NCJ Number
190974
Date Published
2001
Length
32 pages
Annotation
This article examines chemical terrorism and warfare agents, antidotes, and dealing with a chemical exposure incident.
Abstract
Nerve agents are toxic materials that produce injury or death in seconds to minutes; they are similar to insecticides but more toxic. Common nerve agents (with military designations) include tabun (GA), sarin (GB), soman (GD), and GF and VX, which have no common names. Management of nerve agent exposure consists of decontamination, administration of antidotes, and ventilation. Very good antidotes are available for nerve agents, but they must be administered quickly. The antidotes for nerve agent poisoning are atropine and an oxime, 2-pyridoxime chloride or PAMC1 (Protopam). Cyanide can cause serious illness and death within minutes. Treatment of cyanide poisoning includes amyl nitrite perle, or sodium nitrite IV and sodium thiosulfate IV. Patients should be ventilated with oxygen and acidosis should be corrected. Vesicants are agents that cause vesicles or blisters; the most common are sulfur mustard and lewisite. Patients must be decontaminated immediately and the eyes irrigated. Pulmonary agents produce pulmonary edema. The best-known agents are phosgene and chlorine. Initial treatment includes keeping the patient at rest and administering oxygen. Riot control agents include tear gas (CS), Mace (CN), and pepper spray. They cause pain, burning, and irritation to body surfaces, but the effects last only a few minutes after the patient is removed to fresh air. The use of oxygen is indicated. Early responders must quickly evaluate the scene, don protective equipment, and triage all patients to determine treatment categories. Rapid therapeutic intervention is needed only for nerve agents and cyanide. Figures, tables