TREATMENT OF CHEMICAL AGENT CASUALTIES NOR NAVSURNLANT SHIPS

File: 082696_doc1_473.txt
Page: 473
Total Pages: 652

             0  ~ram stain ~sually n9t help4vl
-            0  Dark+ield or phase contrast microscopy will show
                lar~e n~mbers ol chol~ra or~anisms, exhibitin~,,
                characteristic "shooting star" motility
             o  .Cult~re/sensittvity 0+ stool or rectal swab
             o  S~rolo~y not use+ul/not nec.s~ary
             o  ~Iood cultures not necessary, will *bq ne~ative

         o ~ampl. collection~transport

             o  Transmit stool, rectal swabs, or standard inoculated
                rectal culture transport media
                  -  Do not +reeze; avoid temperatures > 100 ~

         o ~egional laboratory

             o  N~MRLJ~~ Cairo
             o  Recommend sit up N~MR~~ detachment at a large
                local medical center, perhaps leasing local
                #ac~ lities.
             o  Hospital ships can also cultur. +or cholera
             o  Many large ships could do cholera cultures,
                but ~emand would probably rapidly overwhelin
                their labs and exhaust their supplies

         0 E~portable training pack~~e

             o  Simple handout should su++ic*

  ~R~4T~ENT

         o ~ielr'~

             o  ~mergency replaciment 0+ *+luids/electrolytes 1%
                critical to survival
                  -  tiere water insu++icient
                  -  Need salts, glucose
             o  Most *~a~~~ can be managed by oral +luids
                     Treat promptly to avoid worsening patient
                     to point where IV is required
                  -  IV 1+ stool volume > 100 ml/kg/24 hr
             o  Estimate initial'+luid loss and replace rapidly
                  -  Patients requirin~ IV should have initial
                     loss replaced within the +irst hour
                  -  Continue +luids to match stool output


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