Chemical weapons

Chemical warfare has been widely condemned since it was first used on a massive scale during the first world war. Chemical weapons are cheap, can cause mass casualties, and are relatively easy to produce, even by developing nations. They have been used in many conflicts during the 20th century (box), most recently by Iraq during the Iran-Iraq war,1 as well as in terrorist attacks. The psychological impact of chemical weapons on society makes them ideal for terrorism, as shown by the release of nerve gas in the Tokyo subway system by members of the Aum Shinrikyo sect in 1995.2 In this review we have focused on the agents that pose the greatest threat, recognising chemical weapons injuries, and the principles of management.


Summary points

Chemical agents should be considered in major incident planning

Consider exposure to chemical agents in any casualty with unexplained and unusual symptoms

Poisoning with many chemical agents, especially nerve agents, can be treated when diagnosed early

Protective equipment must be worn if there is suspicion that chemical agent remains in the local environment

Move casualties from contaminated environment to well ventilated area to give first aid

Decontamination of the casualty involves removal of clothing, shaving contaminated hair, and irrigation with water or dilute sodium hypochlorite to remove residual agent from skin

Demetrius Evison, research fellow, David Hinsley, research fellow, Paul Rice, technical manager for medicine | 2002
In: BMJ, ISSN 0959-8138 | 324 | 7333 | Feb 9 | 332
Placement code: 
Yzermans collectie