 A surprise attack with toxic chemical agents may be visible or invisible depending upon the method of dissemination. If a soldier panics now, loses his head, or becomes so concerned with protecting himself that he forgets about his mission, the enemy's attack will have succeeded. This attack did not succeed. These men are trained. They know what toxic chemical agents are, how they act, and the protective measures to be taken against them. Nerve agents are among those most likely to be employed in chemical operations. Nerve agents. You will be shown how you can protect yourself against these toxic chemical agents, GA, GB, V, and others. They are usually clear, colorless liquids that evaporate and form invisible clouds. Nerve agents were first discovered by German scientists shortly before World War II. They were looking for a better insecticide. They found that the highly toxic properties of the new chemicals made them suitable for another purpose as well, warfare. Nerve agents were a deadly addition to Germany's arsenal of secret weapons. May 1945, the Allied armies pushed deep into German territory. Contrary to many expectations, the German defenders did not resort to toxic chemical agents. That they had made preparations for the use of toxic chemical agents on a massive scale, however, can be seen from the following photographs taken by the American occupation forces. In the American occupation zone alone were stockpiles containing over 100,000 tons of chemical munitions. Over 611,000 artillery shells had been filled with a nerve agent GA. These aerial bombs were also loaded with GA. Most of the chemical munitions were destroyed by neutralization or burning, but for the nerve agents, this method was considered too hazardous. Instead, they were loaded aboard worn-out ships, towed far out to sea, and sunk. The loading and storage facilities in the Allied occupation zones were dismantled. The factories that manufactured the nerve agents were all in the Russian zone. They too were dismantled, taken behind the iron curtain, and put back into production. Here is a demonstration to show you the rapid deadly effects of a nerve agent on a goat. The dust and smoke you see are from the exploding round. The nerve agent is invisible. The invisible cloud has now reached the goat. In a short period of time, it will be possible to see its effect. The visible symptom here is a loss of coordination. The goat's muscles begin twitching. The trembling and twitching of the animal's muscles will soon become full-scale convulsions. When this happens, breathing becomes impaired, and the goat will die from paralysis of the muscles that control breathing. The total time, less than two minutes. The symptoms of nerve agent poisoning are running nose, tightness in chest, dimness of vision, difficulty in breathing, drooling and sweating, nausea, vomiting, cramps, twitching, jerking, staggering, headache, confusion, drowsiness, coma, convulsions, cessation of breathing. If you detect any of the symptoms shown, stop breathing, mask immediately, take atropine. Although their effect on the body is the same, the nerve agents differ slightly in their physical characteristics. GA was the first to be developed. Unlike the others, it has a faint odor, something like fruity chewing gum. It would probably be encountered in the form of a non-persistent vapor or aerosol. GB has no odor. It is about four times as toxic when inhaled as GA. It also would normally be encountered in the form of vapor or aerosol. V agents are also odorless. The most important difference, however, is their slow rate of evaporation. Although a V agent may be used as a vapor or aerosol, it is most likely to be encountered as a liquid contaminant, producing casualties by contact as well as by inhalation. Unlike most toxic chemical agents, nerve agents can enter the body anywhere. They can be inhaled through the nose and mouth. When they enter this way, they work very rapidly. They can be absorbed through the eyes. This way, too, they take effect very quickly. When absorbed through the skin, they do not take effect as quickly, but the effects are the same. Nerve agents act upon the muscles through the nervous system. Every movement of the body depends upon muscles. Voluntary, those which obey our commands. And involuntary, such as those which regulate breathing, circulation, and digestion, over which we have little or no control. The release of acetylcholine from nerve endings is responsible for muscular contraction. Acetylcholine causes the muscle to contract. Cholinesterase, a second chemical, causes the muscle to relax. The cholinesterase combines chemically with the acetylcholine, causing it to break down into waste products. When the acetylcholine has been removed, the muscle can relax. Here's what happens when a soldier has been exposed to a nerve agent. This soldier doesn't know it yet, but the artillery rounds that have been exploding upwind contain nerve agent. It is already beginning to take effect. He is getting a runny nose, a symptom of nerve agent poisoning. At this point, a soldier trained in chemical defense would have put on his protective mask. This soldier did not. Now he's aware of a tight feeling in his chest. His vision is getting blurred because the pupils of his eyes have pinpointed. The chest muscles are among the first to be affected. They feel tight, unable to relax. They cannot perform their work of pumping air in and out of the lungs. They are growing weaker. Breathing will stop entirely, and this man will die. Nerve agents can harm you only if they enter your body. Your protective equipment is designed to keep them out. To keep them from entering through your nose and mouth, and also to guard your face and eyes, you have been trained to use your protective mask. It is the best in the world. When properly fitted, it will protect you against inhalation of all known casualty agents under combat conditions. With nerve agents, speed and masking can mean the difference between life and death. Both liquid nerve agent and high concentrations of nerve agent vapor can enter the body through the skin. To prevent this, you will wear protective clothing, permeable, which is clothing that has been impregnated with special chemicals, which will virtually stop all vapor and slow down, but not stop, the penetration of liquid nerve agent. Certain specialized units will be provided with impermeable clothing. This clothing will protect the wearer from contact with liquid nerve agent, as well as from nerve agent vapor. As soon as the mission permits, clothing should be very carefully inspected, and if possible decontaminated. Splashed areas may be cut or torn away. Keep in mind, however, that this lessens the protection against further exposure. Liquid nerve agent on the skin should be washed away as soon as possible with water, and if available, soap. If you are ever subjected to a nerve agent attack, don't stop to ask questions, mask immediately. And if symptoms of nerve agent poisoning appear, you have still another form of protection, your atropine injector. This is to be used only after symptoms of nerve agent poisoning appear, never before. Here is how the atropine works. Normally, the acetylcholine is neutralized by combining with a relaxing agent, cholinesterase. But nerve agents knock out the relaxing cholinesterase, causing the acetylcholine to build up until it paralyzes the muscle. Atropine blocks the acetylcholine, permitting the muscle to relax. Nerve agents work fast, so the atropine must be injected quickly in order that it can go to work before the muscles become paralyzed. That is why the injection is given through your clothing. There are two types of atropine injectors. You should be familiar with both of them. One of them is the auto-injector, a hard plastic tube containing atropine, and an injection needle, which is triggered by a coiled spring. You remove the wrapper. Pull off the red safety cap, press the blue end of the tube hard against the muscle until the needle releases the fluid into the body. For self-injection, the thigh muscles are the easiest to reach. The injection procedure for the atropine sirrette is somewhat different. The sirrette is removed from its container. The plastic cover is unscrewed and discarded. The wire loop is pressed down firmly with a twisting motion, as far as it will go. This will pierce the inner seal at the base of the needle. To make sure that the seal has been broken, the tube is then gently squeezed from the bottom until a drop of the liquid solution appears at the tip of the needle. The wire loop is removed and discarded. The needle is injected into the muscle. The injector is grasped at the point where the needle joins the tube. The tube itself must not be squeezed until the needle has been completely inserted. Then the tube is squeezed slowly until the entire contents have been injected. Atropine will be given at 10-minute intervals. Normally, only a medical officer would give more than three atropine injections. If medical help is not available and the casualty obviously needs it, additional atropine will be ordered administered by the officer or NCO in charge as long as necessary. Your protective clothing, your protective mask, your atropine injector, these are your safeguards against nerve agents. Remember, nerve agents can strike suddenly without warning. Keep your protective mask with you at all times so you can get it on in a hurry. Nerve agents can either be seen or smelled. Your first warning will be the symptoms they produce. A runny nose, a feeling of tightness in your chest and throat, or blurring or dimness of vision. If any symptoms appear, stop breathing and put on your mask. Give the alarm. Then inject atropine immediately. You must get used to wearing your protective mask as you carry out your duties. And remember, unmasking is a command procedure. If liquid agent has splashed on your face or in your eyes, it must be removed fast. Stop breathing. Flush your face with water and mask. Even though you may have survived a nerve agent attack without harm, others may not be so fortunate. If one of your buddies is in trouble and your mission permits, you should do what you can to help him. This nerve agent casualty is still breathing. If you act fast, you can save his life. First, put on his protective mask. He must not breathe any more contaminated air. Inject him with atropine. Then continue your mission. You have done all you can for the time being. But suppose you find a soldier who exhibits severe symptoms of nerve agent poisoning. For him, atropine alone is not enough. First, turn him so that he lies on his back. At this stage, he will be breathing with great difficulty or not at all. Now, every second counts. Clear the mucus and other foreign matter from his mouth with your finger so he won't choke. Put on his protective mask. Next, give him an atropine injection. Then begin artificial respiration. Tilt his head back. Grasp his arms just above the wrists and place them over the lower ribs. Rock forward and exert steady uniform pressure. This will force the air out of his lungs. Move his arms outward and upward above his head as far back as possible. This draws air back into the lungs. Repeat the cycle 10 to 12 times per minute at a steady uniform rate. Since mouth to mouth rescue breathing cannot be performed, the chest pressure method being used here is preferred. This nerve agent casualty has been wounded. The man giving aid decides that the back pressure method of artificial respiration is necessary so the casualty is turned to the face down position. His face is turned so that it rests on his hands. His elbows are bent and one hand placed over the other. The mouth is cleared of mucus and foreign matter. With one knee on each side of the casualty's head, he places his hands on the middle of his back. Fingers spread downward and outward, thumb tips almost touching. He rocks forward with a slow even pressure until resistance is felt, releases the pressure quickly, rocks back and grasps the victim's arms just above the elbows. Continuing to rock back, he draws the arms upward until resistance is met, then lowers them and the cycle repeated. The important thing is to maintain an even regular rhythm as close as possible to that of normal breathing. Even though it may take some time for normal breathing to be restored, don't give up. If another person is present, he can take over, being careful not to break the rhythm. It is essential that the air passages be kept free of fluid. If fluid accumulates in the protective mask, it should be emptied out. Again, the mouth is 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, the mouth-to-mouth method of artificial respiration can be used. This is always the preferred method in uncontaminated air. A second atropine injection is given 10 minutes after the first one. A third injection may be given after 10 more minutes. The administration of atropine should be stopped when the symptoms of nerve agent poisoning begin to diminish. A dry sensation in the mouth is a sign that sufficient atropine has been given at that time. As soon as possible, the casualty's clothing should be inspected for the presence of liquid nerve agent. If any is discovered, it 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. Following an attack, nerve agents must be assumed to be present until proven otherwise. Protective masks are worn until the order is given for their removal. To determine whether or not it is safe to unmask, the squad leader will order the tests be made of the air. The chemical agent detector kit is used to make the initial test. If the test is negative, the squad leader will have two or three men remove their masks for a period of five minutes. They then remask for an additional 10 minutes. If at any time during this test, symptoms of nerve agent appear, runny nose, constricted pupils, or tightness of the chest, the men will give themselves an atropine injection. When the full 15 minutes have gone by with no sign of nerve agent poisoning, the air can be presumed to be uncontaminated and the order given to unmask. If no chemical agent detector kit is available, the test is made in the following manner. Two or three men will breathe deeply, then stop breathing. As they hold it, they crack the seal of their protective masks for 15 seconds, keeping their eyes wide open. The men reseal and clear their masks. After five minutes, their eyes are examined for constricted pupils. If these are found, the men are immediately given an injection of atropine. If their pupils are not constricted, they again crack the seals of their protective masks this time taking three or four deep breaths. They reseal and clear their masks. Five minutes later, the men are examined again. If symptoms of nerve agent still have not appeared, they will remove their masks for five minutes and then remask for an additional 10 minutes as in the earlier test. If symptoms still have not appeared at the end of 10 minutes, the atmosphere can be considered safe and the order given to unmask. However, personnel should always remain alert for nerve agent symptoms. There is always a possibility of a nerve agent attack. If it should occur, you know what to do. You have learned the characteristics of nerve agents. You have been shown how they act upon your body and the steps you must take to protect yourself. You have also been shown how to assist others. Remember, when the enemy employs nerve agents, it will be for one reason, to prevent you from carrying out your mission, either by killing or incapacitating you or by making you so engrossed in protecting yourself that you forget everything else. Don't let this happen. Continue your mission.