Patients exposed to nerve gas agents need to be rapidly triaged and appropriate therapy initiated. Patients are initially separated based on the clinical severity at the time of presentation.
Features of nerve gas exposure:
(1) Absorption may follow inhalation, ingestion or dermal exposure.
(2) The onset of symptoms may be abrupt and follow an asymptomatic interval of up to 18 hours.
Clinical Severity
Appearance
Signs and Symptoms
light
person able to walk
lacrimation, tearing
salivation
nasal discharge
miosis
blurred vision
stenocardia (angina pectoris)
sweating
nausea and vomiting
abdominal pain
moderate
person unable to walk but breathing spontaneously
findings above, plus
dyspnea
wheezing
feeling of weakness
tremor, muscle fasciculations
diarrhea
urinary frequency
generalized muscle fasciculations (*)
incontinence of stool and/or urine (*)
loss of consciousness, coma (*)
severe
person not breathing
findings above, plus
respiratory failure, apnea
epileptic seizures
flaccid paralysis
(*) These symptoms seem to be moderate-to-severe. They are listed as signs of severe exposure in Table 59-6, page 1271, Ellenhorn (1997).
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