title: Chemical warfare. Nerve agent poisoning.
abstract: The threat of civilian and military casualties from nerve agent exposure has become a greater concern over the past decade. After rapidly assessing that a nerve agent attack has occurred, emphasis must be placed on decontamination and protection of both rescuers and medical personnel from exposure. The medical system can become rapidly overwhelmed and strong emotional reactions can confuse the clinical picture. Initially, care should first be focused on supportive care, with emphasis toward aggressive airway maintenance and decontamination. Atropine should be titrated, with the goal of therapy being drying of secretions and the resolution of bronchoconstriction and bradycardia. Early administration of pralidoxime chloride maximizes antidotal efficacy. Benzodiazepines, in addition to atropine, should be administered if seizures develop. Early, aggressive medical therapy is the key to prevention of the morbidity and mortality associated with nerve agent poisoning.
authors.affiliation: Indiana Poison Center, Indiana University School of Medicine, Indianapolis, USA.
authors.forename: C P
authors.initials: CP
authors.lastname: Holstege
authors.forename: M
authors.initials: M
authors.lastname: Kirk
authors.forename: F R
authors.initials: FR
authors.lastname: Sidell
mesh_terms: D000818:Animals; D002619:Chemical Warfare Agents / Q000506:poisoning*; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D003666:Decontamination; D004189:Disaster Planning; D004632:Emergency Medical Services; D006801:Humans; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000628:therapy*; D062025:Organophosphate Poisoning; D010755:Organophosphates; D009946:Organothiophosphorus Compounds / Q000506:poisoning; D012524:Sarin / Q000506:poisoning; D012999:Soman / Q000506:poisoning
chemical_list: D002619:Chemical Warfare Agents; D002800:Cholinesterase Inhibitors; D010755:Organophosphates; D009946:Organothiophosphorus Compounds; D012524:Sarin; D012999:Soman; C009680:VX-agent; C009374:tabun