Cholinergic symptoms due to nerve agent attack: A strategy for management

Anesthesiology Clinics of North America

Volumn 22, Issue 3, 2004, Pages 579-590

  Schecter, William P ^a  

^a SAN FRANCISCO GENERAL HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDOTE; ATROPINE; BENZODIAZEPINE; CHEMICAL WARFARE AGENT; CHOLINERGIC RECEPTOR BLOCKING AGENT; CYCLOSERINE; DIAZEPAM; LORAZEPAM; MIDAZOLAM; ORGANOPHOSPHATE; OXIME DERIVATIVE; PRALIDOXIME CHLORIDE; SARIN; SOMAN; TABUN;

AMNESIA; BRONCHOSPASM; CLINICAL FEATURE; COMA; CONFUSION; CORRELATION ANALYSIS; DIARRHEA; DRUG EFFECT; DRUG HALF LIFE; DRUG MECHANISM; EXPOSURE; EYE PAIN; FASCICULATION; FIRST AID; HEALTH CARE; HEALTH CARE SYSTEM; HUMAN; HYPERTENSION; INTOXICATION; MEDICAL RESEARCH; MIOSIS; NAUSEA; NEUROTOXICITY; PREMEDICATION; REVIEW; RHINORRHEA; RISK ASSESSMENT; SEIZURE; STATISTICAL SIGNIFICANCE; SYNTHESIS; TACHYCARDIA; TECHNIQUE; VISUAL DISORDER; VOMITING;

CHEMICAL WARFARE AGENTS; CHOLINESTERASE INHIBITORS; EMERGENCY MEDICAL SERVICES; HUMANS; PARASYMPATHETIC NERVOUS SYSTEM;

EID: 4344568779     PISSN: 08898537     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.atc.2004.04.005     Document Type: Review

References (27)

1. Sidell F.R. Nerve agents. Sidell F.R., Takafuji E.T., Franz D.R. Medical aspects of chemical and biological warfare. Textbook of military medicine series. Part 1, Warfare, weaponry and the casualty. 1997;130 Borden Institute, Walter Reed Army Medical Center, Washington DC
2. Augerson W.S. Nerve Agents. A review of the scientific literature as it pertains to gulf war illnesses vol 5. Chemical and biological warfare agents. Available at http://www.gulflink.osd.mil/medsearch/FocusAreas/chemical_warfare. shtml. Accessed June 13, 2004
3. Lenthall J. Vx Gas. Available at http://www.chemoox.ac.uk/mom/vx/VX.htm.
4. Rotenberg J.S., Newmark J. Nerve agent attacks on children: diagnosis and management. Pediatrics. 112:2003;648-658
5. US Department of State, Bureau of Public Affairs. Saddam's Chemical Weapons Campaign: Halabja, March 16, 1988. Available at http://www.nbc-med.org/ SiteContent/MedRef/OnlineRef/FieldManuals/fm8_285/PART_I/chapter2.htm. Accessed June 13, 2004
6. US Department of Defense. Report on Demolition at the Khamisiyah Complex. Available at http://www.gulflink.osd.mil/library/randrep/bw_paper/. Accessed June 13, 2004
7. Ohbu S., Yamashina A., Takasu N., Yamaguchi T., Murai T., Nakano K., et al. Sarin Poisoning on Tokyo Subway. South Med J. 90:1997;587-593
8. Morita H., Yanagisawa N., Nakajima T., Shimizu M., Hirabayashi H., Okudera H., et al. Sarin poisoning in Matsumoto, Japan. Lancet. 346:1995;290-293
9. deJong R.H. Nerve gas terrorism: a grim challenge to anesthesiologists. Anesth Analg. 96:2003;819-825
10. NATO Manual. FM8-285-Part I: Chapter 2, Nerve Agents. Available at http://www.nbc-med.org/SiteContent/Med Ref/OnlineRef/FieldManuals/fm8_285/ Part_I/chapter2.htm. Accessed June 13, 2004
11. Nerve Agent Exposure Protocol. Available at http://www.cmemsc.org/ protocols-state/wmd-protocols-intro.pdf. Accessed June 13, 2004
12. Mitretek Systems. Toxicological Properties of Nerve Agents. Available at http://www.mitretek.org/home.nsf/HomelandSecurity/NerveAgents. Accessed June 13, 2004
13. Nakajima T., Ohta S., Fukushima Y., Yanagisawa N. Sequelae of Sarin toxicity at one and three years after exposure in Matsumoto, Japan. J Epidemiol. 9:1999;337-343
14. Nishiwaki Y., Maekawa K., Ogawa Y., Asukai N., Minami M., Omae K. Effects of Sarin on the nervous system in rescue team staff members and police officers three years after the Tokyo subway Sarin attack. Environ Health Perspect. 109:2001;1169-1173
15. Holstege C.P., Kirk M., Sidell F.R. Chemical Warfare: nerve agent poisoning. Crit Care Clin. 13:1997;923-942
16. Arad M., Berkenstadt H., Zehlinger J., Laor A., Shemer J., Atsmon J. The effects of continuous operation in a chemical protective ensemble on the performance of medical tasks in trauma management. J Trauma. 35:1998;800-804
17. Berkenstadt H., Arad M., Nahtomi O., Atsmon J. The effect of a chemical protective ensemble on intravenous line insertion by emergency medical technicians. Mil Med. 164:1999;737-739
18. Berkenstadt H., Ziv A., Barsuk D., Levine I., Cohen A., Vardi A. The use of advanced simulation in the training of anesthesiologists to treat chemical warfare casualties. Anesth Analg. 96:2003;1739-1742
19. Sidell F.R. Nerve agents. Sidell F.R., Takafuji E.T., Franz D.R. Medical aspects of chemical and biological warfare. Textbook of military medicine series. Part 1, Warfare, weaponry and the casualty. 1997;160 Borden Institute, Walter Reed Army Medical Center, Washington DC
20. Brain N.J. Nerve Agents. Available at http://www.alpharubicon.com/ basicnbc/nerveagents.htm. Accessed June 13, 2004
21. Sidell F.R. Nerve Agents. Sidell F.R., Takafuji E.T., Franz D.R. Medical aspects of chemical and biological warfare. Textbook of military medicine series. Part 1, Warfare, weaponry and the casualty. 1997;162 Borden Institute, Walter Reed Army Medical Center, Washington DC
22. Dunn M.A., Hackeley B.E. Jr., Sidell F.R. Pretreatment for nerve agent exposure. Sidell F.R., Takafuji E.T., Franz D.R. Medical aspects of chemical and biological warfare. Textbook of military medicine series. Part 1, Warfare, weaponry and the casualty. 1997;183 Borden Institute, Walter Reed Army Medical Center, Washington DC
23. Dunn M.A., Hackeley B.E. Jr., Sidell F.R. Pretreatment for nerve agent exposure. Sidell F.R., Takafuji E.T., Franz D.R. Medical aspects of chemical and biological warfare. Textbook of military medicine series. Part 1, Warfare, weaponry and the casualty. 1997;185 Borden Institute, Walter Reed Army Medical Center, Washington DC
24. Nerve Agent Exposure Protocol. Available at http://www.cmemsc.org/ protocols-state/wmd-protocols-intro.pdf. (page 1)Accessed June 13, 2004
25. Nerve Agent Exposure Protocol. Appendix T Nerve Agent Dosing and Reference Tables, page 3 http://www.cmemsc.org/protocols-state/wmd-protocols- intro.pdf. Accessed June 13, 2004
26. Agency for Toxic Substances and Disease Registry. Medical Management Guidelines (MMG) for Nerve Agents: Tabun (GA); Sarin (GB); Soman (GD);and VX. Available at http://www.atsdr.cdc.gov./MHM/mmg166.html. Accessed February 11, 2004
27. Ben Abraham R., Rudick V., Weinbroum A.A. Practical guidelines for acute care of victims of bioterrorism: conventional injuries and concomitant nerve agent intoxication. Anesthesiology. 97:2002;989-1004