 In combat, the alert and well-trained soldier is the one who survives the worst that the enemy can hurl against him. Sudden attack, ambushes, sniper fire, booby traps. These are the dangers that every combat soldier recognizes and guards against. Yet in combat, there is another constant and invisible danger which is too often ignored. The danger of chemical agents. Since World War I, when chemical agents were first used against the unprepared allied forces with devastating effect, our army has recognized that what happened once can happen again. Every major army in the world stockpiles, chemical munitions, or retaliation should an enemy introduce chemical warfare. If it appears to be to his advantage, the enemy may be tempted to resort to his chemical arsenal. If he undertakes this step, it will be without warning. Then only you, his target, will be able to protect yourself. How you will do this is the subject of this film. A chemical agent is one which may be injurious to your body when it enters your system by being inhaled, eaten, or coming in contact with your skin. It could irritate, inflame, burn, destroy tissue, be absorbed into the bloodstream, or affect the body's functions. Any chemical agent employed in combat by the enemy will be powerful. It may last for hours or even days and produce a toxic environment. In order to survive in this environment, you will have to protect yourself against the injurious effects of the agent used and be able to give first aid to yourself and your buddies when necessary. To enable you to do this, the army provides you with four items. These are a protective mask, protective clothing, a personal decontamination kit, and atropine injectors. The mask is your most important piece of equipment and you are given special training in its use and care. It provides you with protection against inhaling chemical agents. When an attack with chemical agents is detected or suspected, you must mask immediately. Do not wait to receive an order or alarm. Mask at once when your position is hit by artillery or mortar fire, missiles, rockets, smoke, mists, aerial spray, or bombs. When you encounter smoke from an unknown source, when a suspicious odor, liquid, or solid is present, or when you are entering an area suspected of being contaminated, remember these conditions and when you encounter them, put on your mask immediately. In combat you should also mask at once if you develop any of the following symptoms, an unexplained runny nose, a feeling of choking or tightness in your chest or throat, dimming of vision, irritation of your eyes or skin, difficulty in or increased rates of breathing without obvious reasons. Remember these five symptoms of chemical agent poisoning and if you experience any one of them in combat, put on your protective mask immediately. When necessary you will be issued protective clothing, dubbing for your boots, and other first aid items. But in the event your skin, clothing, or eyes are contaminated with a chemical agent, you must perform personal decontamination immediately. If you suspect any chemical agent droplets are in your eyes, you must decontaminate them as quickly as possible. To do this you must flush out your eyes at once with water from your canteen. To flush your right eye, tilt your head back and slightly to the right. Then with your eyes looking upward, pour water into each eye slowly so that it will not run onto your face and clothing. If you cannot keep your eyes open, pull your eyelids away from your eyes with your fingers during this flushing. Decontamination consists of removing or neutralizing an agent or both before it causes serious injury. To enable you to do this, you will be issued this decontaminating and re-impregnating kit which contains a skin decontamination pad, a single-edged cutting device encased in a plastic safety sheath, and cloth bags of a knit material which contains decontaminating and re-impregnating powder. Each bag also contains a crushable plastic capsule filled with a chemical agent detector dye. This is how these protective items are used. The skin decontaminating pad is filled with powder to blot and absorb liquid chemical agent from exposed skin surfaces. To use, take the plastic packet from the case and tear it open. Then remove the skin decontaminating pad, unfold it, and fit it over your fingers like this. Using the portion of the pad on the back of your hand, now blot all visible spots from your exposed skin. Then using the palm side, dust the exposed skin, including skin folds, and rub the powder over the skin surface. In decontaminating your face, do not get any of this powder in your eyes. The cutter is packed with the skin decontaminating pad. It is used to cut away heavily contaminated areas of clothing. The powder-filled bags are used in decontaminating clothing. To use, remove the plastic container from the kit, open it, and take out one of the cloth bags. Locate the chemical agent detector dye capsule inside of the bag with your fingers, and crush it between your fingers or the palms of your hands. Then knead the bag with your fingers for approximately one minute to thoroughly mix the dye with the decontaminating and reimpregnating powder. Use the full contents of one bag to decontaminate your clothing. Dust all outer surfaces of your gloves and lightly rub the powder into the gloves with the bag. The chemical agent detector dye that you have mixed with the powder produces a red or brown color when it comes in contact with liquid agents. While dusting and rubbing, inspect for red or brown spots which indicate areas heavily contaminated with liquid agents. Dust all of your outer clothing with the cloth bag and rub the powder in lightly. But if a large number of widely scattered red or brown spots appear, do not attempt to decontaminate the clothing further. Instead, remove and discard it as quickly as possible. Use the buddy system to decontaminate areas you cannot see or reach. Have your buddy help you, and you help him, for all of your clothing must be carefully covered. These are the things you must do to properly decontaminate yourself after exposure to any chemical agent using your canteen water and M13 kit. Atropine, which you have in your protective mask carrier, is a drug which is used to relieve the symptoms of nerve agents poisoning. In a combat situation, you will have with you three atropine auto-injectors, like these. These will be carried in your protective mask carrier. The auto-injector is a hard plastic tube containing atropine and an injection needle which is triggered by a coil spring. To use it, remove the wrapper and hold the tube in your clenched fist with the yellow safety catch extending above your thumb. Then pull out the yellow safety cap and extend the arm until the hand falls naturally against the thigh. Press the green end of the tube hard against the outside of your thigh to release the needle. Wait five seconds and remove the needle with a quick pull. Because of the emergency life-saving nature of the act, atropine may be administered through clothing. A surprise attack with chemical agents may be visible or invisible, depending upon the method of dissemination. Nerve agents, such as GA, GB, GD, V, and others, are among the most likely chemical agents to be employed. These are usually clear, colorless liquids which evaporate to form invisible clouds. Recognizing the symptoms produced may be the only way you will have of knowing that a nerve agent is being used. The initial symptoms are a sudden, runny nose, possible dimness of vision, tightness in your chest, and difficulty in breathing. With only these symptoms, you should be able to treat and protect yourself. Advanced symptoms of nerve agent poisoning are drooling and sweating, nausea, vomiting, or cramps, twitching, jerking, or staggering, headaches, confusion, or drowsiness, coma, convulsions, or stoppage of breathing. With these nerve agent symptoms, a casualty will need help. Nerve agents can enter the body anywhere, inhale through the nose and mouth, or absorb through the eyes, or breaks in the skin. They take effect very quickly. When absorbed through unbroken skin, nerve agents do not take effect as quickly, but the effects are the same. They act upon the muscles of your body through the nervous system, both the voluntary muscles which obey your commands, and the involuntary muscles such as those which regulate your breathing, circulation, and digestion, over which you have little or no control. Nerve agents seriously disrupt the functioning of these muscles in this way. On the left is a normal nerve ending. On the right, a normal muscle. When a nerve impulse is transmitted to the muscle, a chemical substance called acetylcholine is released. This triggers muscle contraction. After such nerve triggered muscle action, a second chemical called cholinesterase is released and causes the muscle to relax. This normally terminates the muscle action. However, nerve agents knock out the cholinesterase and allow an excess of acetylcholine to accumulate. As a result, the muscle contraction which is stimulated by the acetylcholine continues. It becomes excessive and out of control. The muscle cannot relax and literally contracts itself to death. The drug atropine blocks the effects of the accumulated acetylcholine and thereby helps control this excessive muscular contraction. Atropine prevents part of the action of the acetylcholine by building a barrier around the muscle. This eliminates further stimulation and allows the muscle to relax. However, nerve agents work fast and thus the atropine must be injected quickly so that it can go to work before the muscles become paralyzed. This is how it's done in a combat situation. A squad position comes under attack. Immediately, most of the men remember to stop breathing and put on their protective masks without waiting to receive an order or alarm. But one man does not. Moments later he is having difficulty in breathing and feels a tightness in his chest. His nose is running. Suddenly he remembers what these symptoms indicate, nerve agent. Now he has taken the first step in protecting himself against a chemical attack. But he has the symptoms which indicate that the nerve agent has already reached his system. He needs atropine to overcome the effects of the nerve agent. He immediately gives himself an atropine injection. To keep track of the number of injections, each empty injector should be attached to the outer clothing. This can be done by inserting the needle through the clothing and bending it to form a hook. 10 to 15 minutes after the first injection, if the initial symptoms are still present, a second atropine injection should be given. Approximately 10 minutes later, this casualty is breathing easier and there is a dryness in his mouth. This dryness means that the atropine is overcoming the dangerous effects of the nerve agent. Until this dryness of the mouth is present, atropine injection should be continued every 10 to 15 minutes until the casualty has given himself a total of 3 injections. Additional atropine will not be given without the approval of the individual in charge or medical personnel. Other members of the patrol were not as lucky as the man we have just seen. The blast knocked this man unconscious, causing his mask to leak and he has been badly affected by the nerve agent. He is in deep trouble and shows advanced symptoms of nerve agent poisoning. For him, atropine alone will not be enough. He needs help from a buddy and he needs it fast. This is what to do. First, turn the casualty so that he lies on his back. At this stage, he will be breathing with great difficulty or not at all. Every second counts. Clear the mucus and other foreign matter from his mouth with your fingers so he will not choke. Next, give him an atropine injection and immediately begin artificial respiration by means of the M1 resuscitation tube. You place the mouthpiece between the casualty's lips and teeth and secure it in place by forming a seal over the lips with your thumb and index finger. The other three fingers are hooked under the casualty's chin to keep his jaw in a jutting out position. Then, with your free hand, pinch his nose closed. Take a deep breath and blow into the breathing tube bite piece. When the casualty's chest rises, stop blowing and release his nose, thus allowing him to exhale. As soon as the casualty exhales, pinch his nose closed again and the cycle is repeated at a rate from 12 to 20 breaths per minute. When the casualty is able to breathe without assistance, remove the resuscitation tube from his mouth and quickly replace his protective mask. If mask-to-mouth resuscitation is not available and since mouth-to-mouth cannot be performed in contaminated air, the chest pressure method is the alternative choice. Move his head back and grasp his arms just above the wrist and place them over his lower ribs. Then, rock forward and exert steady uniform pressure to force the air out of the casualty's lungs. Move his arms outward and upward above his head as far as possible. This draws air back into his lungs. Repeat this cycle 10 to 12 times per minute at a steady uniform rate. Whichever method of artificial respiration is used, the important thing is to maintain an even, regular rhythm as close as possible to that of normal breathing. If another person is present, he can take over, being careful not to break the rhythm. And even though it may take some time for normal breathing to be restored, don't give up. It is essential that the air passages be kept free of fluid. If fluid accumulates in the mask, it should be emptied out and the mouth should be cleared of mucus and foreign matter before the mask is replaced. When the air is no longer contaminated, the order to unmask is given. Now, mouth-to-mouth artificial respiration can be used. This is always the preferred method in uncontaminated air. Remember that a dry sensation in the mouth or an increase in the heartbeat to approximately 160 beats per minute are signs that sufficient atropine has been given. Additional doses of atropine may be given if the officer, non-commissioned officer, or individual in charge so directs. As soon as possible, the casualty should be inspected for the presence of liquid nerve agent. If any is discovered, he should be decontaminated. This applies to everyone who has been subjected to a nerve agent attack. As soon as the mission permits, troops should inspect themselves and each other for signs of contamination using the buddy system and performing the decontamination procedures which you have seen. This is how you must react to protect yourself against nerve agents. In addition to nerve agents, there are others which may be encountered in combat such as blister agents, which include mustards and arsenicals. The mustard-type agents do not cause pain, but arsenicals and phosgene oxime produce immediate pain. Relatively low doses of blister agents may be serious, for they can cause injury to the eyes, lungs, and skin. Decontamination for all blister agents is the same. It is especially important to flush your eyes immediately when contamination is suspected. Against mustard agents, this must be completed within two minutes to avoid serious damage. Then with your skin decontamination pad, decontaminate your face, first blotting up any agent droplets, and then rubbing the powder over the skin surface, taking care not to get any of the powder in your eyes. Using your skin pad, be sure to decontaminate the portion of your mask which came in contact with your face before putting it back on. With your mask in place, apply powder to your exposed skin using the skin decontaminating pad. This should be done at once, for the longer the blister agent is in contact with your skin, the more serious the injury will become. Use the buddy system to decontaminate all areas which you cannot reach or see. This is what happened to one man who did not follow first aid procedures. Prompt action on your part can avoid such consequences. If blisters form, cover them with a loose sterile dressing and secure with a bandage. Avoid breaking the blisters and seek medical treatment. Another type of chemical agents may be encountered in combat. When you notice a sudden increase in your breathing, an odor like bitter almonds or irritation of your eyes, nose, or throat, put on your mask immediately, for these are the indications of blood agent poisoning. Blood agent has rendered this man helpless. He needs assistance. With a blood agent casualty, the first thing to do is to get his mask on. After his mask is on, take two amyl nitrite ampules, break them, and place them inside the casualty's mask at the eyepiece. If the casualty's breathing is weak or he is not breathing at all, begin artificial respiration. Every four or five minutes, repeat the dosage of two ampules of amyl nitrite. Between each dosage, continue artificial respiration. Do this until normal breathing returns, or until a total of eight ampules have been used. No more than eight should be given. There is another chemical agent which may be encountered in combat. This is the incapacitating agent. An incapacitating agent is any compound which can interfere with the performance of military duties, does not endanger life, and produces no permanent injury. These agents will probably be disseminated as a burning munition or aerosol. They will therefore make their entry through your breathing. Your mask is therefore essential for protection against these agents. Individual reactions on exposure to incapacitating agents will vary. Some men will become extremely listless, uncoordinated, and indifferent to everything about them. Others will cry and become completely dejected and despairing. Still others will become overly aggressive and want to fight their buddies or anyone else in sight. There is no special first aid for the relief of the symptoms of incapacitating agents. Although normally over a period of time, the symptoms will gradually disappear, leaving no organic damage to the affected individual. Physical restraint may be required. Weapons and other potentially harmful materials should be removed from the reach of a casualty. Delirious casualties have been known to attempt to eat items bearing only a slight resemblance to food. This is how to protect yourself in combat from an enemy chemical attack. Remember that chemical agents can affect you by being inhaled, eaten, or coming in contact with your skin or eyes. Remember the symptoms that indicate a chemical attack, an unexplained runny nose, a feeling of choking or tightness in your chest or throat, possible dimness of your vision, irritation of your eyes or skin, difficulty in or increased rates of breathing without obvious reasons. Remember to put on your protective mask immediately when a chemical agent attack is detected or suspected. Do not wait to receive an order or alarm. Put on your mask at once when your position is hit by artillery, mortar fire, missiles or rockets, smoke or mists, aerial spray or bombs, when smoke from an unknown source is present, when a suspicious odor, suspicious liquid or solid is present, or when you are entering an area suspected of being contaminated. If you are subjected to a chemical attack, remember to decontaminate yourself as soon as your mission will permit. And never forget the necessity of atropine injections to overcome the effects of nerve agents or the use of amyl nitrate against blood agents. Keep in mind that a seriously affected chemical agent casualty will need help in breathing. Give him artificial respiration and maintain an even, regular rhythm as close as possible to that of normal breathing. Remember these elements of first aid and decontamination procedures for chemical agents and in any combat situation be ready to use them. This is your responsibility to yourself.