Third Edition, July 2000




Chemical warfare is not a popular topic, and most military health care providers do not willingly become familiar with it. This was painfully obvious during Operation Desert Shield/Desert Storm when it soon became apparent that many health care providers knew little about the effects of chemical agents or the medical defense against them. This ignorance was particularly striking in view of the seven-decade long history of modern chemical warfare and the well-publicized use of mustard and nerve agent during the Iran-Iraq War in the 1980s. The prevailing attitude of military health care providers was that chemical agents would be used only on Hmong, Afghans, Kurds, or similarly unprepared and unprotected groups of people. Further, many health care providers believed if chemical weapons were used the outcome would be disastrous, defense would be

impossible, and the casualty rate and loss of life would

be high.


Through education, however, medical professionals involved in Operation Desert Shield/Desert Storm learned that medical defenses were possible and effective, that chemical casualties could be saved and returned to duty, and that mortality could be minimized. Further, they realized that they might be the targets of chemical agents. More importantly, they rapidly learned that General Pershing's warning (written shortly after World War I) about chemical agents was still true: "...the effect is so deadly to the unprepared that we can never afford to neglect the question."


The purpose of this handbook is to provide medical

personnel in the field a concise, pocket-sized reference

source for the medical management of chemical

casualties. It is not intended to be a definitive text on the

management of chemical casualties.




Pulmonary Agents



Nerve Agents

Incapacitating Agents

Riot-Control Agents


Casualty Management in a Contaminated Area

Chemical Defense Equipment

Appendix A - Patient Decontamination

Appendix B - Casualty Receiving Area

Appendix C - Personnel Decontamination Station

Appendix D - Toxicity Data

Appendix E - Physicochemical Data

Appendix F - Medical Equipment Set

Appendix G - Summary Chart

Appendix H - Glossary of Terms



U.S. Army Medical Research Institute of Chemical Defense (USAMRICD)

Chemical Casualty Care Division



3100 Ricketts Point Road

Aberdeen Proving Ground, MD 21010-5400


July 2000

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