CBRNE - Nerve Agents, G-series - Tabun, Sarin, Soman Clinical Presentation

Updated: Jan 05, 2016
  • Author: Kermit D Huebner, MD, FACEP; Chief Editor: Duane C Caneva, MD, MSc  more...
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Presentation

History

Symptoms of nerve agent toxicity vary with the type of cholinergic receptor affected (muscarinic, nicotinic, or CNS) and include the following [4] :

  • Respiratory - Dyspnea, cough, chest tightness, wheezing
  • Neurologic - Headache, weakness, fasciculations, extremity numbness, decreased level of consciousness (LOC), vertigo, dizziness, convulsions
  • Ophthalmic - Eye pain, blurred vision, dim vision, conjunctival injection, tearing
  • Ear, nose, throat - Rhinorrhea
  • Gastrointestinal - Nausea, vomiting, diarrhea, tenesmus, fecal incontinence
  • Genitourinary - Urinary incontinence
  • Dermal - Sweating
  • Psychological - Agitation
  • General - Fatigue
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Physical

Signs of nerve agent toxicity also vary with the type of cholinergic receptor affected, and include the following:

  • Respiratory - Tachypnea, wheezing, respiratory failure
  • Cardiovascular - Bradycardia, tachycardia
  • Neurologic - Decreased LOC, weakness, fasciculations, seizure
  • Ophthalmic - Miosis, tearing, conjunctival injection
  • Dermal - Sweating
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Causes

Nerve agent exposure may occur as a result of any of the following [12] :

  • Industrial accident involving nerve agent production
  • Accidental release from a military stockpile
  • Chemical warfare
  • Chemical terrorism
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