Nerve Agents

Differential Diagnosis

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Differential Diagnosis

  • The diagnosis in a severely intoxicated individual is straight forward. The combination of miosis, copious secretions, bronchospasm, generalized muscle fasciculations, and seizures is characteristic.
  • Look carefully for miosis (if present will be helpful). Miosis may not be present initially following a low volatility nerve agent exposure.
  • A mild vapor exposure may mimic a child having allergic rhinitis/conjunctivitis in combination with an asthmatic episode.
  • GI symptoms by themselves could be confusing and they could be the only presenting signs.
  • Opiod abuse can include miosis, apnea, seizures, etc.
  • Link to Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool (CHEMM-IST)
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