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|← Sarin Nerve Agent||Foundations of Mental Health Nursing →|
Sarin has a significantly rapid effect to exposed people. Its instant effects require adequate individual protection when dealing with the nerve agent. Therefore, in the event of exposure, Professional Protective Equipments (PPE) like chemical suits, hoods, boots and gloves should be used. Consequently, the uses of decontamination showers are critical after leaving an exposed area. Preventive antidotes should be administered in potential cases of Sarin exposure. These are in the form of tablets which are ingested in preparation for contamination. The preventive antidotes contain pyridostigmine, a Carbamate, which inhibits acetylcholinesterase by preventing the inhibitory effects of Sarin to the enzyme. Despite these measures some individuals may be subjected to various levels of exposure; therefore, antidotes and treatment procedures should commence immediately.
In the event of exposure, an antidote should be introduced immediately to counteract the effects of the nerve agent. This can be introduced through an auto-injector containing the antidote, which is commonly accessible from the military. The methods of use of the auto-injector are essentially straightforward; therefore, any individual is capable of using them. Injectors contain active components like HI-6, Atropine, Obidoxime and VX (Ivarsson et al., 1992). These are categorized as Oximes whose main function is to counteract the effects of the nerve agent in the body. For instance, some Oximes like HI-6 act as a re-activator which restores the inhibited acetylcholinesterase enzyme to a functioning state, while Atropine relieves the indicated systems resulting from exposure to the nerve agent (Ivarsson et al., 1992). Atropine acts by binding itself to the acetylcholine receptors in the cholinergic synapse, where it prevents the transmission of signals, hence, protection against excess acetylcholine. Thus, auto-injectors contain the two active components since they complement each other in mitigating the effects of Sarin exposure.
In the event that the administration of these antidotes does not improve the effects of exposure within ten minutes, an additional auto-injector can be administered while the attention of medical staff is sought. In cases of severe exposure to Sarin nerve agent, large doses of atropine and diazepam may be necessary. However, pretreatment procedures should include the combination of Carbamate and Oximes to reduce the toxicity of the nerve agent, while diazepam protects the brain against damage and strengthens the administered antidotes (Ivarsson et al., 1992).
Personal and Materiel Decontamination
Personal decontamination from Sarin nerve agent exposure involves removal of contaminated clothes through cutting away from the body, rather than pulling clothes over the head. This prevents from contaminating the eyes, the skin, inhalation or possible ingestion. Contaminated individuals should wash themselves with large volumes of water and soap to remove all possible lingering nerve agents on the body. In spillage scenarios, people should not attempt to walk through spilled nerve agent, however, if necessary professional protective equipments should be used (NIOSH, 2008). Oil, papers, wood or any other combustible should be kept away from the contaminated area to prevent possible combustion leading to evaporation of the nerve agent, hence releasing Sarin gas.
In the event of evaporation of Sarin nerve agent, water sprays should be used to reduce the vapors through a condensation process or diversion of the vapor cloud to drift towards the decontamination area away from possible exposure to people. However, water should not be directed at the source of the nerve agent leak or spill. This would aggravate the situation since Sarin is fully solvent in water. Spilling water on the nerve agent spillage would spread the possibility of exposure and enlarge the contaminated area. Therefore, nerve agent spillage should be prevented from reaching waterways, basements, sewers and confined spaces (NIOSH, 2008). These prevent the difficulty involved in contaminating these places since the spilled agent has the possibility or retaining its liquid form, hence, there is high likelihood of exposure levels to increase uncontrollably.
However, it is critical to stop the leaking nerve gas without risking exposure to the decontamination personnel; hence, when and if possible the leaking containers should be turned and exposed to allow the escape of Sarin gas. This is preferable to the spillage of the liquid form of the nerve agent which is difficult to contain and has a higher risk of fatalities than Sarin gas. The exposed region should be isolated and cordoned to prevent accessibility until all the nerve gas has dispersed; thus, ventilating the contaminated area.
After the events of September 11, 2001, the Homeland security act of 2002 was enacted and implemented. The purpose of this act was to prevent possible terrorist acts inside and outside the boundaries of the United States of America. It defines the provisions of disaster preparedness and response, while using intelligence and threat analysis methods to determine the extent of terrorist capabilities. Homeland security has implemented significant security protocols in the event of a chemical attack like the use of Sarin nerve agent. The creation of the Homeland security Advisory System aimed at creating informational infrastructure where every possible security breach scenario is assessed and evaluated on the basis of available information (Wang, 2005). This infrastructure is implemented on every governmental level: agency and people.
Homeland security evaluates each security level for possible terrorist attacks bases on the threat level. Each level is characterized by tasks and responsibilities as outline in the protective measure. All government functions, public and private agencies are required to train their employees on the implementation of these measures. Therefore, to mitigate potential Sarin nerve agent’s attacks, Homeland security has employed strategic measures to detect and prevent terrorist attacks using Sarin nerve agent (Wang, 2005). These include diagnosis and detection strategies like surveillance and detection of strategic positions including airports, subways, water utilities and critical facilities. However, despite these prevention and protective efforts, homeland security is critically prepared to respond to incidents of Sarin nerve agent attacks. It establishes the protocols to mitigate exposure and minimize casualties (Homeland Security Council, 2004). These include protocols on prevention and protection, emergency assessments, incident mitigation, public protection, victim care, investigation and recovery from Sarin nerve agent exposure.
The easy accessibility to the active ingredients in the synthesis of Sarin nerve gas creates a significant degree of apprehension. The physical and chemical characteristics of Sarin make the agent difficult to identify and detect in the absence of specialized equipments. Therefore, the danger posed by possible uses of Sarin as a weapon by terrorists is critical. Training on Sarin diagnosis and treatment should be provided to all levels of medical practitioners across the world. This will mitigate cases of Sarin nerve gas poisoning where remedial action is taken instantly.