Nerve Agent Exposure Author: Elliot Rodriguez, MD, FACEP; Christine M. Stork, PharmD, DABAT
Editorial changes - 2009-12-01
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  • Consider endotracheal intubation and supplemental oxygen as needed in patients with neurocognitive dysfunction or respiratory insufficiency.
  • Initiate decontamination of exposed patients as soon as possible before or at presentation to the emergency department.

Consider endotracheal intubation and supplemental oxygen as needed in patients with neurocognitive dysfunction or respiratory insufficiency. C

  • Consider intubation, mechanical ventilation, and supplemental oxygen in patients with:
    • Excessive respiratory secretions
    • Inadequate respiratory effort due to muscle weakness
    • Decreased oxygenation
    • Central nervous system depression
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Initiate decontamination of exposed patients as soon as possible before or at presentation to the emergency department. C

  • In patients not previously decontaminated:
    • Remove all clothing and jewelry
    • Initiate copious irrigation of skin with water and then soap and water; urge patients to decontaminate themselves if at all possible
    • Double bag all clothing and jewelry
    • Dry and redress the patient in nonexposed items
  • Be aware that if exposure is to vapor only, skin decontamination is not necessary.
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FAQs
Christine M. Stork, PharmD, DABAT has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Elliot Rodriguez, MD, FACEP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Jerrold B. Leikin, MD, editorial consultant, received royalties from McGraw-Hill, Taylor and Francis; editor of Toxicoterrorism (McGraw-Hill).
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given.

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