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Exposure to Nerve Gas

Exposed to Nerve Agents


Presentation

  • The research is being presented at the American Heart Association's High Blood Pressure Research 2010 Scientific Sessions, being held in Washington, D.C., Oct. 13-16, 2010. Story Source: Materials provided by American Heart Association .[sciencedaily.com]
  • (contrast with Bradycardia in adults) Apnea Seizure Adults - common presentations Cholinergic Muscarinic affects are prominent Excessive Salivation and Lacrimation Urination and Defecation Cholinergic Nicotinic affects are also present Muscle fasciculations[fpnotebook.com]
  • The use of nerve agents as a lethal weapon by radical political groups and unstable governments is a clear and present danger. Starting in the 1980’s, the Iraqi military used tabun against Iran.[countervailcorp.com]
  • When sarin is present, the build up of acetyl-cholinesterase results in the accumulation of excessive concentrations of acetylcholine in nerve synapses.[encyclopedia.com]
  • Ultimately, this sad situation presents no simple answers.[futurism.com]
Fatigue
  • Among reported symptoms are chronic fatigue, diarrhea, migraines, dizziness, memory problems, loss of muscle control and loss of balance. "We have to presume that the illnesses the veterans have are related to that exposure.[ourmidland.com]
  • People who have been exposed to small levels of sarin usually recover completely, but fatigue, irritability, nervousness and memory problems could last for weeks.[voanews.com]
  • Fatigue, irritability, nervousness, and memory deficits may persist as long as six weeks after the exposure. Those with mild-to-moderate nerve agent exposure usually recover completely.[publichealth.va.gov]
  • GWI presents a bewildering array of debilitating symptoms, including chronic fatigue, widespread pain, cognitive and memory problems, skin rashes, gastrointestinal and respiratory difficulties, that can persist for decades.[blogs.scientificamerican.com]
  • No less to the point, survivors of the attack in Japan still say they suffer from impaired vision and fatigue. FILE - Subway passengers affected by sarin gas planted in central Tokyo subways are carried into St.[haaretz.com]
Falling
  • PlantForm launched its Ebola project last fall with some funding provided by the National Research Council Canada’s Industrial Research Assistance Program (IRAP), and is now working to produce three drug candidates at its Guelph facility to send to USAMARIID[aginnovationontario.ca]
  • Munitions, devices and other equipment specifically designed to weaponise toxic chemicals also fall under the definition of chemical weapons.[opcw.org]
Swelling
  • Eyes will swell, tear and possibly go blind a few hours after exposure, and when inhaled or ingested, victims will experience sneezing, hoarseness, coughing up blood, abdominal pain and vomiting. But exposure to mustard gas is not always fatal.[nationalinterest.org]
Cough
  • Symptoms of acute, high-dose nerve agents include: coughing and breathing problems, loss of consciousness, seizures, paralysis, and coma and potentially death from respiratory/nervous system failure.[publichealth.va.gov]
  • Initial likely symptoms of coughing, choking, tightness in the chest, nausea, and occasionally vomiting occur minutes after exposure. This may seem quick but it actually means that victims continue to inhale it until symptoms become apparent.[nationalinterest.org]
  • Fasciculations at site of exposure to liquid Following systemic absorption Tightness in chest, with prolonged wheezing expiration suggestive of bronchoconstriction or increased secretion; dyspnoea, slight pain in chest; increased bronchial secretion; cough[emro.who.int]
  • Symptoms may start immediately if you have inhaled or been exposed to higher amounts of nerve gas: Runny nose and eyes Small pupils or blurry vision Coughing, chest tightness, wheezing, or shortness of breath Nausea and vomiting Abdominal pain or diarrhea[drugs.com]
  • Mouth, nose, and lungs: cough, drooling, runny nose, rapid breathing, chest tightness. Skin: excessive sweating. Digestion: nausea, vomiting, abdominal pain, increased urination. Cardiovascular: abnormal blood pressure and heart rate, weakness.[thisisinsider.com]
Dyspnea
  • Symptoms & Effects Depending on the degree of intoxication, symptoms may include: Nervousness and/or restlessness Miosis (contraction of the pupil) Rhinorrhea (runny nose) Excessive salivation Dyspnea (difficulty in breathing due to bronchoconstriction[besurvival.com]
  • Grading: Severity of exposure (used to dose antidote) Vapor Exposure (Effect in seconds, Peaks in minutes) Low Exposure Miosis Rhinorrhea Dyspnea High Exposure Altered Level of Consciousness Seizure s Apnea Flaccid Paralysis Death Liquid Exposure Small[fpnotebook.com]
Rhinorrhea
  • […] secretions) Sweating Bradycardia (slow heartbeat) Tachycardia (fast heartbeat) Loss of consciousness Convulsions Flaccid paralysis Loss of bladder and bowel control Apnea (breathing stopped) The onset of rhinorrhea and difficulty breathing is usually[besurvival.com]
  • Grading: Severity of exposure (used to dose antidote) Vapor Exposure (Effect in seconds, Peaks in minutes) Low Exposure Miosis Rhinorrhea Dyspnea High Exposure Altered Level of Consciousness Seizure s Apnea Flaccid Paralysis Death Liquid Exposure Small[fpnotebook.com]
Nausea
  • Signs that the nerve gas gets into the brain include; anxiety, confusion, dizziness, nausea, vomiting, seizures and respiratory depression. Death is usually the result of respiratory failure. This occurs by 2 routes.[sites.duke.edu]
  • Symptoms of acute, low-dose nerve agent exposure include: runny nose, chest tightness, "pinpoint" or abnormally constricted pupils, excessive salivation and sweating, abdominal cramps, muscle twitching, visual disturbances, headache, slurred speech, nausea[publichealth.va.gov]
  • Following systemic absorption Tightness in chest, with prolonged wheezing expiration suggestive of bronchoconstriction or increased secretion; dyspnoea, slight pain in chest; increased bronchial secretion; cough; pulmonary oedema; cyanosis Anorexia; nausea[emro.who.int]
  • Sarin gas: a deadly nerve agent Symptoms of exposure to the agent include nausea and violent headaches, blurred vision, drooling, muscle convulsions, respiratory arrest and loss of consciousness, the CDC says.[dailymail.co.uk]
  • Longer exposures result in tightness of the chest, headache, cramps, nausea, vomiting, involuntary defecation and urination, convulsions, coma, and respiratory arrest. Atropine acts an antidote for nerve agent, including sarin.[encyclopedia.com]
Vomiting
  • Signs that the nerve gas gets into the brain include; anxiety, confusion, dizziness, nausea, vomiting, seizures and respiratory depression. Death is usually the result of respiratory failure. This occurs by 2 routes.[sites.duke.edu]
  • Digestion: nausea, vomiting, abdominal pain, increased urination. Cardiovascular: abnormal blood pressure and heart rate, weakness.[thisisinsider.com]
  • If these nerve agents have been swallowed, do not induce vomiting or give fluids to drink. Seek medical attention immediately.[emro.who.int]
  • If ingested, do not induce vomiting or flush with fluids. Medical care should be sought immediately. Antidotes are available in many hospitals. Timeline: 1938 - Sarin is developed in Germany as a pesticide.[edition.cnn.com]
  • The nose runs, the eyes cry, the mouth drools and vomits, and bowels and bladder evacuate themselves. It is not a dignified state. Since sarin has no smell or taste, the person may very well have no idea what's going on.[theatlantic.com]
Diarrhea
  • Among reported symptoms are chronic fatigue, diarrhea, migraines, dizziness, memory problems, loss of muscle control and loss of balance. "We have to presume that the illnesses the veterans have are related to that exposure.[ourmidland.com]
  • Symptoms may start immediately if you have inhaled or been exposed to higher amounts of nerve gas: Runny nose and eyes Small pupils or blurry vision Coughing, chest tightness, wheezing, or shortness of breath Nausea and vomiting Abdominal pain or diarrhea[drugs.com]
  • People exposed to these pesticides may experience excessive salivation, tears and sweat, diarrhea, urination, small (constricted) pupils and pulmonary edema , a condition caused by fluid in the lungs, which can lead to death, Nelson said.[livescience.com]
  • “If they’re diagnosed with fibromyalgia or had chronic diarrhea for the past four or five years, it’s considered service-connected. It’s presumptive under the law for Gulf War veterans—even if they can’t diagnose the cause.[newsweek.com]
  • Symptoms of mild to moderate exposure include: (from the CDC) Runny nose Watery eyes Small, pinpoint pupils Eye pain Blurred vision Drooling and excessive sweating Cough Chest tightness Rapid breathing Diarrhea Increased urination Confusion Drowsiness[edition.cnn.com]
Abdominal Pain
  • Symptoms may start immediately if you have inhaled or been exposed to higher amounts of nerve gas: Runny nose and eyes Small pupils or blurry vision Coughing, chest tightness, wheezing, or shortness of breath Nausea and vomiting Abdominal pain or diarrhea[drugs.com]
  • Digestion: nausea, vomiting, abdominal pain, increased urination. Cardiovascular: abnormal blood pressure and heart rate, weakness.[thisisinsider.com]
  • pain Slow or fast heart rate Symptoms of severe exposure include: Loss of Consciousness Convulsions Paralysis Respiratory failure possibly leading to death.[edition.cnn.com]
  • Symptoms of nerve agent poisoning include: Neuromuscular Effects Autonomic Nervous System Effects Central Nervous System Effects Twitching Weakness Paralysis Respiratory failure Reduced Vision Small pupil size Drooling Sweating Diarrhea Nausea Abdominal[faculty.washington.edu]
  • Eyes will swell, tear and possibly go blind a few hours after exposure, and when inhaled or ingested, victims will experience sneezing, hoarseness, coughing up blood, abdominal pain and vomiting. But exposure to mustard gas is not always fatal.[nationalinterest.org]
Abdominal Cramps
  • Symptoms of acute, low-dose nerve agent exposure include: runny nose, chest tightness, "pinpoint" or abnormally constricted pupils, excessive salivation and sweating, abdominal cramps, muscle twitching, visual disturbances, headache, slurred speech, nausea[publichealth.va.gov]
  • Symptoms include: Dilated pupils Headache Sense of pressure Salivation Runny nose or congestion Nausea Vomiting Tightness in chest Anxiety Mental confusion Nightmares Weakness Tremors or twitches Involuntary defecation or urination Abdominal cramps Diarrhea[thoughtco.com]
  • cramps; epigastric and substernal tightness with “heartburn” and eructation; diarrhoea; tenesmus; involuntary defecation Increased/excessive sweating Increased/excessive salivation Increased/excessive lacrimation Bradycardia Slight miosis, occasionally[emro.who.int]
Cyanosis
  • […] exposure to liquid Following systemic absorption Tightness in chest, with prolonged wheezing expiration suggestive of bronchoconstriction or increased secretion; dyspnoea, slight pain in chest; increased bronchial secretion; cough; pulmonary oedema; cyanosis[emro.who.int]
Chest Pain
  • pains, and an increase in the production of saliva.[osha.gov]
Drooling
  • The victim will next have difficulty breathing, and will experience nausea and drooling.[24.wikia.com]
  • The nose runs, the eyes cry, the mouth drools and vomits, and bowels and bladder evacuate themselves. It is not a dignified state. Since sarin has no smell or taste, the person may very well have no idea what's going on.[theatlantic.com]
  • […] contractile strength Bronchi--contraction GI/GI---Smooth muscle sphincters---causes relaxation and contraction Skeletal muscle----NM endplates---contraction Nerve Gas symptoms cont-- Runny nose bronchial secretions Tightness of chest dimming of vision drooling[quizlet.com]
  • Our mouths drool and our noses drip uncontrollably, and our eyes tear and leak – not that we can see ourselves doing this in the mirror, because our vision blurs as our pupils contract.[haaretz.com]
  • Sarin gas: a deadly nerve agent Symptoms of exposure to the agent include nausea and violent headaches, blurred vision, drooling, muscle convulsions, respiratory arrest and loss of consciousness, the CDC says.[dailymail.co.uk]
Foaming at the Mouth
  • Then, as some images from yesterday’s attack reveal, victims will often then foam around the mouth. “This is very, very common,” he said. Syrian doctors treat a child following a chemical weapons attack.[nypost.com]
  • YouTube/Shajul Islam Other victims were seen foaming at this mouth, another possible symptom of nerve-agent exposure.[nytimes.com]
  • Images from the rebel-held town of Khan Sheikhun showing victims suffering convulsions, breathing problems and foaming at the mouth have shocked the world.[dailymail.co.uk]
  • But doctors from the Syrian-American Medical Society (SAMS) who are in the area say victims exhibited “constricted (or ‘pinpoint’) pupils, foaming at the mouth, and the loss of consciousness, slow heart rate, slow breathing, vomiting, muscles spasms and[newscientist.com]
  • HALEY SLAMS RUSSIA OVER SYRIAN CHEMICAL ATTACK, WARNS US MAY TAKE 'OUR OWN ACTION' Videos and witness accounts of victims in respiratory distress and foaming at the mouth seem to indicate that sarin is the culprit. Fox News medical analyst Dr.[foxnews.com]
Hypersalivation
  • Atropine sulfate blocks the muscarinic effects of acetylcholine that cause bronchorrhoea, hypersalivation, bronchoconstriction and bradycardia, thereby reducing these effects.[emro.who.int]
Blurred Vision
  • Symptoms may include: “pinpoint” pupils and blurred vision; difficulty breathing; muscle twitching; excess saliva and other secretions; impaired judgment, seizures and unconsciousness.[voanews.com]
  • Immediate signs of sarin exposure include runny nose , watery eyes, constricted (or pinpoint) pupils, blurred vision, excessive sweating, chest tightness, rapid breathing and altered heart rate.[abcnews.go.com]
  • Sarin gas: a deadly nerve agent Symptoms of exposure to the agent include nausea and violent headaches, blurred vision, drooling, muscle convulsions, respiratory arrest and loss of consciousness, the CDC says.[dailymail.co.uk]
  • The first symptoms of sarin poisoning include a runny nose, blurred vision, sweating, and muscle twitches.[encyclopedia.com]
  • However, if you have symptoms like blurred vision, chest tightness and nausea, you may have been affected by a low to moderate dose of VX.[straitstimes.com]
Miosis
  • Miosis is a very characteristic symptom of nerve agent intoxication. Victims will often report difficulty in seeing (blurred & dimmed vision).[besurvival.com]
  • These include, intense constriction of the pupils (miosis) and severe eye pain, constriction of the bronchioles producing labored breathing, nausea and vomiting, lacrimation (tearing), salivation, sweating, urination, defecation, (basically everything[sites.duke.edu]
  • Signs: General See Cholinergic Toxicity Children - common presentation (initially misdiagnosed in 80% of cases) Cholinergic Muscarinic affects Miosis Excessive Salivation Cholinergic Nicotinic affects Muscle Weakness and hypotonia Lethargy Tachycardia[fpnotebook.com]
  • Main clinical signs and symptoms Following local exposure Rhinorrhoea and hyperaemia of nasal mucosa membrane Miosis, (pin‐point pupils), sometimes unequal Hyperaemia of conjunctivitae Excessive sweating at site of exposure Frontal headache, eye pain[emro.who.int]
Excessive Tearing
  • This is why exposure to them causes excessive tears, salivation, sweat, urination, diarrhea, and constricted pupils, all leading to fluid in the lungs and pulmonary edema, which can be fatal.[futurism.com]
Muscle Twitch
  • […] and muscle twitching leading to muscle paralysis. Signs that the nerve gas gets into the brain include; anxiety, confusion, dizziness, nausea, vomiting, seizures and respiratory depression. Death is usually the result of respiratory failure.[sites.duke.edu]
  • A drop of sarin can cause muscle twitching and sweating, according to the CDC. How can people become exposed to the nerve agent? Sarin can be absorbed into the body by inhaling or ingesting it. Also, it can be absorbed through skin or eye contact.[usatoday.com]
  • Symptoms of acute, low-dose nerve agent exposure include: runny nose, chest tightness, "pinpoint" or abnormally constricted pupils, excessive salivation and sweating, abdominal cramps, muscle twitching, visual disturbances, headache, slurred speech, nausea[publichealth.va.gov]
  • Symptoms may include: “pinpoint” pupils and blurred vision; difficulty breathing; muscle twitching; excess saliva and other secretions; impaired judgment, seizures and unconsciousness.[voanews.com]
Muscle Cramp
  • Workers poisoned by CPF experience vomiting, muscle cramps and twitching, tremors and weakness.[greenlatinos.org]
  • The only possible point of reference we may have is experiencing an excruciating muscle cramp, but amplified horrendously to muscles throughout the entire body while being choked to death.[blogs.scientificamerican.com]
Muscle Weakness
  • Signs: General See Cholinergic Toxicity Children - common presentation (initially misdiagnosed in 80% of cases) Cholinergic Muscarinic affects Miosis Excessive Salivation Cholinergic Nicotinic affects Muscle Weakness and hypotonia Lethargy Tachycardia[fpnotebook.com]
Seizure
  • It causes seizures and has been used as a chemical warfare agent.[fpnotebook.com]
  • Signs that the nerve gas gets into the brain include; anxiety, confusion, dizziness, nausea, vomiting, seizures and respiratory depression. Death is usually the result of respiratory failure. This occurs by 2 routes.[sites.duke.edu]
  • In addition to diazepam, lorazepam, midazolam and pentobarbital have been used to treat soman-induced seizures. Seizure control declines markedly if there is any delay in treatment; 40 minutes after exposure, control is minimal.[emro.who.int]
  • Symptoms of acute, high-dose nerve agents include: coughing and breathing problems, loss of consciousness, seizures, paralysis, and coma and potentially death from respiratory/nervous system failure.[publichealth.va.gov]
Irritability
  • People who have been exposed to small levels of sarin usually recover completely, but fatigue, irritability, nervousness and memory problems could last for weeks.[voanews.com]
  • Example agents Tear Gas (CS) Pepper Spray (OC) Dispersal Liquid, aerosol Mode of Action Absorption through lungs, skin and eyes Effects Tears, coughing, and irritation to eyes, nose, mouth and skin; constricts airway[opcw.org]
  • Fatigue, irritability, nervousness, and memory deficits may persist as long as six weeks after the exposure. Those with mild-to-moderate nerve agent exposure usually recover completely.[publichealth.va.gov]
  • It belongs to the group of blister agents (or vesicants) that work by targeting the eyes, respiratory tract and skin, first as an irritant and then as poison for the body’s cells. It’s particularly grisly and slow acting.[nationalinterest.org]
  • Heart Block Ventricular arrhythmia Neurologic Effects Onset Vapor: 1 minute of large exposure Skin contact: 1-30 minutes Acute Loss of consciousness Seizure s Apnea Prolonged (4-6 weeks) Forgetfulness Inability to concentrate fully Insomnia Bad dreams Irritability[fpnotebook.com]
Dizziness
  • Among reported symptoms are chronic fatigue, diarrhea, migraines, dizziness, memory problems, loss of muscle control and loss of balance. "We have to presume that the illnesses the veterans have are related to that exposure.[ourmidland.com]
  • Signs that the nerve gas gets into the brain include; anxiety, confusion, dizziness, nausea, vomiting, seizures and respiratory depression. Death is usually the result of respiratory failure. This occurs by 2 routes.[sites.duke.edu]
  • “Soldiers were nauseous, dizzy and had diarrhea and muscle spasms. About 30 of us went to the medic, who gave us Motrin and told us to drink water.” Later that month, Bunker almost died. As the demolitions continued, his symptoms became more severe.[newsweek.com]
Flaccid Paralysis
  • Signs: Nicotinic Receptors (Skeletal muscle, Ganglia) Skeletal Muscle changes Initial Fasciculations Muscle Twitching Later Weakness Flaccid paralysis Ganglion ic effects Tachycardia Hypertension Cardiovascular Effects Heart Block Ventricular arrhythmia[fpnotebook.com]
  • paralysis Loss of bladder and bowel control Apnea (breathing stopped) The onset of rhinorrhea and difficulty breathing is usually very rapid, occurring within seconds to minutes of exposure to nerve agent vapors, and within half an hour of exposure to[besurvival.com]
Memory Impairment
  • If you want to: Protect children from learning and memory impairments Protect communities from pesticide poisonings when chlorpyrifos drifts in the air into nearby neighborhoods and schools Prevent contamination of our food Prevent contamination of our[greenlatinos.org]
  • impairment, and other disabilities.[blogs.scientificamerican.com]

Treatment

  • A Guelph-based company is using its low-cost drug manufacturing technology based on tobacco plants to develop an Ebola treatment as well as a nerve gas antidote.[aginnovationontario.ca]
  • Purified human serum BuChE was incubated with sarin, soman or VX, and the adduct was purified by sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) and digested in gel by treatment with chymotrypsin.[ncbi.nlm.nih.gov]
  • It was stated that the Mark 1 Autoinjector kits (although not approved for pediatric use) should be used as initial treatment for children with severe, life-threatening nerve agent toxicity for whom IV treatment is not possible or available, or for whom[academiccommons.columbia.edu]
  • CHAPTER 1 The treatment of nerve agent poisoning is still a major challenge for medical services.[pubs.rsc.org]
  • Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only.[drugs.com]

Prognosis

  • This prognosis is based on decades of research on rats and mice, and the fate of veterans of the 1990-1991 Gulf War who were exposed to low-levels of sarin gas and who continue to suffer serious health effects 26 years later.[blogs.scientificamerican.com]

Epidemiology

  • GAO concluded that epidemiological studies that relied on the computer model would be invalid. A Pentagon spokesman reached Friday would not immediately comment on the findings.[ourmidland.com]
  • Biden: Syrian gov't responsible for "heinous use" of chem. weapons Syrian state news agency: Kerry lying about chemical weapons attack "The reported symptoms of the patients, in addition to the epidemiological pattern of the events -- characterized by[cbsnews.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Penetrates skin, eyes, and lungs Toxic effects manifest as Cholinergic Toxicity Organophosphate esters ( Acetylcholinesterase Inhibitor s) Most toxic of chemical agents Similar to Insect icide Organophosphate s (e.g.[fpnotebook.com]

Prevention

  • If you want to: Protect children from learning and memory impairments Protect communities from pesticide poisonings when chlorpyrifos drifts in the air into nearby neighborhoods and schools Prevent contamination of our food Prevent contamination of our[greenlatinos.org]
  • Centers for Disease Control and Prevention. 2003. Public Health Emergency Preparedness and Response Sheets. U.S. Department of Health and Human Services. Public Health Service; Atlanta, GA. U.S.[health.ny.gov]
  • Decontamination may be followed by the administration of antidotes such as diazepam, atropine, and oximes to prevent initial and/or continued physical effects. 1 Answer A You may not be able to prevent nerve gas poisoning, but in the unlikely event that[sharecare.com]
  • Resources organizations Centers for Disease Control and Prevention . "Facts About Sarin" [cited March 25, 2003]. . Council on Foreign Relations.[encyclopedia.com]
  • Nerve agents are highly poisonous chemicals that can interfere with the nervous system's signaling, according to the Centers for Disease Control and Prevention (CDC).[livescience.com]

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