Nerve agents exposure categories

Toxins present a variety of both incapacitating and lethal effect. Most toxins of military significance can be broadly classified in one of two ways. Neurotoxins disrupt the nervous system and interfere with nerve impulse transmission similar to nerve agents (Chapter 1). However, all neurotoxins do not operate through the same mechanism of action or do they produce the same symptoms. Cytotoxins are poisons that destroy cells or impair cellular activities. Symptoms may resemble those of vesicants (Chapter 3) or they may resemble food poisoning or other diseases. Toxins may also produce effects that are a combination of these general categories. The consequences of intoxication from any individual toxin can vary widely with route of exposure and dose. In addition, some toxins act as biomediators and cause the body to release excessive, and therefore harmful, amounts of chemicals that are normally produced by the body. 

This section discusses the general principles of treating nerve agent poisoning. The specific treatment of casualties in the six exposure categories (suspected, minimal, mild, moderate, moderately severe, and severe) is addressed in the next section. Terminating the Exposure... 

In accordance with Department of the Army Pamphlet 40-8, Occupational Health Guidelines for the Evaluation and Control of Occupational Exposure to Nerve Agents GA, GB, GD, and VX, the following four categories of personnel are required to have their RBC-ChE measured5 ... 

Category C personnel with minimal probability of exposure to nerve agents, even under accident conditions, but whose activities may place them in close proximity to agent areas. 

Category D transient visitors to agent areas where a potential for exposure exists and who are not included in the medical surveillance program for nerve agents at the visited installation. 

Prophylaxis (pre-treatment) is defined as the implementation of medical countermeasures prior to exposure of an organism to a nerve agent [6]. These countermeasures fall into two main categories protection against AChE... 

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