Sarin: guidelines on the management of victims of a nerve gas attack

Sarin is now a weapon of the terrorist. Its acute effects are primarily due to unrestricted cholinergic activity at both muscarinic and nicotinic receptors. Treatment is based on the use of large doses of atropine and pralidoxime which may lead to practical problems of sufficient drug supplies for the average hospital. Ventilation may be necessary and present problems. Victim decontamination involves use of bleach, soap and water. Staff handling casualties need protection with respirators and butyl rubber boots and gloves.