Mark I Kits

[EMTCaresGuy]

Does everyone carry Mark I kits in their ambulance? Mark I kits contain 2-PAM and atropine to treat organophosphate exposure from either a pesticide or nerve gas exposure. Thanks!

 

[trevor1189]

All the ALS units here do.

 

[Veneficus]

All the ALS units here do.

Are there any canaries, I mean BLS units in your area responding without them?

 

[TransportJockey]

I've only ever seen them in class (from Basic on). When I lived in NM not a single unit that I know of carried them

 

[EMSLaw]

My service does not. It was a big step forward to even carry epi pens.

 

[MMiz]

I'm so confused by all of the responses. Aren't you required to carry them for personal use during a potential biological attack?

 

[TransportJockey]

I'm so confused by all of the responses. Aren't you required to carry them for personal use during a potential biological attack?

Nope. Never had to carry one on me or in the truck

 

[triemal04]

I'm so confused by all of the responses. Aren't you required to carry them for personal use during a potential biological attack?

I think that's the direction that most states are moving in. There may be a push at the federal level to do so as well but I'm not positive on that one.

 

[usafmedic45]

No we did not, but then again we did carry massive amounts of atropine which is what is really needed in the short term management of organophosphate and/or nerve agent toxicity (2-PAM/pralidoxime can wait for the hospital in most circumstances). It's cheaper and a whole lot more effective to carry multiple multi-dose vials of atropine when you might giving 20+ mg of atropine to single patient (you keep giving it until the secretions dry up basically). We were within 70 miles of the world's largest stockpile of VX nerve agent so we were well versed in the response to exposures (although most people said they would not show up if off duty when the crap was released).

I'm so confused by all of the responses. Aren't you required to carry them for personal use during a potential biological attack?

Except in the military, no. BTW, it's useless in a biological attack. It is useful only in one particular instance of a chemical attack.

 

[imurphy]

All units (BLS and ALS) in my service carry the 2 Mark-1 and 2 Escape hoods for the crew. I for one hope never to use them. And I hope if I DO have to use them I don't have a third rider on board!

 

[usafmedic45]

Mark-1 and 2 Escape hoods for the crew

I think you're talking about something entirely separate from what was asked about.

 

[trevor1189]

No there are no bls units that carry them that I am aware of. I would love to see them carried BLS for the providers, but not really sure how I would get that implemented.

On that note, there are a lot of things I would like to see carried including CPAP, but the person who's pretty much in charge of our ambulance has never taken one of my suggestions seriously.

 

[imurphy]

I think you're talking about something entirely separate from what was asked about.

Nope. We have Mark 1 kits for the exposure and escape hoods (pretty much like gas masks) to prevent further exposure.

 

[usafmedic45]

On that note, there are a lot of things I would like to see carried including CPAP, but the person who's pretty much in charge of our ambulance has never taken one of my suggestions seriously.

That's when you get the medical director on board with you along with a bunch of the other people at your service. You'd be amazed how much a well-executed (read as: "covert") end-run around an idiot can pay off, especially if you're willing to give up taking credit for the idea.

escape hoods (pretty much like gas masks) to prevent further exposure.

You know, if I have a bunch of people on the ground foaming at the mouth and convulsing, I'm not going to get out of the vehicle or walk any closer, i.e. close enough to be exposed. Remember nerve agent is NOT a gas in a technical sense...you have to have release it either with an aerosolizing action (this is why it was packed into bombs and rockets) and/or released into a confined space (like the Tokyo subway trains). Most of them resemble vegetable or olive oil at room temperature and normal atmospheric pressure. VX actually was more like warm molasses or motor oil according to my father who was a lab technician who helped break down the US stockpile of it. The only documented attack using it involved it being placed on the skin of the back of the victim (Zurer P: "Japanese cult used VX to slay member" Chemical and Engineering News 1998, Vol 76 (no. 35)).

Almost all nerve agents are oily liquids that have poor profiles for aerial suspension. Sarin is something of an exception to this as it is more volatile but only relatively speaking compared to other agents, but it still is not going to form a cloud in an open environment, especially if the conditions are not dead calm. One of the major routes of exposure is actually through cutaneous exposures (via environmental contamination or the mist settling on the skin) so that respirator is not going to offer much in the way of protection. VX was actually originally designed to be used more as an area denial weapon because of its properties. That is, it was such a poor aerosol that it was much more effective at simply "dirtying" an area thereby preventing the enemy from invading the area. This is one reason why I think the hoods give a false sense of security, especially given the number of "cowboys" we have in our midst who might be tempted to use the masks to makes "rescues" from the scene within the first few moments. If we ever face an attack using nerve agent, a number of EMS personnel and firefighters are going to die simply because of the brazen stupidity and desire to be a "hero" overriding common sense and self-preservatory instinct.

The sort of scenario I described should set off alarm bells in the head of anyone. Anyone walking into a scene of an incident where you have more than one person down and no traumatic explanation for it is an idiot. It practically screams "environmental cause". I would not go in there until the fire department or HAZMAT team cleared it or brought the victims out to me and decontaminated them, most likely the latter.

Just my two cents as a former HAZMAT team member....

 

[Hockey]

All units (BLS and ALS) in my service carry the 2 Mark-1 and 2 Escape hoods for the crew. I for one hope never to use them. And I hope if I DO have to use them I don't have a third rider on board!

What third rider?

And nope we don't