Napalm Exposure Medication
- Author: Lisandro Irizarry, MD, MPH, FAAEM; Chief Editor: Robert G Darling, MD, FACEP more...
Medication Summary
Implement medical therapy as indicated by the patient's medical condition. Remember to administer tetanus prophylaxis.
Toxoid
Class Summary
Toxoid is used for immunization; a booster injection in previously immunized individuals is recommended.
Tetanus toxoid adsorbed or fluid
Used to induce active immunity against tetanus in selected patients. The immunizing agents of choice for most adults and children >7 y are tetanus and diphtheria toxoids. Necessary to administer booster doses to maintain tetanus immunity throughout life.
Pregnant patients should receive only tetanus toxoid not a diphtheria-antigen-containing product.
In children and adults, may administer into deltoid or midlateral thigh muscles. In infants, preferred site of administration is the mid thigh laterally.
Analgesics
Class Summary
These agents ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained injuries.
Morphine sulfate (Duramorph, Astramorph, MS Contin, MSIR, Oramorph)
DOC for analgesia due to reliable and predictable effects, safety profile, and ease of reversibility with naloxone.
Various IV doses are used; commonly titrated until desired effect obtained.
Meperidine (Demerol)
Analgesic with multiple actions similar to those of morphine; may produce less constipation, smooth muscle spasm, and depression of cough reflex than similar analgesic doses of morphine.
Nonsteroidal anti-inflammatory agents (NSAIDs)
Class Summary
These agents have analgesic, antiinflammatory, and antipyretic activities. Mechanism of action is not known but may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions, may exist as well.
Ibuprofen (Motrin, Ibuprin)
DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Naproxen (Aleve, Naprelan, Naprosyn, Anaprox)
For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.
Topical antibiotics
Class Summary
Therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting.
Neomycin/polymyxin B/bacitracin topical (Neosporin)
Used in treatment of minor infections. Inhibits bacterial protein synthesis and growth. Polymyxin B disrupts bacterial cytoplasmic membrane, permitting leak of intracellular constituents and causing inhibition of bacterial growth.
Silver sulfadiazine (Silvadene, Thermazene, SSD, SSD-AF)
Useful in prevention of infections from second-degree or third-degree burns. Has bactericidal activity against many gram-positive and gram-negative bacteria, including yeast.
Napalm. Globalsecurity.org. Available at http://www.globalsecurity.org/military/systems/munitions/napalm.htm. Accessed July 3, 2007.
Bullens EF. Chemicals in combat. Armed Forces Chem J. 1952;5(4):4-7.
Fieser LF. Napalm. Indust and Engin Chem. 1946;38:768-773.
Harvey F. Air war in Vietnam. Flying. 1966;5:38-95.
Hollingsworth EW. Use of thickened gasoline in warfare. Armed Forces Chem J. 1951;4(6):26-32.
McLean AD. Burns and military clothing. J R Army Med Corps. Feb 2001;147(1):97-106. [Medline].
Napalm. Wikipedia. Available at http://en.wikipedia.org/wiki/Napalm. Accessed July 3, 2007.
Reich P, Sidel VW. Current concepts. Napalm. N Engl J Med. Jul 13 1967;277(2):86-8. [Medline].
Print
