Biological and Chemical Impaled UXO

While there are no documented cases of combat patients with loose or impaled UXO containing chemical or biological agents, it is conceivable that ordnance containing these agents could become impaled in a patient. Current doctrine states that it is a “command decision,” on how to manage the patient.1 However, it does not state if this is the local senior medical unit commander or local senior combatant commander that makes the decision whether to make the patient expectant or to provide full care. If the decision is made to provide full care and attempt to remove the agent containing UXO, individuals involved should be fully protected. All participating staff will need to wear available biological-chemical protective gear to include mask, body suit, boots, and gloves under their body armor if attempting to remove the ordnance. Ordnance containing chemical or biological agents usually has a much lower explosive force than traditional high-explosive or fragmentation ordnance to prevent destruction of the agents, and therefore the treating staff is at a lower risk of injury from a blast if the ordnance were to detonate. Therefore, there is more of a risk from contamination than blast when compared to a traditional high-explosive or fragmentation munitions. Agent containing ordnance should immediately be handed over to EOD followed by decontamination of the patient and medical staff when necessary before moving to the main treatment facility for further treatment.1