MINISTRY of HEALTH UKRAINE
Higher state educational establishment of Ukraine
«Ukrainian medical stomatological academy»
“It is ratified"
on meeting of Department
of Accident Aid and Military Medicine
Manager of department
DMSc, Associate Professor Shepitko K.V.
29.08.2016
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENTS
DURING PREPARATION TO PRACTICAL EMPLOYMENT
First medical care for affected to
catastrophes at chemical factories
Poltava-2016
1. Topic relevance
Lesson should be directed to the formation of theoretical and practical basis
of future professionals, during catastrophes atchemical factories. Particular
attention must be drawn to issues of toxic substances and evaluation of
environment during accidents atchemicalfactories,indicationoftoxic
substances.Considering the results of current emergency events it may be
appropriate and timely. It also is actual for liquidation of its results.
2.
Educational objectives of the course are:
1. To be know organization and means of chemical control at the chemical
objects.
2. To be able to conduct control of chemical situation at chemical objects.
3. To be able to evaluate the chemical situation on the areas.
4. To be know objectives ofchemical ranging
5. To be knoworganization and of chemical survey.
6. To be use means ofchemicalsurvey.
7. To be use methodsofindicationof toxic substances during situations
accidents.
3. Basic knowledge, abilities, practical skills required for studying of the
theme (interdisciplinary integration
Courses
Practical skills
1. Chemistry
1. To know chemicalpropertiesofacidsandalkalis
2.Biochemistry
2. To know the chemical changes in human
organism after influence of toxic agent.
3. Normal
Physiology
3. To know the change of basic functions of
human body after influence of toxic agent.
4.Lawyer’s basis
4. To know main international laws about
prohibition of chemical weapon.
5.Safety of life
functions
5. To use main rules of people during accidents
with toxic agent.
4.1Tasks for independent work during preparation to practical employment
1. Chemical survey
includemeasures to detect toxic substances
contamination in the areas of the terrain and the
direction of troops action that are carried out in order
to prevent injury of personnel by chemical weapons.
2. Requirements
chemical
investigation for
3. The task of
chemical
observation posts
Requirements for chemical investigation:
timeliness, continuity, reliability, inheritance.
4. The focus of
chemical
contamination
5. Area of chemical
weapons
This is area of chemical weapons and area of spread of
contaminated air.
6. Specific features
of assistance after
using chemical
weapon
Chemical observers and chemical observation
posts carry out following tasks:
• Identification of irradiation of local area and air;
determination of the type of chemical agents in the
area of the observer or office;
• reports of chemical contamination of the units
in the location where they are established;
• determination of the degree of contamination of
air with chemical agents;
• monitoring changes of the degree of
contamination of local areas and air, sampling water,
soil, vegetation etc.
This is part of the region where the chemical weapon
was applied. This isarea where maybe irradiation of
toxic substance.
• stop the further flow of poison into the body;
• use of specific antipoisons (antidotes);
• restore and maintain vital functions of body systems
(respiratory, circulatory);
• use of symptomatic therapy.
4.2Questions:
1. Chemical survey.
2. Objective and goal of chemical survey and its requirements.
3.Requirementsof chemical investigation.
4. The tasks of chemical observation posts.
5. Instruments used for chemical survey.
6. Indication oftoxical substances after chemical accident.
7.The focus of chemical contamination.
8.Area of chemical weapons.
9.Specific features of assistance after using chemical weapon.
10.The term of carry out firstmedicalaid after chemical weapons.
11.The kinds of means individual protection of respiratory organs and skin.The
rules of it`s using .
Professional algorithms for forming practical skills and abilities:
1.To be know the definition of «chemical survey ".
2. To be knowobjective and goal of chemical survey and its requirements.
3.To be knowthe tasks of chemical observation posts.
4. To be able to use instruments used for chemical survey.
5. To be defiant toxically substances after chemical accident in virtual training.
6. Tobedefiant specific features of assistance after using chemical weapon in
virtual training.
7. To be able to use the main kinds of respiratory organs and skin (filtering gas
mask, respirator, isolating gas mask, means of skin protection).
5. Detailedthemecontent:The high toxicity of chemical weapon agents and
their ability to cause mass destruction personnel, protection of troops from
chemical weapons activities such as exploration and chemical indication of toxic
substances are considered to be essential in the system of protection of troops.
These measures are an important area of civil protection agencies, because of the
timeliness, accuracy of their conduction depends on their lives.
Word indication translated from Latin means "show, detect". In military
affairs, the term was first used at the end of World War II to identify measures to
detect chemical agents at their use.
Detection of chemical agents solves two main tasks:
1. Timely notification about using chemical weapons to take the necessary
measures for protection of crew and elimination of effects of chemical
attack in the shortest term possible.
2. Control of measures to eliminate chemical attack.
Objectives and organization of chemical investigation
Chemical investigation is a set of measures to detect toxic substances
contamination in the areas of the terrain and the direction of troops action that are
carried out in order to prevent injury of personnel by chemical weapons.
Requirements for chemical investigation: timeliness, continuity, reliability,
inheritance.
The objectives of chemical research are to: determination of irradiation with
chemical agents of territory and air and immediate notification of crew about
infection;
- Determining the nature and extent of contamination;
- Determination of borders of contaminated areas and their indication with
signs "contaminated" indicating the type of chemical agent and the time of
determination;
- Determination of areas of stagnation of chemical agents;
- Determine the direction of movement of contaminated clouds;
- Determination of ways of bypass (detour) areas of contamination;
- Monitoring the change in the degree of contamination and air agents, as well
as changes in the boundaries of borders of contaminated areas;
- Detection of contamination sources of drinking water and water supply
points with chemical agents.
Chemical investigation is organized by headquarters units and commanders of
units. Immediately management of investigation at units is conducted by the subunit commander, and in military units it is conducted by the chief of chemical
service.
Chemical investigation in companies and battalions are conducted by
chemical observers and chemical monitoring observation posts, which are
appointed by the personnel of these units. Monitoring posts are usually located at
the command post of their units.
In units (connections) chemical investigation is conducted by chemical
observation posts and chemicalreconnaissance patrol (CRP) emitted from chemical
reconnaissance units of troops. CRP conduct reconnaissance usually at the
command post units (connections), and chemical reconnaissance patrols operate
independently or as part of military investigation, advanced, exploration, racing,
special and visitation detachments, advance guard, movement of troops and
detachments ofelimination of mass destructionweapons (MDW). In the division, in
addition, it can be carried by helicopters of radiation and chemical reconnaissance.
Chemical investigation is carried out by means of surveillance and inspection
of contaminated areas. Observation is conducted by chemical observers and
chemical observation posts (COP), and survey is conducted by chemical
reconnaissance patrols (CRO), which moved on specially equipped vehicles.
Chemical observers and chemical observation posts carry out following tasks:
• Identification of irradiation of local area and air; determination of the type of
chemical agents in the area of the observer or office;
• reports of chemical contamination of the units in the location where they
are established;
• determination of the degree of contamination of air with chemical agents;
• monitoring changes of the degree of contamination of local areas and air,
sampling water, soil, vegetation etc.
In addition to the duties born by chemical monitors (post), investigation
patrols perform the following tasks: identification and marking the boundaries of
areas of chemical contamination; finding bypass routs (bypass); determination of
directions, routes and areas with the lowest degree of chemical agents.
COP and CRO are provided with devices of chemical reconnaissance,
communication tools and signaling devices, barriers for contaminated areas. They
fill in a journal of chemical and radiation monitoring and the team immediately
reports the discovery of chemical agents.
In medical units, offices, chemical investigation is organized by commanders
(chiefs) of these units (offices) and performed as in their interests, and that of the
troops.
In the interests of their chemical investigation is carried out: in places where
deployed stages of medical evacuation are conducted; on the routes of their
movements; in the areas of further evacuation; at units of evacuation of wounded
patients.
In three other cases, chemical investigation is carried out in the absence of
headquarters units of data about chemical contamination in these areas.
Chemical reconnaissance is conducted by, acting as an observer of the
chemical, medical instructor – dosimetrician of sorting post. During the movement
(exploration of new areas of deployment, etc.) medical instructor-dosimetriscian
joins the reconnoiter group of medical unit (office).
In the case of participation in conducting chemical reconnaissance in the
interests of military, medical services conduct contamination agents testing of
water and food, and in some cases the warehouses of food, water intake points etc,
and sampling of water and food for further laboratory analysis (chemical control).
The concept of chemical seat
Seat (area) of chemical contamination refers to the territory, where are
situated crew, military equipment, transport and other facilities, exposed to
chemical weapons, resulting in or may occur irradiation of people and animals, and
infected areas of military equipment , transport and other facilities.
In the focus of chemical contamination distinguished area of chemical
weapons and area of spread of contaminated air.
Area of chemical weapons use is area, which is irradiated directly under the
explosion of chemical munitions or as a result of spraying of chemical
agentswithaircraftspraytanksapparatus that is part of the region where the chemical
weapon was applied.
Area of spread of contaminated air generated by the primary and secondary
clouds and is the area within which there is a possibility of irradiation of
unprotected crew.
Cloud of contaminated air (CA) refers to the volume of air, where are
distributed steam or aerosol of chemical agent. Clouds of vapor and aerosol
chemical, formed at the time of application of chemical weapon is called the
primary cloud of contaminated air. Cloud of chemical agents vapor that appeared is
due to evaporation of chemical agents from contaminated surfaces, is called the
secondary cloud of contaminated air.
Persistent seats include those in which the damaging effects of chemical
agents stored for 1 hour or more, a few days, weeks, months. These centers can be
formed not only for direct irradiation of personnel but also for irradiation of
vehicles and buildings, creating a so-called "restricting effect" and hinders military
actions for a long time.
Unstable seats include seats irradiating force of chemical agents is terminated
within one hour. In most cases, the use of volatile chemical agents is used to
destroy personnel during their application.
Evaluation of chemical environment
Chemical environment is a set of conditions that arise during the use of
chemical weapons as a result of infection of toxic substances terrain, air, water
sources, personnel, vehicles and weapons and other objects that significantly affect
the operations and combat efficiency of troops.
Evaluation of the chemical environment is determined by its possible impact
on the fighting troops to take measures aimed at keeping combat troops in potential
or actual use of chemical weapons by enemy.
Tasks to be solved in evaluating chemical environment:
• identifying the casualties in operations in chemical seats and surmounting
them;
• determine the number of personnel, vehicles and weapons, contaminated by
toxic substances;
• determine the duration of irradiating effect of toxic substances;
• selecting the most appropriate action to ensure the least loss of personnel
and weapons contracting, engineering, property;
• identifying measures to protect personnel, units and institutions in
conditions of irradiation with toxic substances and elimination of chemical
weapons.
Initial data for the evaluation of chemical environment:
- Position, objectives and character of the troops;
- The degree of crew protection;
- Type of used toxic substances;
- The means and ways of toxic substances used by the enemy;
- Place and time of use of chemical weapons;
- Weather conditions, topographical conditions.
Chemical environment is evaluated in two stages:
Stage I - prediction - made when there is no relevant information about the
application of toxic substances.
Evaluation of the chemical environment by means of forecasting allows
determining possible effects of chemical weapons and their impact on tasks and
preserving combat troops, the most appropriate next steps, to identify measures to
protect personnel from injury by toxic substances and elimination of chemical
weapons.
Stage II - Evaluation of actual conditions, according to investigation, is based
on accurate data from affected departments and units about loss of personnel, as
well as real data about the nature and size of irradiation seat.
On the bases of evaluation of chemical environment troops are informed
about chemical contamination of location and air, combat capability is evaluated,
measures to protect crew are taken and elimination of sequences of chemical
weapons, most appropriate actions in this situation are scheduled, direction and
routes to overcome and bypass areas infection are determined, safest areas for
accommodation units are defined, areas of putting on and removing personal
protective equipment are defined when dealing with areas of chemical
contamination, procedure for special treatment are defined.
Organization of medical care for irradiated with chemical agents
Medical care for affected by chemical agents is immediate and remarkable by
its specificity.
Specific features of assistance for affected individuals is the sequence of the
following measures:
• stop the further flow of poison into the body;
• use of specific ant poisons (antidotes);
• restore and maintain vital functions of body systems (respiratory,
circulatory);
• use of symptomatic therapy.
Organization of health care for affected by chemical gents should ensure
maximum reduction of the transportation form the seats and time of wearing gas
masks by patients, the activities of partial and complete sanitization during
infection with resistant agents.
The basis of medical assistance to affected with chemical agents individuals is
staging treatment system with evacuation according to prescription.
Conducting medical evacuation provides the following types of care: first
medical aid, pre-doctor (medical assistant), the first drug, a qualified and
specialized.
First aid is available on the site of injury or neighbor caches and is aimed at
addressing the initial signs of irradiation with chemical agents and prevents
development of severe lesions. It is conducted by the people as self-and mutual aid.
The term first aid lasts up to 5-10 min. since the onset of symptoms of
intoxication, primarily medical facilities are used and preventive medical care to
the affected individuals.
5.Materials of methodological and material support:
A. Tasks for self-education
1.The duties of chemical monitoring posts include (specify false statement):
a) timely detection of radioactive contamination;
b) alert notification;
c) determination of a nuclear explosion and the direction of movement of
radioactive clouds;
d) determination of levels of radiation in the area of the post and exploration of
radioactive contamination in the area of observation;
e) determination and designation of the boundaries of the zones of radioactive
contamination.
2. Name chemical agents of slow action that creates a steady seat on the ground:
a) sarin;
b) soman;
c) CO;
d) yperite;
e) Adamsite.
3. Seat of chemical weapons is called:
a) The area where detection of chemical agents is possible;
b) The area that is exposed to chemicals in the fall;
c) The area that was subjected to the influence of chemical agents in irradiation
concentrations;
d) Affected personnel in the area of chemical agents;
d) Affected personnel with equipment covered by chemical agents.
4.Chemical agents of psychochemical effect include:
a) sarin;
b) Phosgene;
c) Hlortsian;
d) lysergic acid diethylamide;
e) Chloratsetofenon.
5. Chemical agents of irritating action include:
a) Adamsite;
b) lysergic acid diethylamide;
c) Phosgene;
d) sarin;
f) SB.
6.The depth of distribution of secondary clouds does not depend on:
a) wind speed;
b) the nature of the terrain;
c) Speed of chemical agents effect;
d) Vertical stability of atmosphere;
e) Four Seasons.
7.For detection of chemical agents in food and water they use:
a) VPHR;
b) GSP-11;
c) Device of chemical reconnaissance of medical and veterinary units;
d) KRBH;
e) PC-56.
8.What zones does a chemical seat of contamination:
a) two;
b) four;
c) five;
d) six;
e) other.
9.Chemical agents of nerve effect include:
a) Adamsite;
b) C-Es;
c) Phosgene;
d) Soman;
e) Chloratsetofenon.
10.How deep do chemical agents irradiate surface of food:
a) 2 - 5 mm;
b) 2 - 5 cm;
c) 10 - 15 cm;
d) 20 - 30 cm;
d) 15 - 20 cm
B. Tasks for final control of knowledge with answers:
Task №1. Combined complex protective suit (CCPS) consists of (specify false
statement):
a) jackets;
b) pants;
c) protective underwear;
d) boots;
e) head protector and cap comforter.
Task №2. The number of sizes of general military protective kit is:
a) Two;
b) three;
c) four;
d) Five.
Task №3. It is possible to dive this deep wearing isolating gas mask:
a) 1 m;
b) 3 m;
c) 5 m;
g) 7 m
Task №4. During hard work one can remains in a portable breathing device no
longer than:
a) 10 minutes;
b) 20;
c) 30;
d) 40.
Task №5. How many stages are there in gas mask training:
a) one;
b) two;
c) three;
d) four.
Task №6. Combined filtering mask does not protect against:
a) toxic substances;
b) radioactive dust;
c) carbon dioxide;
d) carbon monoxide.
Task №7. What is the maximum permissible concentration of carbon monoxide in
shelters of combined military purpose:
a) 2%;
b) 3%;
c) 5%;
g) 6%;
Task №8. With no threat of enemy using weapons of mass destruction personnel
wear gas mask in position of:
a) field;
b) alert;
c) the battle;
d) personnel do not wear gas masks.
Task №9. What area of anti-smoke filter of combined military filtering gas mask:
a) 200 m²;
b) 2000 m²;
in) 2000 cm²;
d) 200 cm²;
Task №10..Chemical agents of asphyxiating include:
a) V-x gases;
b) HCN;
c) Phosgene;
d) LDK;
d) BZ.
References literature
Basic references:
1.
Methodical development of practical training for students of 2nd year
stomatology departments: « First medical care for affected to catastrophes at
chemical factories».Poltava, 2013 – 14ст.
Additionalreferences:
Methodical development of independent work for students of 2nd year
stomatology
departments:
«Preparationtopracticallessons
–
theoreticaltrainingandstudingofpracticalskills.Preparation to the final module
control».Poltava, 2013 – 14ст.
Guidelines prepared by:
PhD in Medical Sciences
Assistant Professor
V.V. Shevchenko