Nerve agent-induced acute poisoning: principles of medical management

Abstract

Chemical warfare agents represent an ever-lasting threat, not only for military forces but also for civilian populations as illustrated by the recent events in Syria. Nerve agents such as those used by Iraq during the Iran/Iraq war or by the Aum Shinri Kyo sect in Japan are among the deadliest of those non-conventional weapons. Their effects are mainly due to their ability to inhibit cholinesterases throughout the body. After a short review of the main characteristics of nerve agents and of the pathophysiology and clinical presentation of acute nerve agent poisoning, the general principles of clinical management will be reviewed.