Capability 1: Chemical Weapon and Toxic Industrial Antidote Administration

The first capability of the Hampton Roads Metropolitan Medical Strike Team’s (HRMMST) is Chemical Weapon and Toxic Industrial Antidote Administration. In the
mid to late 90’s, the emphasis of the Metropolitan Medical Response System (MMRS) was to respond to a terrorist attack involving chemical weapons; specifically, nerve agents.
Nerve agents are chemicals that affect the nervous system. The health effects are similar to those produced by some pesticides. The main nerve agents are the chemicals sarin (GB),
soman (GD), tabun (GA) and VX. These agents are man-made and have been manufactured for use in chemical warfare.

The Hampton Roads Metropolitan Medical Response System (HRMMRS) oversees a regional cache of Weapons of Mass Destruction (WMD) Antidote Kits. Each kit contains
30 – DuoDote Auto-Injectors (pralidoxime 600 mg/2 ml + atropine 2.1 mg/0.7 ml) and three – sets of TEMS/PEMS Regional Medical Protocols on CBRNE (Nerve Agents –
Adult; Nerve Agents – Pediatric). The WMD Antidote Kits are issued to licensed emergency medical services agencies and stored in locked cabinets in stations, EMS vehicles or HRMMST equipment trailers, or in hospital pharmacies without CHEMPACKs. Additional information regarding the WMD Antidote Kits can be found by visiting and clicking on the 2013 WMD Antidote Familiarization Course.

Nerve agent poisoning can be treated by all members of the HRMMST, who are trained in using DuoDote autoinjectors. This autoinjection quickly injects the antidotes into muscular areas like the thigh or buttock. Repeated use of antidotes may be needed to treat some nerve agent victims. It might also be necessary to give nerve agent victims other drugs to control seizures or other effects. The HRMMST is also positioned to deploy assets from the CHEMPACKs located throughout the region. The CHEMPACK program is an ongoing initiative of the Centers for Disease Control and Prevention's (CDC) Division of Strategic National Stockpile (SNS) launched in 2003, which provides antidotes to nerve agents for pre-positioning by state, local, and/or tribal officials throughout the United States. The CHEMPACK Program is envisioned as a comprehensive capability for the effective use of medical countermeasures in the event of an attack on civilians with nerve agents.

Additionally, the HRMMST, in cooperation with the Southside and Peninsula Regional Hazardous Materials Teams, helped to review and revise the contents of the regional hazardous materials drug box and support box. Antidotes are stored in these boxes and are readily available to treat members of the hazardous materials (HAZMAT) teams from exposure to chemicals such as, cyanide, fluoric acid, and phenol. Guidance on the use of these antidotes can be found in Appendix J of the TEMS Regional Protocols.

Last modified on Friday, 30 December 2016 20:34
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Our Location


Our office is co-located with the Tidewater Emergency Medical Services Council (TEMS) at 1104 Madison Plaza, Chesapeake, Virginia 23320.


Our History

The HRMMRS began as a DHS Grant Program in 1999. The HRMMRS continues to support & enhance Hampton Roads public safety, hospital, public health, & emergency management response capabilities to manage mass casualty incidents.


Our Vision

Sustain regional emergency medical response capabilities with MMRS & SHSP grants for the next 10 years.

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