New Jersey Administrative Code
Title 8 - HEALTH
Chapter 41 - ADVANCED LIFE SUPPORT SERVICES; MOBILE INTENSIVE CARE PROGRAMS, SPECIALTY CARE TRANSPORT SERVICES AND AIR MEDICAL SERVICES
Subchapter 7 - STANDING ORDERS FOR ADULT PATIENT
Section 8:41-7.22 - Standing orders for nerve agent poisoning (optional, at medical director$DQ$s discretion)

Universal Citation: NJ Admin Code 8:41-7.22

Current through Register Vol. 56, No. 6, March 18, 2024

(a) The following standing orders (optional, at medical director's discretion) are authorized in the event that an adult patient presents with nerve agent poisoning:

1. Do not enter or attempt to rescue a person in an area suspected or documented to be contaminated with nerve agent poison;

2. Before making patient contact, ensure that appropriate decontamination has been performed. No decontamination is need for pure vapor exposure;

3. Assess the patient for signs of nerve agent toxicity (SLUDGE) and constricted pupils (miosis);

i. SLUDGE stands for:

(1) Salivation (excessive production of saliva);

(2) Lacrimation (excessive production of tears);

(3) Urination (uncontrolled urine production);

(4) Defecation (uncontrolled bowel movements);

(5) Gastrointestinal distress (cramps, hyperactive bowel sounds); and

(6) Emesis (excessive vomiting);

4. Determine the level of exposure;

i. If the level of exposure is mild (that is, the patient is conscious and breathing):

(1) Assess and secure the airway;

(2) Administer high concentration oxygen;

(3) Observe the patient for respiratory distress; and

(4) Establish IV access;

ii. If the level of exposure is severe (that is, the patient is unconscious or if respirations are severely compromised):

(1) Assess and secure the airway;

(2) Administer high concentration oxygen;

(3) Establish IV access;

(4) Administer Atropine 2 mg/kg IV; and

(5) Administer Pralidoxime Chloride 1 gram IV;

iii. If unable to establish IV access, administer Nerve Agent Antidote Kit (NAAK), consisting of auto injectors of Atropine 2 mg and Pralidoxime Chloride 600 mg intramuscularly; and

5. Contact the medical command physician.

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