[Chemical attacks and accidents : Prehospital management]

Chemical attacks and accidents involving so-called C (chemical)-agents are rare but represent a significant challenge for emergency medical services. More often than classical warfare agents, "dual-use" substances used in industry and everyday settings are involved. Early recognition of a possible exposure is crucial, for example, through clustering of cases or unexplained symptom patterns consistent with a toxidrome. Simple interventions such as undressing and dry decontamination can substantially reduce contamination and help with patient and personnel safety. Initial medical management follows ABCDE (airway, breathing, circulation, disability, and exposure) principles and may be supplemented by targeted antidote therapy. Knowledge of the clinical features, key problems, and management of common substance groups such as organophosphates or cyanides enables a structured and effective approach and is discussed in this article.