What you need to know about chemical weapons Nina Widfeldt, MD, PhD Anestesikliniken Södra Älvsborgs Sjukhus Inspector OPCW Member of Socialstyrelsens C-MeG

SAFETY : You, Environment, Victim Chemical injury - AHLS Trauma - ATLS Advanced HAZMAT Life Support HAZMAT – HAZardous MATerials FIRST ASSESSMENT SAFETY : You, Environment, Victim A Airway Upper airway, eyes, nose B Breathing Disturbed ventilation, impaired oxygen metabolism C Circulation Disturbed circulation D Disability Disturbed neural function 2019-01-15 © Nina Widfeldt

Identify dangerous substance and treatment A – Airway Upper airway irritation, irritation eyes and nose Water soluble irritant gas, ammonia Secure airway B – Breathing Suffocating gas, irritant gas with low water solubility Chlorine, Carbon monoxide, Cyanide Oxygen, Optimize ventilation C – Circulation Hypovolemia, electrolyte disturbance Mustard gas, Hydrofluoric acid Treat cardiac arrhythmia, optimize cardiac function, avoid hypovolemia D – Disability Disturbed neural function Nerve gas; Sarin, Tabun, Soman, VX Treat seizures and Antidotes (Atropine, Obidoxim, Toxogonin)