Sarin and other nerve agents of the organophosphate class: properties, medical effects and management

Abstract

Nerve gases of the organophosphate class were discovered around the time of World War II, with sarin, tabun and soman among their best known representatives. Despite the Geneva Convention of 1925 and the Chemical Weapons Convention (CWC) of 1997, chemical warfare agents, among them nerve agents like sarin, have been used in Iraq and in Japan. With an increased worldwide terrorist threat these relatively cheap but effective nerve agents have become a major concern for preparedness planners, rescue health‐care workers and security agencies. The different medical effects and physicochemical properties of these nerve agents may require a differentiated triage scenario. Early evacuation, decontamination, basic life support measures and specific pharmacologic therapy are the cornerstones of successful mass casualty management of nerve gas victims.