Treating exposure to chemical warfare agents: Implications for health care providers and community emergency planning
- Oak Ridge National Lab., TN (USA)
Current treatment protocols for exposure to nerve and vesicant agents found in the US stockpile of unitary chemical weapons are summarized, and the toxicities of available antidotes are evaluated. The status of the most promising of the new nerve agent antidotes is reviewed. In the US, atropine and pralidoxime compose the only approved antidote regimen for organophosphate nerve agent poisoning. Diazepam may also be used if necessary to control convulsions. To avoid death, administration must occur within minutes of substantial exposure together with immediate decontamination. Continuous observation and repeated administration of antidotes are necessary as symptoms warrant. Available antidotes do not necessarily prevent respiratory failure or incapacitation. The toxicity of the antidotes themselves and the individualized nature of medical care preclude recommending that autoinjectors be distributed to the general public. In addition, precautionary administration of protective drugs to the general population would not be feasible or desirable. No antidote exists for poisoning by the vesicant sulfur mustard (H, HD, HT); effective intervention can only be accomplished by rapid decontamination followed by palliative treatment of symptoms. British anti-Lewisite (BAL) (2,3-dimercapto-1-propanol) is the antidote of choice for treatment of exposure to Lewisite, another potent vesicant. Experimental water-soluble BAL analogues have been developed that are less toxic than BAL. Treatment protocols for each antidote are summarized in tabular form for use by health care providers.
- DOE Contract Number:
- AC05-84OR21400
- OSTI ID:
- 5624027
- Journal Information:
- Environmental Health Perspectives; (USA), Journal Name: Environmental Health Perspectives; (USA) Vol. 89; ISSN 0091-6765; ISSN EVHPA
- Country of Publication:
- United States
- Language:
- English
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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ALKALOIDS
AMINES
ATROPINE
AUTONOMIC NERVOUS SYSTEM AGENTS
BIOLOGICAL EFFECTS
CHEMICAL WARFARE
CLEANING
DECONTAMINATION
DRUGS
EMERGENCY PLANS
HEALTH SERVICES
HUMAN POPULATIONS
HYDROXY COMPOUNDS
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ORGANIC NITROGEN COMPOUNDS
ORGANIC PHOSPHORUS COMPOUNDS
ORGANIC SULFUR COMPOUNDS
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POPULATIONS
PUBLIC HEALTH
SOCIAL SERVICES
THERAPY
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WARFARE