lördag 15 juli 2017

POW - sotavankiajat maailmansodassa. Sandpostel tänään 2017

 POW = Prisoner Of War, Sotavanki
https://en.wikipedia.org/wiki/Prisoner_of_war
  • POW läpikulkuleiri löytyy Zeven nimisen kylän lähistöllä siitä länteen. Niedersachsenissa  Sandpostel-nimisessä paikassa
Muista NYKYAIKA, kun luet historiaa!     SANDPOSTEL TÄNÄÄN  https://www.stiftung-lager-sandbostel.de/


-ja sitten palaan taas historian puolelle 

 ( katselen Ension tuomaa karttaa maailman sodan ajoilta. Kartasta löydän Ze
ven- kylän.
Koetan löytää Neuenkirchenin suunnalta senaikaisia karttanimiä kohti Quackenbrückiä, kun luen Renate rangermannin kirjaa Quakenbråuckin kylän historiasta. Vanhasta kartasta siten lötyy asemakylä Zeven, Weser joen yhden itähaaran aluetta,Teufelmoore Weseristä itään, sen Zeven-kylästä länteen- Zeven kylässä on ainakin nykyään asema ja bussilinja esim Bremen Zeven välillä. Ala olevassa kertomuksessa mainitaan Zeven- tällaisessa yhteydessä:

  • The Sandbostel )camp was liberated on 29 April 1945 by the British Armed Forces of XXX Corps following fighting with the German 15th Panzergrenadier-Division. The camp commandant, however, realizing that the end of the war was close, had already agreed to hand over control of the camp to the prisoners, led by the French Colonel Marcel Albert. On 21 April, the same day that the officer ordered to take control of the camp complained to his superiors about conditions there (see picture), two prisoners carried the call for assistance from the camp to the Guards Armoured Division at Zeven. Two armoured units were sent to Sandbostel but fighting delayed their arrival until 29 April.[6]
  • The British discovered around 15,000 surviving POWs in the camp, as well as around 8,000 KZ-inmates.[6]

Tästä artikkelista löytyy runsaasti POW leirejä. Otan wikipediasitaatin.

POW-leirin nimi oli Stalag X-B. Mitä siellä tapahtui?

Leiri STALAG X-B toimi saksalaisten ottamien sotavankien läpikulkuleirinä 1939- 1945. ja se sijaitsei lähellä sStandbostel nimistä paikkaa Ala-Saksenissa. Lounais-saksassa. Satoja tuhansia POW vankeja 55 kansasta kulki tämä-n leirin läpi. Tuhannet kuolivat kurjien olosuhteiden takia siellä nälkään, tauteihin tai vartijoiden surmaamina. Kuolleitten määrä on vain arvio: 8000- jopa 50 000 välillä. Siis tuntematon määrä.

  • Stalag X-B was a World War II German Prisoner-of-war camp located near Sandbostel in Lower Saxony in north-western Germany. Between 1939 and 1945 several hundred thousand POWs of 55 nations passed through the camp. Due to the bad conditions in which they were housed, thousands died there of hunger, disease, or were killed by the guards. Estimates of the number of dead range from 8,000 to 50,000.
Contents

Establishment and operation

Sandbostel lies 9 km south of Bremervörde, 43 km northeast of Bremen. In what was then the Province of Hanover, the Lutheran Church of the State of Hanover opened a camp for out of work singles and employed them in public works (roadworks, amelioration) in 1932, during the Great Depression.[citation needed]
In 1933, the Reichsarbeitsdienst took over the camp and used it later as a Nazi internment camp for undesirables.[citation needed]
In August 1939, a commission of Heeresbauamt Bremen (military construction department) decided to create a Mannschafts-Stammlager (POW camp) for the local Wehrkreis X. In September, construction of the camp began between the village of Sandbostel and the Arbeitsdienstlager in the Teufelsmoor. The latter area was now used as barracks to house the Wehrmacht guards.[1][2]
Beginning in September 1939, Polish POWs were used to expand the camp. Initially, huts for around 10,000 prisoners were built. Once it began operating, the camp was divided into several sub-camps:[1]
  • a Stalag holding enlisted men from the occupied countries (Poland, Belgium, the Netherlands, France, Southeastern Europe and Italy after the armistice)
  • an officers' camp ( Oflag ) for officers from the occupied countries. In 1941, this part of the camp was merged with Oflags elsewhere
  • a Marinelager ( Marlag ), controlled by the Kriegsmarine, holding British sailors, marines and officers. In the fall of 1941, this part of the camp was moved to Westertimke
  • an Internierungslager ( Ilag ), or internment camp for civilian citizens of enemy nations, including members of the British merchant marine. This section was also moved in 1941 to Westertimke[1] (see: Marlag und Milag Nord)
At first, prisoners were housed in tents, but from spring 1940 inmates constructed masonry huts. Later, prefabricated wooded huts were added. By 1941, there were over 100 huts housing prisoners as well as latrines, kitchens, buildings for punishment confinement and the commandant's office. In addition, there was a hospital (Reservelazarett X-B) and a punishment work camp of two huts inside the moor.[1] By 1940, after the German victory over France, the camp was filled beyond capacity. Stalag X-B was then expanded to house a total of 30,000 prisoners.[1]
From the fall of 1941, sections of the camp were cleared or moved to make room for Soviet prisoners taken during "Operation Barbarossa". The camp now administered hundreds of Arbeitskommandos each made up of around 30 forced labourers. These were supplied to local farmers and industry.[1][3]
There was a clear hierarchy among prisoners. At the top were British and American POWs, generally treated correctly according to the Geneva Convention and receiving numerous aid packages from the International Red Cross. As a consequence, they were well-fed until the very end of the war, when transportation and supply links broke down. Prisoners from western Europe (French, Belgians) were also treated as POWs but received less outside help and were not as well-nourished. However, they were in contact with international help organisations. Serbian and Polish nationals were denied access to outside observers. Italians, who came here after September 1943, were deemed traitors by both the German guards and the other prisoners and were at the low end of the hierarchy. They were ill-fed and from the fall of 1944 forced to work with the Wehrmacht or be treated as civilian forced labour. Worst-off of all were the Soviet POWs. They were denied POW status, received no outside food, and were not allowed access to international observers. Guards had a special shoot-to-kill policy for them. Due to the ill-treatment of the Soviets and a lack of shelter, several epidemics broke out among them. Thousands of them died from disease, starvation and brutal treatment by guards. They were buried in mass graves on the camp graveyard (today's war cemetery).[1]
Among the Italian prisoners, who were mostly soldiers who did not surrender to the German army after the Cassibile armistice, was journalist and writer Giovannino Guareschi, who wrote La favola di Natale ("A Christmas Fable") there on Christmas 1944. The Canadian Neurologist Charles Miller Fisher, who served as a Lieutenant Commander in the Canadian navy, was interned in this camp after being torpedoed and rescued by a German ship.[4]
In August 1944, all POW camps were removed from Wehrmacht control and were assigned to Heinrich Himmler's Schutzstaffel (SS). Although this was without immediate consequences at Sandbostel, in January 1945 POWs were evacuated here from other camps closer to the frontline. In the final phase of the war, concentration camp prisoners were relocated to Sandbostel. Around 9,000 former inmates of Neuengamme concentration camp and its subcamps were transferred to Stalag X-B in April 1945.[1] They were housed in the former Marlag and guarded well but otherwise left to their own devices: they received no medical help despite rampant diseases, sanitary conditions were dire and the inmates went virtually without food. On 20 April, most of the SS members guarding that section of Stalag X-B marched out of the camp with several hundred prisoners. After that, the POWs were allowed to help the remaining former concentration camp inmates with some of their own food.[5]

Liberation

Letter dated 21 April 1945 about the handover of the camp, exhibited at Neuengamme concentration camp.
The camp was liberated on 29 April 1945 by the British Armed Forces of XXX Corps following fighting with the German 15th Panzergrenadier-Division. The camp commandant, however, realizing that the end of the war was close, had already agreed to hand over control of the camp to the prisoners, led by the French Colonel Marcel Albert. On 21 April, the same day that the officer ordered to take control of the camp complained to his superiors about conditions there (see picture), two prisoners carried the call for assistance from the camp to the Guards Armoured Division at Zeven. Two armoured units were sent to Sandbostel but fighting delayed their arrival until 29 April.[6]
The British discovered around 15,000 surviving POWs in the camp, as well as around 8,000 KZ-inmates.[6]
The camp was divided into three sections when liberated. The first contained allied prisoners in unsatisfactory conditions, but generally in compliance with the International Red Cross Convention. Soviet prisoners, without the Convention's protection, were in substantially worse conditions. In the third section were around 8,000 civilian prisoners in appalling conditions, described in the Army medical history as "utterly horrifying"; "everywhere the dead and dying sprawled amid the slime of human excrement."[7] According to members of the British forces present at the liberation, conditions were so bad, they referred to the Stalag as "Little Belsen" in a reference to Bergen-Belsen concentration camp.[3]
The commander of the British Forces in north-western Germany, General Brian Horrocks, was called in and ordered local German civilians and medical orderlies to help with the clean-up, and to bury the numerous dead bodies. Like at Bergen-Belsen, despite the best efforts of the British, hundreds of inmates died every day immediately following the liberation as a result of starvation, typhus and other diseases.[6] Estimates of the total number of people who died here in 1939-45 range between 8,000 and 50,000.[2] There is evidence of at least 5,162 dead. Claims of up to 46,000 killed Soviets alone were made by the Soviet Union but are considered to be exaggerated.[3]
Inmates were cleaned and transferred to an improvised hospital outside the camp and thence to convalescence camps. The former Marlag was burned between 16 and 25 May to prevent a typhus epidemic and the last 350 patients left the hospital on 3 June.[7]
Other, more serviceable, huts were used by the British to house imprisoned Nazis and SS members, who were awaiting trial.[6]

Cemeteries

POW camps were required by Wehrmacht regulations to have a cemetery close-by. Initially, the dead of Stalag X-B were buried in the war cemetery at Parnewinkel, where a World War I POW camp had been located previously. As the number of dead rose in 1940, a second cemetery was established near Sandbostel, about 1.2 kilometres from the camp.[2][8]
Non-Soviet and Soviet POWs were treated differently even in death. The former were buried with military honours in individual graves, the latter in 70 mass graves.[8]
At Sandbostel, the cemetery has two sections. Gräberfeld 1 includes the mass graves. In 1954-56 Gräberfeld 2 received the roughly 2,400 dead among the former concentration camp inmates who could not be identified.[9]

Post-war use

British internment camp

As early as 8 July 1945, the British military authorities established one of nine civilian internment camps in a part of the former Stalag X-B. At "No. 2 Civil Internment Camp" or "No. 2 CIC" around 5,000 males, including SS members, were interned. Soon, inmates were subject to "re-education", intended to turn Nazi supporters in democrats. To further this goal, internees were allowed to publish their own newspaper Der Windstoss.[10]
In June 1947, the trials began at the Spruchkammergericht at Stade. Internees were not charged with individual crimes but with membership in a criminal organisation, as defined by the Nuremberg trials. The court handed down 3,500 verdicts, ranging from several months to six years imprisonment. However, the time of internment was counted as time served, so many of the defendants were released immediately following the trial.[10]
After the last inmates were released on 9 March 1948, the British closed the camp on 1 August 1948.[10]

Prison

In March 1948, the Justice Department of the State of Lower Saxony established the Strafgefängnis Lager Sandbostel at the site of the Stalag. This prison soon housed around 600 male inmates, imprisoned for periods between two months and two years, mostly for property-related crimes, in six large huts.[11]
The prison featured a small hospital, workshops and a Protestant church. Around 110 people worked there, mostly German refugees from the eastern territories lost after WW II. In 1952, the prison was dissolved due to falling numbers of incarcerated.[11]

Camp for refugees from the GDR

Beginning in 1952, parts of the camp were used as an emergency reception centre for refugees from communist Eastern Germany or GDR. On 1 April 1952, the Federal Ministry for Refugees established the Notaufnahmelager Sandbostel for young male refugees aged 15 to 24. In September 1952, a similar camp for women was established at the site of the POW camp at Westertimke. These two camps were under the supervision of the Durchgangslager Uelzen-Bohldamm and a committee decided on individuals' admission to Western Germany or to West-Berlin. Refugees also received help in finding jobs or apprenticeship positions. Most of the young people were in the camp for just one or two weeks. At Sandbostel, their number averaged around 800, at Westertimke around 300. Daily intake at Sandbostel was up to 100, with roughly the same number leaving each day. In total, around 250,000 young men and 80,000 young women passed through the camps.[12] This use ended around 1960.[2]

Bundeswehr and business park

In 1963, the German armed forces took over the remaining huts of the camp and used them to store medical supplies. Ten years later, in 1973, the Bundeswehr stopped using the facility. The Ministry of Defence for a while considered building a barracks at the site, but eventually chose Seedorf as the location.[13]
In 1974, the business park "Immenhain" was established in the area of the camp not given over to agricultural use. Businesses set up there included a horse-riding establishment, a reject shop, a militaria shop and a brothel. This use of the former camp area only ended with the establishment of the memorial in the 2000s.[13][14]

Memorial

A Soviet memorial erected at the cemetery site in 1945 was dynamited in 1956 by orders of the Bremervörde district authorities and the Lower Saxony Ministry of the Interior, due to the memorial's excessive claims regarding the number of victims. Its inscription had read "Hier ruhen 46.000 russische Soldaten und Offiziere, zu Tode gequält in der Nazigefangenschaft" ("Here lie 46,000 Russian soldiers and officers, tortured to death in Nazi imprisonment").[15] The remains of most non-Soviet POWs were repatriated to their countries of origin. The Italians were reinterred at the Italian war cemetery at Hamburg-Öjendorf. Only around 170 individual graves of POWs from Poland, Yugoslavia or of unknown nationality remain in the graveyard at Sandbostel.[2]
A private club was founded in 1992 to work for the maintenance of the camp site. Since that year, most of the huts were treated as listed or protected buildings. The creation of a memorial at the site of the former camp met with substantial local opposition.[16] In 2004, a foundation (Stiftung Lager Sandbostel) was established. Following three years of preparations, the Gedenkstätte Sandbostel was opened in 2007. In April 2013, the permanent exhibition was opened. Out of a total of around 150 huts, more than 20 remain (largely in the area that used to house the Soviet prisoners). Some appear mostly as they did in the 1940s, others have been altered to serve changing needs in the post-war period.[2][17][18]

References

  • Ropper, A. H. (2012). "C. Miller Fisher". Annals of Neurology. 72 (1): 1–3. doi:10.1002/ana.23657.
  • Two Weeks in May 1945, Clifford Barnard, Quaker Home Service, 1999. ISBN 0-85245-315-9
  • Scheurmann, Ingrid (August 2013), "Sandbostel (German)", Monumente, pp. 16–18, ISSN 0941-7125
  1. "Gedenkstätte Lager Sandbostel (German)". Stiftung Lager Sandbostel. Retrieved 6 March 2014.
  • Borgsen, W./Volland, K. (2010), Stalag X B Sandbostel, Edition Temmen, ISBN 9783926958655.
  • Ehresmann, A. (2013), Das Stalag X B Sandbostel. Geschichte und Nachgeschichte eines Kriegsgefangenenlagers (German). In: Gedenkstättenrundbrief Nr. 171 (09/2013), p. 19-31. Available online at [1]

External links

See also


[hide]
Main German prisoner-of-war camps for Western Allied soldiers (1944–1945)





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Etiketter:

söndag 5 mars 2017

Mosulin taisteluissa jälleen kemiallista kaasua käytetty

Al Jazeera kertoo seuraavaa:
http://www.aljazeera.com/news/2017/03/alleged-mosul-chemical-attack-amounts-war-crime-170304132854968.html
 Twelve people, including women and children, are being treated for possible exposure to chemical-weapons agents in Mosul, where ISIL is fighting off an offensive by US-backed Iraqi forces, according to the UN.

The UN said all 12 patients had been received since March 1 for treatment which they are undergoing in Erbil, the capital of Iraq's Kurdish region, east of Mosul.
Four of them are showing "severe signs associated with exposure to a blister agent".
The patients were reportedly exposed to the chemical agents in the eastern side of Mosul.
Reporting from Erbil, Al Jazeera's Stefanie Dekker, who visited the hospital where the patients were being treated, said: "I saw a young boy, about eight or nine years old, and his entire body had burn marks, black and brown marks, all across his body.
"The manager of the hospital told us when these patients came in, the emanated a very strong odour, which is one of the side effects of being affected by these chemical gases."
The hospital manager was "certain that some form of chemical gas has been used", our correspondent said.
So far, no investigation into the use of chemical weapons has been launched.
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lördag 25 februari 2017

Kim Jong Namin äkkikuoleman syy: hermokaasu

 http://www.dn.se/nyheter/varlden/nervgas-hittad-i-kim-jong-nams-ansikte/
 26.2. 2017

Flygplatsen i Kuala Lumpur undersöktes av tekniker efter giftmordet på Kim Jong-Nam. Arkivbild.

 DN
Enligt AP undersöker man nu om det finns rester av gasen på flygplatsen.
VX har tidigare förekommit i rapportering från kriget i Syrien. Det är en modern nervgas med högre giftverkan än nervgaserna sarin och tabun. VX är klassat som ett massförstörelsevapen av FN.
Gasen är smak- och luktlös, och i tillräckligt stora doser är den dödlig inom 15 minuter. Nordkorea tros ha det tredje största lagret av kemiska vapen, enligt Nuclear Threat Initiative project, som analyserar förekomsten av massförstörelsevapen, skriver Reuters.
Kim Jong Nam skulle på måndagen den 13 februari flyga till regionen Macao i södra Kina och togs efter överfallet först om hand i flygplatsens sjukrum. Han avled i ambulansen på väg till sjukhus.



25.2. 2017
Kim Jong Namin äkkikuoleman syyksi on osoittautunut kuolettava ihoannos VX hermokaasua. Otan sitaatin että tästä  anamneesista voi arvioida myrkyn määrän.

By Rozanna Latiff and Emily Chow | KUALA LUMPUR

VX nerve agent, a chemical the United Nations classifies as a weapon of mass destruction, was used to kill the estranged half-brother of North Korean leader Kim Jong Un in a bizarre murder in Malaysia last week, police said on Friday.
Kim Jong Nam was killed on Feb. 13, shortly after being assaulted at the airport in the Malaysian capital, Kuala Lumpur, by two women who wiped the chemical on his face as he prepared to board a flight to the Chinese territory of Macau. South Korean and U.S. officials have said they believe North Korean agents assassinated Kim Jong Nam. He had been living with his family in Macau under Beijing's protection and had spoken out against the North Korean regime.
Malaysian police were investigating whether the VX - which is believed to be the most toxic known nerve agent and is banned globally except for research - was brought into the country or made there.
"If the amount of the chemical brought in was small, it would be difficult for us to detect," police chief Khalid Abu Bakar told reporters. The two women suspects - one Vietnamese and the other Indonesian - are in police detention along with a North Korean man. Seven other North Koreans are wanted in connection with the case, including a diplomat at the embassy in Kuala Lumpur. Malaysia has repeatedly urged the victim's family to come forward to help with the inquiry, while North Korea has demanded the body be handed over to its embassy directly, sparking tension between the two usually friendly countries.
Malaysia's chemical weapons analysis unit found
traces of VX, or
S-2 Diisopropylaminoethyl methylphosphonothioate, on swabs taken from the eye and face of the victim, according to police.
"Other exhibits are under analysis," Khalid said in a statement, citing a preliminary report.
Police have said the two women were paid to carry out the assault and had been told to wash their hands before fleeing from the airport. They had rehearsed the attack in shopping malls before carrying it out on Kim. One of the women had suffered from the effects of the chemical and had been vomiting, Khalid said.
Airport camera footage released on Monday by Japanese broadcaster Fuji TV shows the moment they assaulted Kim Jong Nam. In later clips he is seen asking airport officials for medical help, and rubbing his eyes and stumbling as he entered an airport clinic. Authorities said he complained of dizziness and died on the way to hospital.
Authorities raided an apartment in an upscale Kuala Lumpur suburb on Wednesday in connection with the killing, but no chemicals were found, said an official with direct knowledge of the matter.
FATAL IN MINUTES
VX is tasteless and odorless, and is outlawed under the Chemical Weapons Convention, except for "research, medical or pharmaceutical purposes". It can be manufactured as a liquid, cream or aerosol.
Experts say it has no commercial uses.
"This is not something you make in a kitchen lab. This is something that is made in a very sophisticated chemicals weapons lab," said Bruce Bennet, a senior defense researcher at the California-based RAND Corporation.
North Korea is believed to have the world's third-largest stockpile of chemical weapons, according to the Nuclear Threat Initiative project, which analyses weapons of mass destruction.
South Korean analysts have identified sarin and VX as the focus of the North Korean chemical weapons program.
VX in liquid form can be absorbed into the body through skin or eye contact and does not evaporate easily.
After giddiness and nausea, exposure to VX quickly progresses to convulsions and respiratory failure before death, according to the U.S. Centers for Disease Control and Prevention (CDC).
It can be fatal after 15 minutes, according to the U.S. Army's Edgewood Chemical Biological Center.
Police chief Khalid said authorities intended to sweep Kuala Lumpur airport, and other locations the suspects had visited, for "radioactive" material.
VX is not known to contain radioactive elements and Reuters calls to police for clarification went unanswered
Malaysian authorities on Thursday requested Interpol to put an alert out to apprehend four North Korean suspects who are believed to have fled from Malaysia on the day of the attack.
They also want to question the second secretary at the North Korean embassy, though he has diplomatic immunity.
The murder has strained relations between North Korea, which has been increasingly isolated in response to its nuclear and missile programs, and Malaysia.
North Korea has said Malaysia should be held responsible for the killing of one of its citizens, though it has not acknowledged that the victim is the half brother of North Korean leader Kim Jong Un.
Malaysia has recalled its ambassador from Pyongyang for consultations.
(Additional reporting by Tom Allard, A. Ananthalakshmi, Liz Lee and Joseph Sipalan; Writing by Kanupriya Kapoor and Praveen Menon; Editing by Simon Cameron-Moore)

Mitä tarkoitttaa VX?
Tämä on erään tyypin hermokaasun merkintä.
Hermokaasut ovat kaikkein myrkyllisimpiä tunnetuista kemiallisista aseista (Internet. Center for Disease Control and Prevention, WHO). Ne voivat aiheuttaa kuoleman minuuttien kuluessa altistuksesta. Kokemuksia sariinimyrkytyspotilaiden hoitamisesta on saatu Japanissa kahden terrori-iskun yhteydessä sekä Irakin ja Iranin sodassa.

Sariinin lyhennys on GB, Tabuunin lyhennys on GA. Somaanin lyhennys on GD.
VX on metylfosfotionaatteja (USA:ssa ja UK:ssa tehty muoto on VX ja VXA on Neuvostoliitossa kehitetty muoto, VX Analogi).

Hermokaasut ovat toisin sanoen organofosfaatteja. Samaan ryhmään kuuluu myös hyönteismyrkkyjä, joista toksisimpia ovat atsinfossimetyyli, isofenfossi, oksidemetoni-metyyli ja sulfoteppi.

Elimistössä ne vaikuttavat erittäin nopeasti estämällä asetyylikoliiniesteraasia ( AKE- entsyymiä). Vaikutus on voimakas ja pitkäkestoinen. Seurauksena ovat asetyylikoliinin kertyminen ja kolinerginen ylistimulaatio sekä sentraalisesti että perifeerisesti.
Keskushermoston kautta välittyvinä oirfeina esiintyy yleistä heikkouden tunnetta, sekavuutta, hengityslamaus, vasomotorisen keskuksen lamaa, tajuttomuutta, kouristeluja, ataksiaa, levottomuutta, rauhattomuutta, ahdistuneisuutta ja puheen puuroutumista.
Perifeerisen hermoston muskariinireseptorien (M-reseptorit) kautta välittyviä oireita ovat mioosi(pieni pupilli), näön hämärtyminen, limaisuus, keuhkoputkien supistuminen, lisääntynyt syljeneritys, pahoinvointi, vatsakrampit, ripuli, hikoilu, bradykardia ( hidastunut sydämen rytmi) sekä virtsan -ja ulosteenpidätyskyvyttömyys. N-reseptorien eli nikotiinireseptorien kautta välittyviä, pääasiallisesti hermo-lihasliitoksen salpautumisesta johtuvia oireita ovat lihasnykäykset, faskikulaatiot (lihasvärinä), lihaskrampit, lihasheikkous, velttohalvaus, hengityslihasten toiminnan lama ja hikoilu.
Hermokaasumyrkytyksen aiheuttama kuolema johtuu hengityslihasten lamautumisesta ja samanaikaisesta hengityskeskuksen lamasta.
Tämä Duodecimin artikkeli esittää taulukkona lievän, kohtalaisen ja vaikean myrkytyksen oireita altistuksen tapahduttua keuhkojen tai ihon kautta.

Japanissa 1994 tapahtuneen ensimmäisen sariinihyökkäyksen (GB) jälkeen potilaat valittivat akuuttivaiheen aikana yleisimmin näköhäiriöitä, mioosia ja päänsärkyä. Pahoinvointi ja oksentelu ovat alkuoireina yleisiä, mutta ripuli on harvinainen.
Diagnoosi perustuu kliinisiin löydöksiin, tietoihin altistumisesta ja laboratoriolöydöksiin. Asetyylikoliiniesteraasin (AKE) aktiivisuus (punasoluissa) voidaan mitata, mutta muutokset eivät välttämättä korreloi oireiden vakavuuteen akuuttitilanteessa. Muina löytöinä voidaan todeta asidoosia hypoksian seurauksena, hyperglykemiaa adrenergisen stimulaation aiheuttamana ja muita oireista johtuvia sekundaarisia muutoksia. Varmuus tietystä altisteesta perustuu ilmaisulaitteiden antamaan tietoon (Internet: Environics) ja lopullisesti ympäristönäytteisiin. Ympäristönäytteiden vastaukset viipyivät Japanissa kuusi vuorokautta.
Hoidon kulmakivet ovat varhainen dekontaminaatio, hengityksen avustaminen ( hapen anto, ventilaatio) antidoottien -erityisesti atropiinin - anto ja mahdollisten kouristusten tehokas hoito. Altistuksen pikainen lopettaminen siirtämällä potilas puhtaalle alueelle, ihon puhdistus (dekontaminaatio) ja saastuneiden vaatteiden riisuminen niistä vapautuvien höyryjen poistamiseksi on tärkeää. Pelkän höyryaltistuksen jälkeen ei ihon peseminen ole välttämätöntä, mutta nestemäisen myrkyn positaminen keholta vaatii puhdistusta.

Atropiini kumoaa perifeeriset muskariinivaikutukset ( M-reseptorivaikutukset) . Kohtalaiset ilmatieoireet, bronkospasmi ja keuhkoputkieritteiden lisääntyminen hoidetaan atropiinilla. Sen alkuannos aikuiselle on yksi - kaksi milligrammaa (1- 2 mg/im) lihakseen tai mieluummin laskimoon (iv) . Annos voidaan uusia 5 – 10 minuutin välein, kunnes hengitys sujuu vaivatta. Potilaita, joilla on lieviä hengitysoireita, voidaan tarkkailla 15- 30 minuutin välein, kunnes hengitys on helppoa ja eritteet kuivumassa. Pelkkiin silmoireisiin kannattaa antaa paikallishoitoa.

Oksiimia( suomessa obidoksiimia) annetaan asetyylikoliiniesteraasin (AKE- entsyymin) vapauttamiseksi sitoutuneesta hermokaasusta. Ajan mittaan hermokaasun ja entsyymin sirdos muuttuu irreversibeliksi (palautumattomaksi) eli kompleksi ikääntyy. Ikääntymisen tapahduttua oksiimi ei enää pysty reaktivoimaan (uudelleen aktivoimaan) entsyymiä .
Somaani (GD) ikääntyy erittäin nopeasti (ikääntymisen puoliaika 2 minuuttia). Sariinilla(GB) ikääntymisen puoliaika on viisi tuntia ja tabuunilla (GA) ja VX:llä yli 40 tuntia.
Obidoksiimin alkuannos on 175 milligrammaa lihakseen (175 mg/im) ja lisäannos 200- 250 mg laskimoon (iv). Yleensä yksi lisäannos riittää. Jos tämän jälkeen vielä tarvitaan lisäannoksia, on syytä odottaa kaksi- neljä tunita ennen seuraavan annoksen antamista. Tulioss on H-oksiimit, jotka vaikuttavat tehokkaammilta.

Kouristusten hoitoon annetaan diatsepaamia 5- 10 mg laskimoon. Annos voidaan toistaa tarpeen mukaan.

Pelastajien on käytettävä asianmukaista suoja-asua välttyäkseen altistumasta itse. Sekundaarialtistuksen vaara on olemassa myös puhtaalla alueella erityisesti puhdistamattomista vaatteista leviävän höyryn vuoksi.
TAULUKKO hermokaasumyrkytyksen oireista.

AKUUTTI INHALAATIOALTISTUS

Lievät oireet pienelle annokselle altistumisen jälkeen
sekuntien tai minuuttien kuluttua altistuksesta:
Silmät ja nenä oireilevat eniten
Mioosi (pieniksi supisituneet silmän mustuaiset)
Hämärtynyt tai epäselvä näköhäiriö
Konjuktiviitti ( silmän sidekalvon tulehdus)
Nenän vuotaminen
Bronkokonstriktio, keuhkoputkien supistuma, ahdistava tunne rinnassa
Lievästi lisääntyneet bronkuseritteet (keuhkoputkieritteet, siis keuhkot limaiset )

Kohtalaiset oireet keskisuuren annoksen jälkeen
Ilman loppumisen tunne (kohtalainen tai huomattava dyspnea, hengityvaikeus)
Yskä
Hengityksen vinkuna
Pahoinvointi
Oksentelu
Lihasnykäykset
Yleinen heikkouden tunnetta

Vakavat oireet suurelle annokselle altistumisen jälkeen
sekuntien tai minuuttien kuluttua altistuksesta
Tajuttomuus
Kouristelu
Apnea (hengittämättömyys)
Velttolihashalvaus
Kuolema yleensä minuuttien kuluessa

AKUUTTI IHOALTISTUS hermokaasuille: oireet ja löydökset

Lievät oireet pienelle annokselle altistumisen jälkeen
10- 18 tuntia altistuksesta
Altistuskohdan paikallinen hikoilu
Altistuskohdassa vähäisiä lihasnykäyksiä
Mioosi ei ole varhaisoire nesteen joutuessa iholle, voi puuttua kokonaan

Kohtalaiset oireet keskisuuren annoksen jälkeen
Pahoinvointi
Oksentelu
Voimakas päänsärky
Koko kehon lihasnykäykset
Yleinen heikkouden tunnetta
Ei vielä hengityselimistön oireita tai löydöksiä

Vakavat oireet suurelle annokselle altistumisien jälkeen
(minuutteja - 1 tunti altistuksesta)
Äkillinen tajuttomuus
Kouristelu
Velttolihashalvaus
Apnea
Kuolema -
INTERNET aineistoja
Kemiallisen aseen kieltosopimus:

LÄHDE:
Vesa Riihimäki ja Irma Jousela. Kappale: Hermokaasut ( sivulta 471- 472) artikkelista Kemikaalien aiheuttama joukkomyrkytys. Duodecim 2004; 120: 465-76.
musitiin 25. 2. 2017
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