Nerve Agent Treatment (ATNAA)
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Meaning of ATNAA?
Antidote Treatment Nerve Agent Auto-Injector
What is in ATNAA?
Atropine 2.1mg and Pralidoxime Chloride 600mg
What is the purpose of the ATNAA?
It is used for initial treatment of the symptoms of organophosphate nerve agent or insecticide. (which cause the inhibition of acetylcholinesterase - AChE, leading to the accumulation of acetylcholine - ACh.)
Who are able to use the ATNAA?
This specific ATNAA are only available to the United States military personnel.
How is it delivered when used?
It gives 2.1mg of Atropine and 600mg of Pralidoxime Chloride sequentially through a single needle using the two chambered BinaJect drug delivery system.
Specifications of ATNAA?
- Length of Unit: 145mm
- Diameter of Unit: 19mm
- Needle Gauge: 23
- Needle Lenght: 21mm
How is the ATNAA administered?
When should ATNAA be used during Self Aid?
- Inject one ATNAA right away when the following symptoms are detected:
- 1. Runny nose
- 2. Headache
- 3. Drooling
- 4. Vision problems
- 5. Tight feeling in the chest
- 6. Breathing problems
- 7. Wheezing or coughing
- 8. Sweating
- 9. Muscle twitch
- 10. Stomach cramps
- 11. Nausea or Vomiting
- 12. Heart rate change from fast to slow
What other help guide can be used to detect organophosphate poisoning?
- Gastrointestinal Motility
What should not be done during Self Aid with ATNAA?
Do not give more than one ATNAA to yourself, especially when if you know who and where you are, the second ATNAA will be unnecessary. (Note: If you still have symptoms, have a buddy check your symptoms to decide if you need another injection.)
What should be done during Buddy Aid?
Use your buddy's own ATNAA to give your buddy injections.
How many ATNAA can be administered during Buddy Aid?
- If self-aid has been administered, give your buddy a second or third injection in rapid succession. OR if self aid has not been administered, give three (3) ATNAAs in rapid succession, IF MOST OR ALL of the following symptoms occur:
- 1. Severe symptoms from the Self Aid list.
- 2. Strange or confused behavior
- 3. Pinpoint pupils
- 4. Red, watery eyes
- 5. Very weak feeling
- 6. Loss of bladder or bowel control
- 7. Seizures (fits)
- 8. Unconsciousness
- 9. Not Breathing
- 10. Slow heart rate.
Step by step instruction of how to administer ATNAA?
- 1. Pull gray safety cap off of the injector. Do not touch the green end.
- 2. Gather clothing away from the injection site (the meaty part f the thigh). Push injector firmly against the thigh.
- 3. Hold in place for 10 seconds.
- 4. Bend needle into a hook by pushing it against a hard surface.
- 5. Hook bent needle onto pocket flop.
During a life threatening poisoning of nerve agent, are there any contraindication?
What is the max dose of ATNAA?
No more than three doses should be administered unless definitive medical care (hospitalization, respiratory support) is available.
If a person is pregnant is it safe to use the ATNAA?
ATNAA is pregnancy Category C and should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
What concerning factors are there when the ATNAA has been administered?
Muscle tightness and sometimes pain may occur at the injection site.
What are the common adverse effects of Atropine?
Antimuscarinc actions which are dryness of mouth, blurred vision, dry eyes, photophobia, confusion, headache, and dizziness.
What are the common adverse effects of Pralidoxime?
Change in vision, dizziness, headache, drowsiness, nausea, tachycardia, increased blood pressure, muscular weakness, dry mouth , emesis, rash, dry skin, hyperventilation, decreased renal function, excitement, manic behavior, and transient elevation of liver enzyme and creatine phosphokinase.
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