exposure Reference Material
  • US Army Medical Research Institute of Chemical
    Defensehttp//ccc.apgea.army.mil/courses/distance
    /cbt.htm
  • Advanced Topics on Medical Defense against
    Biological and Chemical Agentshttp//www.swankhea
    lth.com
  • NBC Med NBC Online Medical Information
    Serverhttp//www.nbc-med.org
  • USAMRIID Bio-Treatment HandbookUSAMRIID Medical
    NBC BattlebookNBC Field Handbook - US ArmyNBC
    Protection - US ArmyNBC Decontamination - US
    ArmyNBC Field Training Exercise - US
    ArmyMedical Aspects of NBCEmergency Response to
    TerrorismNerve Agent Overview Recognition /
    Pathophysiology / Treatmenthttp//www.sc-ems.com
  • Northeast Hospital Bio-Terrorism Preparedness
    ChemPack Committee
  • Minnesota Department of Health Office of
    Emergency Preparedness
Write a Comment
User Comments (0)
About PowerShow.com