Tactical Pocket Reference

Medical Care Responsibilities Patient Decontamination

Email: usarmy.meade.tradoc.mbx.usarmy-ft-meade-tradoc-list-
SIPR: https://dodtechspace.dtic.smil.mil/groups/asymmetric-
Patient decontamination begins at the incident site.

NIPR: https://www.milsuite.mil/book/groups/asymmetric-
A Guide for U.S. Forces
Self Aid: Perform immediate lifesaving self-aid and

Counter WMD:
personal decontamination.

Contaminated

2282 Morrison St. Ft. Meade, MD 20755-5355

Casualty Care
Buddy Aid: If unable to decontaminate yourself due to
injury or incapacitation, a buddy performs this function.
June 2016

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• Treat immediate life threating injuries (TCCC- MARCH)

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• Determine type of contamination (Chem, Bio, Rad)

Asymmetric Warfare Group

• Decontaminate exposed skin and contaminated

awg-opcen@mail.mil
MOPP gear using:
• RSDL or M291 SDK (Chem)
• Soap and Water (Chem, Bio, Rad)
• Dry earth, Bleach and water, etc. (Chem)
• Brushing or vacuum (Rad)
UNCLASSIFIED
DISCLAIMER: The information contained herein is not current U.S.
• Move to decontamination point ASAP for more
doctrine or policy and is not meant to supersede doctrine, definitive care
commander’s guidance, or established unit standard operating On the battlefield, medical care focuses on:
procedures. Examine and use the information in light of your
mission, the operational environment, the Law of Armed Conflict,
and other situational factors. This document does not constitute
• Minimizing the effects of wounds, injuries, disease, Initial Wound Decontamination
the provision of additional information or the approval of environment, occupational hazards, and psychological stressors
additional information upon request. • During thorough patient decontamination, all
on unit effectiveness, readiness, and morale.
DISTRIBUTION STATEMENT C: Distribution authorized to US bandages suspected of contamination are removed
Government agencies and their contractors; operations security;
31 May 16. Other requests for this document shall be referred to • Returning to duty as many service members as possible at each and the wounds are flushed with isotonic saline
Asymmetric Warfare Group, Fort Meade, MD 20755.
level of care. solution or water.
REFERENCES:
• ATP 4-02.7, Multiservice TTPs for Health Service Support in a
CBRN Environment
NOTE: Refer to the JACKS website (https://jacks.jpeocbd.osd.mil) and the • Bandages are replaced only if bleeding begins after
• FM 3-11.9 Potential Military Chemical/Biological Agents and references listed in this TPR’s title block for the most current CBRN decontamination.
Compounds information.
Patient Decontamination Responsibilities Special Equipment • Tourniquets suspected of being contaminated are
Special Equipment that will help replaced with clean tourniquets, and the sites of the
Self-Aid original tourniquets decontaminated.
Self-aid consists of measures that service members can apply in helping with patient decon:
themselves. These include self-administration of antidotes (only for nerve • Litters, backboards and • Both bandage replacement and tourniquet
agent exposure) and assumption of the appropriate MOPP level. wheeled carriers replacement are performed by medical personnel.
• Voice amplifiers for pro mask • Splints are thoroughly decontaminated but removed
Buddy Aid
• Radios only by a physician or under physician supervision.
Mental confusion, muscular incoordination, physical collapse,
unconsciousness, and cessation of breathing may occur so rapidly that the • Chemical lights, engineer tape • Once the patient has been thoroughly
individual is incapable of providing self-aid. These actions include— • Toxicological Agent Protective decontaminated and enters the medical facility, the
• Decontaminating the casualty (TAP) Apron new dressings are removed and submerged in 5%
• Putting the remaining protective clothing on the casualty to preclude • JCAD/ICAM hypochlorite or sealed in a plastic bag.
further absorption of contamination through any exposed skin
• Decontamination materials
• Evacuating the casualty as soon as possible
• Administer appropriate antidotes (use the casualty’s own antidotes) Biological Agent Considerations
If biological agents are suspected then Soldiers should enter a quarantine after they have been
decontaminated. Most biological agents would need an incubation period of several days (1-7)
in order to cause sickness. Many biological agents can mimic symptoms related to the flu so the
diagnosis of contamination is difficult.
 Treatment of Casualties Example Decontaminants and Usage

Wind

MAS – Medical Aid Station

CCP – Casualty Collection Point
LU – Link up
Radiation Sickness Similarities Between Heat Injuries and
Symptoms Nerve Agent Poisoning
• Bleeding from the Heat Injuries Nerve Poisoning
nose, mouth, gums * Unique symptom to injury
• Bloody stool Heat Exhaustion: Mild Nerve Poison:
• Bruising Nausea Nausea
• Confusion Dizziness Pinpoint pupils
• Dehydration Headache Runny nose Other CWA Symptoms
• Diarrhea Weakness Sweating Blood (AC, CK, SA): Incapacitating (BZ): Choking (Cl, HCl, Phosgene):
• Fainting Clumsy/unsteady walk Vomiting* Confusion Dry mouth and skin Eye and skin irritation
• Fatigue Muscle cramps* Slight difficulty breathing* Nausea Altered consciousness, delusions Airway irritation
• Fever Gasping for air Lack of coordination Coughing
• Fever Heat Stroke: Severe Nerve Poison: Seizures Hallucinations Sore throat
• Hair loss Loss of consciousness Loss of consciousness Chest tightness
• Mouth ulcers Convulsions and chills Convulsions Blister (H, HD, L, CX, HN-series):
• Nausea and vomiting Vomiting Loss of bodily fluid control Redness and blisters of the skin
• Skin burns Profuse sweating Loss of breathing Tearing, conjunctivitis
Confusion, mumbling* Muscle twitching* Mild respiratory distress
Possibly combative* Paralysis*
Antidote Treatment Nerve Agent, Auto-Injector (ATNAA) and Mark I Kit ATNAA and Convulsive Antidote, Nerve Agent (CANA) instructions
Atropine and 2-PAM CL solutions freeze at • Administer ATNAA as soon as any signs or symptoms are noted.
about 30°F • If symptoms of the nerve agent are not relieved, the Service Member should
be given two additional ATNAAs.
• Administer the CANA after administering 3 ATNAAs to severely poisoned
casualties or those obviously seizing.
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