DOSAGE AND ADMINISTRATION
THE DUODOTE AUTO-INJECTOR SHOULD BE ADMINISTERED BY EMERGENCY MEDICAL SERVICES PERSONNEL WHO HAVE HAD ADEQUATE TRAINING IN THE RECOGNITION AND TREATMENT OF NERVE AGENT OR INSECTICIDE INTOXICATION.
CAUTION! INDIVIDUALS SHOULD NOT RELY SOLELY UPON ATROPINE AND PRALIDOXIME TO PROVIDE COMPLETE PROTECTION FROM CHEMICAL NERVE AGENTS AND INSECTICIDE POISONING.
PRIMARY PROTECTION AGAINST EXPOSURE TO CHEMICAL NERVE AGENTS AND INSECTICIDE POISONING IS THE WEARING OF PROTECTIVE GARMENTS INCLUDING MASKS DESIGNED SPECIFICALLY FOR THIS USE.
EVACUATION AND DECONTAMINATION PROCEDURES SHOULD BE UNDERTAKEN AS SOON AS POSSIBLE. MEDICAL PERSONNEL ASSISTING EVACUATED VICTIMS OF NERVE AGENT POISONING SHOULD AVOID CONTAMINATING THEMSELVES BY EXPOSURE TO THE VICTIM'S CLOTHING.
DuoDote is indicated for the treatment of poisoning by organophosphorous nerve agents as well as organophosphorous insecticides. DuoDote should only be administered to patients experiencing symptoms of organophosphorous poisoning in a situation where exposure is known or suspected. DuoDote should be administered as soon as symptoms of organophosphorous poisoning appear.
The DuoDote Auto-Injector is intended as an initial treatment of the symptoms of organophosphorous insecticide or nerve agent poisonings; definitive medical care should be sought immediately.
NERVE AGENT AND INSECTICIDE POISONING SYMPTOMS
Common symptoms of organophosphorous exposure are listed below. Individuals may not have all symptoms:
MILD SYMPTOMS
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SEVERE SYMPTOMS
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- Strange or confused behavior
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- Excessive, unexplained teary eyes
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- Severe difficulty breathing or copious secretions from lungs/airway
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- Excessive, unexplained runny nose
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- Severe muscular twitching and general weakness
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- Increased salivation such as sudden drooling
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- Involuntary urination and defecation
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- Chest tightness or difficulty breathing
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- Tremors throughout the body or muscular twitching
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- Unexplained wheezing, coughing or increased airway secretions
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- Acute onset of stomach cramps
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- Tachycardia or bradycardia
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Three (3) DuoDote Auto-Injectors should be available for use in each patient (including emergency medical services personnel) at risk for organophosphorous poisoning; one (1) for mild symptoms plus two (2) more for severe symptoms as described below. Each DuoDote Auto-Injector delivers atropine 2.1 mg plus pralidoxime chloride 600 mg.
TREATMENT OF MILD SYMPTOMS
FIRST DOSE: In the situation of known or suspected organophosphorous poisoning, administer one (1) DuoDote injection into the mid-lateral thigh if the patient experiences two or more MILD symptoms of nerve gas or insecticide exposure.
Emergency medical services personnel with mild symptoms may self-administer a single dose of DuoDote.
Wait 10 to 15 minutes for DuoDote to take effect. If, after 10 to 15 minutes, the patient does not develop any of the SEVERE symptoms listed above, no additional DuoDote injections are recommended, but definitive medical care should ordinarily be sought immediately. For emergency medical services personnel who have self-ad ministered DuoDote, an individual decision will need to be made to determine their capacity to continue to provide emergency care.
ADDITIONAL DOSES: If, at any time after the first dose, the patient develops any of the SEVERE symptoms listed above, administer two (2) additional DuoDote injections in rapid succession, and immediately seek definitive medical care.
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