Appendix A: Class VIII Medical Materiel

Based on the Joint Trauma System Clinical Practice Guideline (CPG) for arachnid and snake envenomation in military working dogs (MWDs), the following is a detailed medical materiel list tailored for field treatment and stabilization:

Medical Material List for MWD Envenomation

#### 1. Antivenom & Administration Supplies

Crotalidae Polyvalent Immune Fab (CroFab) or Crotalidae Immune F(ab)₂ Equine

- Used for North American pit viper envenomations.

Saudi Polyvalent Scorpion (Equine) F(ab)₂ Antivenom

- Used for specific scorpion envenomations.

Lactrodectus mactans antivenin

- Used for Black Widow Spider envenomations.

Additional antivenom products, if available and indicated.

Syringes and needles

#### 2. Additional Medications

Diphenhydramine HCl Injection

Dexamethasone Injection

Epinephrine Injection

Analgesics

- Opioids (e.g., fentanyl, morphine) for pain management.
- Avoid NSAIDs due to risk of coagulopathies.

Gastroprotectants

- Omeprazole
- Pantoprazole

Antibiotics

- Broad-spectrum antibiotics (e.g., amoxicillin-clavulanate, cephalosporins) if significant tissue necrosis or infection is present.

#### 3. Fluids & IV Equipment

Crystalloid Fluids

9% Sodium Chloride or Lactated Ringer’s Solution.

IV Pump

IV Catheters and Administration Sets

- Clippers and chlorhexidine scrub (IV catheter site preparation)
- Medical tape

#### 4. Monitoring & Diagnostic Tools

Vital Signs Monitoring Equipment

- Thermometer, stethoscope, pulse oximeter, and blood pressure cuff suitable for canines.

Laboratory Supplies

Equipment for Complete Blood Count (CBC), blood chemistry panel, and urinalysis.

#### 5. Wound Management Supplies (if indicated)

Bandages and Dressings

- For example: sterile gauze, island dressings, cast padding, roll gauze, elastic wraps.

Antiseptics

- For cleaning periwound skin.

Surgical Instruments

- Hemostats, scissors, forceps, and scalpel blades for wound care +/- debridement.

Sterile gloves

#### 6. Airway Management Equipment

Oxygen Delivery Systems

- Endotracheal tubes as appropriate.
- Laryngoscope
- Bag valve mask (if manual ventilation required).
- Oxygen canisters or oxygen concentrator with appropriate tubing.

This comprehensive list ensures preparedness for managing arachnid and snake envenomation cases in military working dogs, aligning with established clinical guidelines and field practices.

For additional information including National Stock Number (NSN), please contact dha.ncr.med-log.list.lpr-cps@health.mil

DISCLAIMER: This is not an exhaustive list. These are items identified to be important for the care of combat casualties.