Unmasking procedures following a chemical attack: a critical review with recommendations

U.S. Marine Corp and Army doctrine specifies a process for troops to remove the field protective mask in the aftermath of a chemical weapon attack. At the company/battery level, this procedure culminates in exposure of the respiratory system of selected troops to potential gas vapor. Commanders in the field rely on front-line corpsman and medics to provide lifesaving first aid in the event that toxic exposures take place. After this initial stabilization, casualties would be evacuated to an Echelon I medical facility, typically a Battalion Aid Station. The current tactical unmasking procedure, as specified in doctrine, is critically analyzed from a field medical perspective. Easy to implement recommendations are made, both to prevent lethal exposures and to better treat toxicity should prevention fail.