DOI: https://doi.org/10.22141/2224-0586.8.103.2019.192375

Current problems of the health protection of Ukrainian Armed Forces servicemen from military toxic agents

L.A. Ustinova, V.I. Saglo, V.A. Barkevich, N.V. Kurdil, A.A. Yevtodiev, O.B. Kaplyuk

Abstract


Background. The accumulation of huge quantities of chemical weapon in certain countries of the world, the continuing research work on its improvement and cases of use in terrorist activities make the problem of the protection of military personnel of the Armed Forces of Ukraine from toxic warfare agents extremely relevant. The research aimed to assess the current state of medical protection and provision of antidotes from toxic warfare agents of neuro-paralytic action to servicemen of the Armed Forces of Ukraine. Material and methods. The provision of antidotes to servicemen in the Armed Forces of Ukraine for the past 20 years has been analyzed. The orders of the Ministry of Defense and the Ministry of Health of Ukraine regarding the full-board equipment of the medical service of the Armed Forces of Ukraine are considered. The research methods applied were as following: historical, bibliosemantic and systematic approaches. Results. The authors review the historical aspects of the development and use of chemical weapons. The global danger of the use of nerve agents such as Novichok is defined. The characteristic of losses from the use of organophosphorus toxic substances depending on the level of the organization of medical care at different stages of its delivery was given. The main directions of the development of medical protection means from organophosphorus toxic substances are analysed. The last orders of the Ministry of Defense and the Ministry of Health of Ukraine regarding the complete and standard equipment of the medical service for the Armed Forces of Ukraine are considered. The authors conducted a comparative analysis of the individual kit (different sets) used in Ukraine and the USA. The first-aid medical kit of the general medical personnel was found to be intended for reducing the impact of the striking factors of firearms and first aid through self-help and mutual assistance. There are no means for preventing or reducing the damaging effect of military toxicants and for the provision of medical care in case of injury by them (therapeutic antidote). In the serviceman's individual first-aid kit of the Special Operations Forces, there are no medicines (antidotes) for the provision of medical assistance in case of damage due to the paralytic action of toxicants. Only in the first-aid kit for the group of Special Operations Forces, there is atropine sulphate (solution for injection 0.1% ampoule 1.0). The authors emphasize that in the US Armed Forces a serviceman has the individual medical tools. These tools include the MARK I Kit, a set of therapeutic antidotes for nerve agents Nerve Agent Antidote Kit. It is a double container, in which two auto-inverters with antidotes are inserted. The newer model, ATNNA (Antidote Treatment Nerve Agent Auto-Injector), contains both preparations — atropine and pralidoxime chloride in a single injector, which simplifies the injection. The most important requirement for individual sets of medical protection is the presence of preventive use that eliminates the effects of mass destruction weapons or significantly reduces them. The preventive antidotes for organophosphorus substances have been developed based on the reversible inhibitors of cholinesterase. Such antidote in the United States is pyridostigmine — a pill (30 mg) used before the contact with an organophosphorus substance, and repeatedly, if necessary, after 6–8 hours. Authors stated that in the late 1990s and early 2000s, all the necessary medical preparations for military use were scarce in the kits of the Armed Forces of Ukraine. Today, there are no prophylactic antidotes for organophosphorus agents in the individual medical kits. Also, there are no necessary antidotes. The authors note that today in the East of Ukraine, many industrial enterprises have been taken by the terrorists. Terrorist diversion can cause man-made and war-time emergencies with after-effects close to those of chemical weapons. Therefore, the medical protection of the personnel of the armed forces is one of the key factors determining the ability to conduct combat in the context of a modern war that has the risk of using mass destruction weapons. Conclusions. The complete absence of the medical equipment of the Armed Forces of Ukraine for the medical prophylaxis, assistance, and treatment of the people affected by the toxic agents was revealed. Today, in the context of a modern armed conflict, where the probability of using mass destruction weapons including toxic nerve agents is extremely high, the presence of antidotes to toxic warfare agents is a critical condition for the preservation of life and combat capability of the personnel.


Keywords


military toxicology; chemical weapon; toxic nerve agents; medical protection of military personnel

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