injuries poisoning
Overview of Chemical Warfare Agents
Classification of Chemical Warfare Agents
Toxic chemical warfare agentsare divided into 4 major classes: Nerve Chemical-Warfare Agents None Pulmonary Chemical-Warfare Agents None Systemic Asphyxiant Chemical-Warfare Agents (blood agents) Vesicant Chemical-Warfare Agents (blistering agents) Nerve agentsinhibit the enzyme acetylcholinesterase, causing excess cholinergic stimulation and cholinergic crisis (eg, diarrhea, urination, miosis, bronchorrhea, bronchoconstriction, emesis, lacrimation, salivation). Becausepulmonary agentsinclude substances that also affect primarily the upper respiratory tract rather than lung parenchyma, some experts prefer to call this class “agents with acute local effects on the respiratory tract.” Because most toxic industrial chemicals capable of generating mass casualties affect the respiratory tract, they are discussed with pulmonary CW agents. Systemic asphyxiants,specifically cyanide compounds and hydrogen sulfide, interfere with mitochondrial energy transport, blocking cellular respiration. They are distributed in the blood (and are thus termed blood agents in military references) and thus affect most tissues. Vesicantsdamage the dermoepidermal junction, causing pain and typically blistering. Many can affect the lungs if inhaled. Incapacitating agentscan be divided into Anticholinergic Chemical-Warfare Compounds None Riot-Control Chemical Agents (often incorrectly called tear gas) are dispersed as solid aerosols or as solutions (Note: The US military does not consider riot-control agents to be chemical warfare agents.) Opioids, especially potentfentanylderivatives derivatives reputedly used by Russia against Chechnyan terrorists in 2002, can be considered incapacitating in that their use is not typically intended to cause serious injury or death. However, when they are used as mass-casualty weapons they can far too easily cause death via respiratory depression. (See Opioid Toxicity and Withdrawal .) In mass-casualty situations, the route of exposure will most likely be inhalation of an aerosolized agent; larger than usual doses of In addition to their chemical designations, most CW agents also have a 1- to 3-letter North Atlantic Treaty Organization (NATO) code. designed to create light and flame, may also cause thermal burns in large numbers of casualties. Hydrogen fluoride (HF) may likewise cause chemical burns. Some of these burns require specific management apart from the Treatment . The views expressed in this article are those of the author and do not reflect the official policy of the Department of Army, Department of Defense, or the US Government. 