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ATP 4-02.85. Multi-Service Tactics *ATP 4-02.85 MCRP 3-40A.1 *NTRP 4-02.22 *AFTTP(I) 3-2.69 MULTI-SERVICE TACTICS, TECHNIQUES, AND PROCEDURES FOR TREATMENT OF CHEMICAL WARFARE AGENT CASUALTIES AND CONVENTIONAL MILITARY CHEMICAL INJURIES AUGUST 2016 DISTRIBUTION RESTRICTION: Approved for public release; distribution is unlimited. *This publication supersedes ATP 4-02.85/NTRP 4-02.22/AFTTP(I) 3-2.69, dated 19 August 2015. FOREWORD This publication has been prepared under our direction for use by our respective commands and other commands as appropriate. This publication is available at the Army Publishing Directorate site at https://armypubs.army.mil/ and at the Central Army Registry site at https://atiam.train.army.mil/catalog/dashboard. Also available through the United States Marine Corps Doctrine site at https://www.doctrine.usmc.mil/, United States Navy site at https://ndls.nwdc.navy.mil/, and through the United States Air Force Doctrine site at https://doctrine.af.mil/. ATP 4-02.85, C1 MCRP 4-11.1A NTRP 4-02.22 AFTTP(I) 3-2.69 Change 1 Army Techniques Publication No. 4-02.85 Headquarters Marine Corps Reference Publication 4-11.1A Department of the Army Navy Technical Reference Publication 4-02.22 Washington, DC, 16 April 2019 Air Force Tactics, Techniques, and Procedures (Instruction) 3-2.69 Multi-Service Tactics, Techniques, and Procedures for Treatment of Chemical Warfare Agent Casualties and Conventional Military Chemical Injuries 1. This change updates pyridostigmine bromide (PB) use in accordance with Food and Drug Administration (FDA)-approved labeling and updates the Marine Corps number to ATP 4-02.85/MCRP 3-40A.1/NTRP 4-02.22/AFTTP(I) 3-2.69, Multi-Service Tactics, Techniques, and Procedures for Treatment of Chemical Warfare Agent Casualties and Conventional Military Chemical Injuries. 2. Change Army Techniques Publication (ATP) 4-02.85/MCRP 4-11.1A/NTRP 4-02.22/AFTTP(I) 3-2.69, dated 2 August 2016, as follows: Remove Old Pages Insert New Pages_______________________ Front cover Front cover Foreword Foreword ii ii page 1-9 page 1-9 page 3-10 page 3-10 pages 3-18 through 3-20 pages 3-18 through 3-20 pages E-1 through E-3 pages E-1 through E-3 page F-3 page F-3 page H-2 Page H-2 Glossary-2 Glossary-2 Index-1 Index-1 3. New or changed material is indicated by a bar mark ( ). 4. File this transmittal sheet in front of the publication. DISTRIBUTION RESTRICTION: Approved for public release; distribution is unlimited. Marine Corps PCN: 144 000129 00 ATP 4-02.85, C1 MCRP 4-11.1A NTRP 4-02.22 AFTTP(I) 3-2.69 16 April 2019 By Order of the Secretary of the Army: MARK A. MILLEY General, United States Army Chief of Staff Official: KATHLEEN S. MILLER Administrative Assistant to the Secretary of the Army 1911303 DISTRIBUTION: Active Army, Army National Guard, and United States Army Reserve: Distributed in electronic media only (EMO). By Order of the Secretary of the Air Force ROBERT I. MILLER Major General, USAF, MC, SFS Director, Medical Operations and Research, Office of the Surgeon General Air Force Distribution: ACCESSIBILITY: Publications and forms are available for downloading or ordering on the Air Force Doctrine Web site at https://doctrine.af.mil/. Marine Corps Distribution: PCN: 144 000129 00 PIN: 105464-001 *ATP 4-02.85 MCRP 4-11.1A *NTRP 4-02.22 *AFTTP(I) 3-2.69 Headquarters, Army Techniques Publication (ATP) Department of the Army No. 4-02.85 Washington, DC Marine Corps Reference Publication (MCRP) Marine Corps Combat Development and No. 4-11.1A Integration Command Quantico, Virginia Navy Technical Reference Publication (NTRP) Navy Warfare Development Command No. 4-02.22 Norfolk, Virginia Air Force Tactics, Techniques, and Procedures (Instruction) Headquarters, Air Force Doctrine Center (AFTTP [I]) Maxwell Air Force Base, Alabama No. 3-2.69 2 August 2016 Multi-Service Tactics, Techniques, and Procedures for Treatment of Chemical Warfare Agent Casualties and Conventional Military Chemical Injuries Contents Page PREFACE............................................................................................................... v INTRODUCTION ................................................................................................. viii Chapter 1 CHEMICAL WARFARE AGENT CASUALTIES ............................................... 1-1 General ............................................................................................................... 1-1 Military Employment of Chemical Warfare Agents ............................................. 1-1 Routes of Entry ................................................................................................... 1-1 Classification of Chemical Warfare Agents ........................................................ 1-2 Means of Delivery of Chemical Warfare Agents ................................................. 1-4 Diagnosis of Exposure to Chemical Warfare Agents ......................................... 1-5 Chapter 2 CHOKING (LUNG-DAMAGING) AGENTS ........................................................ 2-1 General ............................................................................................................... 2-1 Central Pulmonary Agents .................................................................................. 2-1 Peripheral Pulmonary Agents ............................................................................. 2-2 Properties of Phosgene ...................................................................................... 2-3 Distribution Restriction: Approved for public release; distribution is unlimited. *This publication supersedes ATP 4-02.85//NTRP 4-02.22/AFTTP(I) 3-2.69, dated 19 August 2015. i Contents Chapter 3 NERVE AGENTS ................................................................................................ 3-1 General ............................................................................................................... 3-1 Physical and Chemical Properties ...................................................................... 3-1 Absorption of and Protection Against Nerve Agents ........................................... 3-1 Effects of Nerve Agents ...................................................................................... 3-2 Clinical Presentation and Diagnosis of Nerve Agent Poisoning ......................... 3-8 Prevention and Treatment of Nerve Agent Poisoning ........................................ 3-9 Antidote Treatment Nerve Agent, Autoinjector ................................................. 3-11 Convulsant Antidote for Nerve Agent, Autoinjector .......................................... 3-13 Pyridostigmine Bromide .................................................................................... 3-18 Chapter 4 BLOOD (CYANIDE) AGENTS ........................................................................... 4-1 General ............................................................................................................... 4-1 Protection ............................................................................................................ 4-1 Hydrogen Cyanide .............................................................................................. 4-1 Cyanogen Chloride ............................................................................................. 4-1 Chapter 5 BLISTER (VESICANT) AGENTS ....................................................................... 5-1 General ............................................................................................................... 5-1 Self-Aid ................................................................................................................ 5-1 Precautions for Receiving Casualties ................................................................. 5-1 Protection ............................................................................................................ 5-2 Mustard ............................................................................................................... 5-2 Lewisites ............................................................................................................. 5-9 Phosgene Oxime ............................................................................................... 5-12 Chapter 6 INCAPACITATING AGENTS ............................................................................. 6-1 General ............................................................................................................... 6-1 Anticholinergics ................................................................................................... 6-4 Indoles ................................................................................................................. 6-5 Other Agents ....................................................................................................... 6-5 Chapter 7 RIOT CONTROL AGENTS (IRRITANT AGENTS AND VOMITING AGENTS) 7-1 General ............................................................................................................... 7-1 Irritant Agents ...................................................................................................... 7-1 Vomiting Agents .................................................................................................. 7-4 Chapter 8 OBSCURANTS ................................................................................................... 8-1 General ............................................................................................................... 8-1 Protection Against
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