A) Chemical Dispersion A1) Pepper; A2) Pepper Mist Case Study Video; A3) Lethal Dosing Ranges By Common Agent Chart; B) Disaster Medicine: B1) Hospital Protocol; C) Chemical Agent (Military) Overview Table C2) Novichok Class Nerve Agents D) Limited Resource Protocol; E) Dispersal Acoustic Weaponry Effects: Sub/Hyper & LRAD; F) Basic Tourniquet Procedure.



Federal Court Has Banned This Page: Riot, Protest & Disaster Medicine Q-Ref

…Nah, jk. You’re alright mate.

But I get the feeling you are going to need this:

A/A1) Chemical Dispersion



Be aware, chemical agents simulate these symptoms by generating the conditions for these symptoms. The symptoms are genuine, it is the duration of effects that are generally limited. This is not the same thing.

Also note, long term respiratory and systemic damage has been reported from brief exposures. As with “Taser” style or acoustic weaponry, ‘general non-lethality’ has a broad definition: one that can include death and permanent disability.

Take the example below, from youth volunteer group the “Janoskians“, as a patient symptom presentation reference.

A2) Pepper Mist Case Study







A3) Be aware of the lethal dose ranges for tear gas and pepper sprays, especially in confined or repeated dosing:

B) Disaster Medicine – Chemical Weapon Hospital Base Protocol: Riot Related Injury.

Remember: Agents are designed to irritate throat, eyes, lung lining and skin. Remove all clothes, apply supportive care up to and including asthma medications and intubation. Rule out anaphylaxis. Do not allow oils or ointments that may increase skin permeability.

C) Chemical Agent Overview Table

Use bases if agent is known (supplemental material below).

C2) “The Novichok [New] class of agents were reportedly developed in an attempt to circumvent the Chemical Weapons Treaty”. This is a Russian line of cholinesterase inhibiters, and the class alleged to have been used in the 2018 UK attack. They differ from other cholinesterase inhibiters, however, in that it is alleged that they have been engineered to be 1) undetectable by standard detection equipment, and 2) Able to penetrate standard chemical protective gear. Novichok agents may come in 2 inactive compounds that only become active, and detectable, when mixed. Alleged to be ~10 fold more lethal than VX nerve agent. Onset of action within 30 seconds. Unless the agent, and antidote, are known: standard life support and decontamination protocols hold. Repeat dose Atropine and diazepam are indicated.

D) Riot Protest: Limited Resource Protocol

Use Eye Flush Laboratory Protocol.

What does water look like? In a lab eye irrigation protocol, you get to have a closer look:

E) Dispersal Acoustic Weaponry Effects: Sub/Hyper & LRAD

.

Sound Physics Crash Course:

Remember: 160db-180db of projected sound can have lethal circulatory and respiratory effects. They can also aggravate underlying conditions.

*WARNING* Standard LRAD dispersal technology has a max sustained power output capable of generating 190db+. This must be considered in disaster medicine differentials.

F) Basic Tourniquet Procedure: Remember placement proximal and distal of injury if possible. ALWAYS REMEMBER TIME(!) Write it on patient’s head if need be.

Good luck out there! Save some citizens, and be safe in your triage unit – or else you can not help others.

And always use appropriate precautions for unknown agents, contaminants or general unknown symptom cluster source.

Check with your CTC Medical Liaison officer for current warnings of radiological or other chemical/biological alerts.

Notify shift manager if there is a sudden influx of patients with a similar (non-standard) symptom profile.

..

JJR (2017) Digital/Cyber Law, Disaster Medicine & National Security Consultant (ChronLS 0171009Ed4).

Refer

Jennifer S. Love, MD , Edward T. Dickinson, MD, NRP, FACEP (SEP 2017) Review of Chemical Warfare Agents and Treatment Options, JEM: J EmergMedServ., http://tinyurl.com/y9av5gog ACLU (a2017) Lethal In Disguise: Health Consequences of Crowd Control Weaponry, Physicians for Human Rights. http://tinyurl.com/yahcqexw Overall View of Chemical and Biochemical Weapons. Toxins, 6(6), 1761–1784. http://tinyurl.com/yb68df7j Pitschmann, V. (2014).(6), 1761–1784. https://doi.org/10.3390/toxins6061761/ Chemical warfare agents. Journal of Pharmacy and Bioallied Sciences, 2(3), 166. http://tinyurl.com/y6uftb8c Ganesan, K., Raza, S., & Vijayaraghavan, R. (2010).(3), 166. https://doi.org/10.4103/0975-7406.68498/ Disaster Management: The WMD Dimension – Some Observations, Journal on Chemical and Biological Weapons, Lt PR Charie (2008), Journal on Chemical and Biological Weapons, http://tinyurl.com/yapwvzgb Birnbaum, M., & Daily, E. (2009). Competency and Competence. Prehospital and Disaster Medicine, 24(1), 1-2. doi:10.1017/S1049023X00006452/ http://tinyurl.com/y8xcprat S. M. White Chemical and biological weapons. Implications for anaesthesia and intensive care, BJA: British Journal of Anaesthesia, Volume 89, Issue 2, 1 August 2002, Pages 306–324, https://doi.org/10.1093/bja/aef168 Electronic Alerts for Triage Protocol Compliance Among Emergency Department Triage Nurses: A Randomized Controlled Trial. Nursing Research, 64(3), 226–230. http://tinyurl.com/ya8afn58 Holmes, J. F., Freilich, J., Taylor, S. L., & Buettner, D. (2015).: A Randomized Controlled Trial.(3), 226–230. https://doi.org/10.1097/NNR.0000000000000094/ Hospital Preparedness for Incidents with Chemical Agents. International Journal of Disaster Medicine, 1(1), 42–50. http://tinyurl.com/y8mdqj5z Debacker, M. (2003).(1), 42–50. https://doi.org/10.1080/15031430310000865/ Retrospective Analysis of Mosh-Pit-Related Injuries. Prehospital and Disaster Medicine, 1–6. http://tinyurl.com/ya7chfc6 Milsten, A. M., Tennyson, J., & Weisberg, S. (2017)., 1–6. https://doi.org/10.1017/S1049023X17006689/ Hospital Preparedness for Incidents with Chemical Agents. International Journal of Disaster Medicine, 1(1), 42–50. http://tinyurl.com/y78hfpmh Debacker, M. (2003).(1), 42–50. https://doi.org/10.1080/15031430310000865/ Haley, T., & De Lorenzo, R. (2009). Military Medical Assistance Following Natural Disasters: Refining the Rapid Response. Prehospital and Disaster Medicine, 24(1), 9-10. doi:10.1017/S1049023X00006476/ http://tinyurl.com/y7bahye Wattana, M., & Bey, T. (2009). Mustard Gas or Sulfur Mustard: An Old Chemical Agent as a New Terrorist Threat. Prehospital and Disaster Medicine, 24(1), 19-29. doi:10.1017/S1049023X0000649X/ http://tinyurl.com/y9ajd2dd Zeitz, K., Tan, H., Grief, M., Couns, P., & Zeitz, C. (2009). Crowd Behavior at Mass Gatherings: A Literature Review. Prehospital and Disaster Medicine, 24(1), 32-38. doi:10.1017/S1049023X00006518/ http://tinyurl.com/y7mv8c7o Feigenbaum, Anna (2017) “This Is Hell” cf www.versobooks.com/books/2109-tear-gas | https://goo.gl/SZG8Lu Gassed. London: House of Stratus.

Evans, R. (2001).. London: House of Stratus. https://www.amazon.com/Gassed-Rob-Evans/dp/075510353X Greaves & Hunt (a2018) Chemical Agents – Novichok. Science Direct. – https://www.sciencedirect.com/topics/neuroscience/novichok-agent

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