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Maiti A, Ahamed S, Tohora N, Roy D, Ray T, Sahana S, Roy MN. A Pyrene Coupled Azaine-linkage Chromo-fluorogenic Probe for Specific Detection of Sarin Gas Stimulant, Diethylchlorophosphate. J Fluoresc 2024:10.1007/s10895-024-03681-1. [PMID: 38795209 DOI: 10.1007/s10895-024-03681-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/20/2024] [Indexed: 05/27/2024]
Abstract
Owing to the extreme toxicity and easy synthesis protocol of G-series nerve agents, developing an efficient sensor for selective detection is necessary. Although various traditional methods are utilized to identify these nerve agents, chromo-fluorogenic probes have gained attractive attention from the scientific communities. In the present contribution, we have introduced a new symmetrical aza-substituted chromo-fluorogenic sensor, BPH, for specific detection of sarin gas, one of the fatal G-series nerve agents surrogate, diethylchlorophosphate (DCP). BPH shows a noticeable naked eye colorimetric change from pale yellow to light pink in the presence of DCP, displaying highly intense bright greenish cyan color photoluminosity under a 365 nm UV lamp,which is also manifested from the color chromaticity diagram. A BPH-staining paper stirps-based test kit experiment has been demonstrated for the on-site detection of nerve agent mimics. A more attractive and efficient application of BPH as a sarin gas vapor phase sensor mimics DCP in solid and solution phases. The BPH-based chromo-fluorogenic sensor shows excellent selectivity toward DCP with a detection and quantification limit in the µM range. This report invokes a new way for the researchers to detect DCP employing a simple chromo-fluorogenic sensor, which could be prepared by a time-saving, straightforward, handy protocol from the cost-effective starting materials.
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Affiliation(s)
- Arpita Maiti
- Department of Chemistry, University of North Bengal, Raja Rammohunpur, Darjeeling, West Bengal, 734013, India
| | - Sabbir Ahamed
- Department of Chemistry, University of North Bengal, Raja Rammohunpur, Darjeeling, West Bengal, 734013, India
| | - Najmin Tohora
- Department of Chemistry, University of North Bengal, Raja Rammohunpur, Darjeeling, West Bengal, 734013, India
| | - Debadrita Roy
- Department of Chemistry, University of North Bengal, Raja Rammohunpur, Darjeeling, West Bengal, 734013, India
| | - Tanusree Ray
- Department of Chemistry, Siliguri College, Siliguri, India
| | - Sudip Sahana
- Department of Chemistry, Saldiha College, Bankura, India
| | - Mahendra Nath Roy
- Department of Chemistry, University of North Bengal, Raja Rammohunpur, Darjeeling, West Bengal, 734013, India.
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Mishra N, Raina K, Agarwal R. Deciphering the role of microRNAs in mustard gas-induced toxicity. Ann N Y Acad Sci 2020; 1491:25-41. [PMID: 33305460 DOI: 10.1111/nyas.14539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 12/16/2022]
Abstract
Mustard gas (sulfur mustard, SM), a highly vesicating chemical warfare agent, was first deployed in warfare in 1917 and recently during the Iraq-Iran war (1980s) and Syrian conflicts (2000s); however, the threat of exposure from stockpiles and old artillery shells still looms large. Whereas research has been long ongoing on SM-induced toxicity, delineating the precise molecular pathways is still an ongoing area of investigation; thus, it is important to attempt novel approaches to decipher these mechanisms and develop a detailed network of pathways associated with SM-induced toxicity. One such avenue is exploring the role of microRNAs (miRNAs) in SM-induced toxicity. Recent research on the regulatory role of miRNAs provides important results to fill in the gaps in SM toxicity-associated mechanisms. In addition, differentially expressed miRNAs can also be used as diagnostic markers to determine the extent of toxicity in exposed individuals. Thus, in our review, we have summarized the studies conducted so far in cellular and animal models, including human subjects, on the expression profiles and roles of miRNAs in SM- and/or SM analog-induced toxicity. Further detailed research in this area will guide us in devising preventive strategies, diagnostic tools, and therapeutic interventions against SM-induced toxicity.
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Affiliation(s)
- Neha Mishra
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Komal Raina
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado-Anschutz Medical Campus, Aurora, Colorado.,Department of Pharmaceutical Sciences, South Dakota State University, Brookings, South Dakota
| | - Rajesh Agarwal
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
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Chen L, Wu D, Yoon J. Recent Advances in the Development of Chromophore-Based Chemosensors for Nerve Agents and Phosgene. ACS Sens 2018; 3:27-43. [PMID: 29231710 DOI: 10.1021/acssensors.7b00816] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The extreme toxicity and ready accessibility of nerve agents and phosgene has caused an increase in the demand to develop effective systems for the detection of these substances. Among the traditional platforms utilized for this purpose, chemosensors including surface acoustic wave (SAW) sensors, enzymes, carbon nanotubes, nanoparticles, and chromophore based sensors have attracted increasing attention. In this review, we describe in a comprehensive manner recent progress that has been made on the development of chromophore-based chemosensors for detecting nerve agents (mimic) and phosgene. This review comprises two sections focusing on studies of the development of chemosensors for nerve agents (mimic) and phosgene. In each of the sections, the discussion follows a format which concentrates on different reaction sites/mechanisms involved in the sensing processes. Finally, chemosensors uncovered in these efforts are compared with those based on other sensing methods and challenges facing the design of more effective chemosensors for the detection of nerve agents (mimic) and phosgene are discussed.
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Affiliation(s)
- Liyan Chen
- Department
of Chemistry and Nano Science, Ewha Womans University, Seoul, 120-750, Korea
| | - Di Wu
- Department
of Chemistry and Nano Science, Ewha Womans University, Seoul, 120-750, Korea
| | - Juyoung Yoon
- Department
of Chemistry and Nano Science, Ewha Womans University, Seoul, 120-750, Korea
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Chen L, Wu D, Kim JM, Yoon J. An ESIPT-Based Fluorescence Probe for Colorimetric, Ratiometric, and Selective Detection of Phosgene in Solutions and the Gas Phase. Anal Chem 2017; 89:12596-12601. [DOI: 10.1021/acs.analchem.7b03988] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Liyan Chen
- Department
of Chemistry and Nano Science, Ewha Womans University, Seoul 120-750 Korea
| | - Di Wu
- Department
of Chemistry and Nano Science, Ewha Womans University, Seoul 120-750 Korea
| | - Jong-Man Kim
- Department
of Chemical Engineering, Hanyang University, Seoul 04763, Korea
| | - Juyoung Yoon
- Department
of Chemistry and Nano Science, Ewha Womans University, Seoul 120-750 Korea
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Abou-Donia MB, Siracuse B, Gupta N, Sobel Sokol A. Sarin (GB, O-isopropyl methylphosphonofluoridate) neurotoxicity: critical review. Crit Rev Toxicol 2016; 46:845-875. [PMID: 27705071 PMCID: PMC5764759 DOI: 10.1080/10408444.2016.1220916] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Sarin (GB, O-isopropyl methylphosphonofluoridate) is a potent organophosphorus (OP) nerve agent that inhibits acetylcholinesterase (AChE) irreversibly. The subsequent build-up of acetylcholine (ACh) in the central nervous system (CNS) provokes seizures and, at sufficient doses, centrally-mediated respiratory arrest. Accumulation of ACh at peripheral autonomic synapses leads to peripheral signs of intoxication and overstimulation of the muscarinic and nicotinic receptors, which is described as "cholinergic crisis" (i.e. diarrhea, sweating, salivation, miosis, bronchoconstriction). Exposure to high doses of sarin can result in tremors, seizures, and hypothermia. More seriously, build-up of ACh at neuromuscular junctions also can cause paralysis and ultimately peripherally-mediated respiratory arrest which can lead to death via respiratory failure. In addition to its primary action on the cholinergic system, sarin possesses other indirect effects. These involve the activation of several neurotransmitters including gamma-amino-butyric acid (GABA) and the alteration of other signaling systems such as ion channels, cell adhesion molecules, and inflammatory regulators. Sarin exposure is associated with symptoms of organophosphate-induced delayed neurotoxicity (OPIDN) and organophosphate-induced chronic neurotoxicity (OPICN). Moreover, sarin has been involved in toxic and immunotoxic effects as well as organophosphate-induced endocrine disruption (OPIED). The standard treatment for sarin-like nerve agent exposure is post-exposure injection of atropine, a muscarinic receptor antagonist, accompanied by an oxime, an AChE reactivator, and diazepam.
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Affiliation(s)
- Mohamed B Abou-Donia
- a Department of Pharmacology and Cancer Biology , Duke University , Durham , NC , USA
| | - Briana Siracuse
- a Department of Pharmacology and Cancer Biology , Duke University , Durham , NC , USA
| | - Natasha Gupta
- a Department of Pharmacology and Cancer Biology , Duke University , Durham , NC , USA
| | - Ashly Sobel Sokol
- a Department of Pharmacology and Cancer Biology , Duke University , Durham , NC , USA
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Rick J, Tsai MC, Hwang BJ. Biosensors Incorporating Bimetallic Nanoparticles. NANOMATERIALS (BASEL, SWITZERLAND) 2015; 6:E5. [PMID: 28344262 PMCID: PMC5302532 DOI: 10.3390/nano6010005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 12/12/2022]
Abstract
This article presents a review of electrochemical bio-sensing for target analytes based on the use of electrocatalytic bimetallic nanoparticles (NPs), which can improve both the sensitivity and selectivity of biosensors. The review moves quickly from an introduction to the field of bio-sensing, to the importance of biosensors in today's society, the nature of the electrochemical methods employed and the attendant problems encountered. The role of electrocatalysts is introduced with reference to the three generations of biosensors. The contributions made by previous workers using bimetallic constructs, grouped by target analyte, are then examined in detail; following which, the synthesis and characterization of the catalytic particles is examined prior to a summary of the current state of endeavor. Finally, some perspectives for the future of bimetallic NPs in biosensors are given.
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Affiliation(s)
- John Rick
- NanoElectrochemistry Laboratory, Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan.
| | - Meng-Che Tsai
- NanoElectrochemistry Laboratory, Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan.
| | - Bing Joe Hwang
- NanoElectrochemistry Laboratory, Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan.
- National Synchrotron Radiation Research Center, Hsinchu 300, Taiwan.
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Petrikovics I, Budai M, Kovacs K, Thompson DE. Past, present and future of cyanide antagonism research: From the early remedies to the current therapies. World J Methodol 2015; 5:88-100. [PMID: 26140275 PMCID: PMC4482825 DOI: 10.5662/wjm.v5.i2.88] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 01/09/2015] [Accepted: 04/20/2015] [Indexed: 02/06/2023] Open
Abstract
This paper reviews milestones in antidotal therapies for cyanide (CN) spanning early remedies, current antidotal systems and research towards next generation therapies. CN has been a part of plant defense mechanisms for millions of years. It became industrially important in the nineteenth century with the advent of CN assisted gold mining and the use of CN as a pest control agent. The biochemical basis of CN poisoning was actively studied and key mechanisms were understood as early as 1929. These fundamental studies led to a variety of antidotes, including indirect CN binders that generate methemoglobin, direct CN binders such as hydroxocobalamin, and sulfur donors that convert CN to the less toxic thiocyanate. Research on blood gases at the end of the twentieth century shed new light on the role of nitric oxide (NO) in the body. The discovery of NO’s ability to compete with CN for enzymatic binding sites provided a previously missed explanation for the rapid efficacy of NO generating antidotes such as the nitrites. Presently used CN therapies include: methemoglobin/NO generators (e.g., sodium nitrite, amyl nitrite, and dimethyl aminophenol), sulfur donors (e.g., sodium thiosulfate and glutathione), and direct binding agents [(e.g., hydroxocobalamin and dicobalt salt of ethylenediaminetetraacetic acid (dicobalt edetate)]. A strong effort is being made to explore novel antidotal systems and to formulate them for rapid administration at the point of intoxication in mass casualty scenarios. New antidotes, formulations, and delivery systems are enhancing bioavailability and efficacy and hold promise for a new generation of improved CN countermeasures.
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Dinis-Oliveira RJ, Carvalho F, Moreira R, Proença JB, Santos A, Duarte JA, Bastos MDL, Magalhães T. Clinical and forensic signs related to chemical burns: A mechanistic approach. Burns 2015; 41:658-79. [PMID: 25280586 DOI: 10.1016/j.burns.2014.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 09/04/2014] [Accepted: 09/08/2014] [Indexed: 12/14/2022]
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Zhang W, Guo X, Zhang Y, Wang F, Shi H, Zhang J, Wang R, Tang S, Wang H, Sun H. The mechanistic study of the hydroxyl radical reaction with trans-2-chlorovinyldichloroarsine. J Mol Model 2014; 20:2335. [DOI: 10.1007/s00894-014-2335-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 06/08/2014] [Indexed: 10/25/2022]
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Moshiri M, Darchini-Maragheh E, Balali-Mood M. Advances in toxicology and medical treatment of chemical warfare nerve agents. ACTA ACUST UNITED AC 2012; 20:81. [PMID: 23351280 PMCID: PMC3556041 DOI: 10.1186/2008-2231-20-81] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/17/2012] [Indexed: 11/10/2022]
Abstract
Organophosphorous (OP) Nerve agents (NAs) are known as the deadliest chemical warfare agents. They are divided into two classes of G and V agents. Most of them are liquid at room temperature. NAs chemical structures and mechanisms of actions are similar to OP pesticides, but their toxicities are higher than these compounds. The main mechanism of action is irreversible inhibition of Acetyl Choline Esterase (AChE) resulting in accumulation of toxic levels of acetylcholine (ACh) at the synaptic junctions and thus induces muscarinic and nicotinic receptors stimulation. However, other mechanisms have recently been described. Central nervous system (CNS) depression particularly on respiratory and vasomotor centers may induce respiratory failure and cardiac arrest. Intermediate syndrome after NAs exposure is less common than OP pesticides poisoning. There are four approaches to detect exposure to NAs in biological samples: (I) AChE activity measurement, (II) Determination of hydrolysis products in plasma and urine, (III) Fluoride reactivation of phosphylated binding sites and (IV) Mass spectrometric determination of cholinesterase adducts. The clinical manifestations are similar to OP pesticides poisoning, but with more severity and fatalities. The management should be started as soon as possible. The victims should immediately be removed from the field and treatment is commenced with auto-injector antidotes (atropine and oximes) such as MARK I kit. A 0.5% hypochlorite solution as well as novel products like M291 Resin kit, G117H and Phosphotriesterase isolated from soil bacterias, are now available for decontamination of NAs. Atropine and oximes are the well known antidotes that should be infused as clinically indicated. However, some new adjuvant and additional treatment such as magnesium sulfate, sodium bicarbonate, gacyclidine, benactyzine, tezampanel, hemoperfusion, antioxidants and bioscavengers have recently been used for OP NAs poisoning.
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Affiliation(s)
- Mohammd Moshiri
- Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Weibrecht K, Rhyee S, Manuell ME, Longo C, Boyer EW, Brush E. Sulfur Mustard Exposure Presenting to a Community Emergency Department. Ann Emerg Med 2012; 59:70-4. [DOI: 10.1016/j.annemergmed.2011.07.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 07/13/2011] [Accepted: 07/15/2011] [Indexed: 10/17/2022]
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Abolghasemi H, Radfar MH, Rambod M, Salehi P, Ghofrani H, Soroush MR, Falahaty F, Tavakolifar Y, Sadaghianifar A, Khademolhosseini SM, Kavehmanesh Z, Joffres M, Burkle FM, Mills EJ. Childhood physical abnormalities following paternal exposure to sulfur mustard gas in Iran: a case-control study. Confl Health 2010; 4:13. [PMID: 20630096 PMCID: PMC2917398 DOI: 10.1186/1752-1505-4-13] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Accepted: 07/14/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mustard gas, a known chemical weapon, was used during the Iran-Iraq war of 1980-1988. We aimed to determine if exposure to mustard gas among men was significantly associated with abnormalities and disorders among progenies. METHODS Using a case-control design, we identified all progenies of Sardasht men (exposed group, n = 498), who were born at least nine months after the exposure, compared to age-matched controls in Rabat, a nearby city (non-exposed group, n = 689). We conducted a thorough medical history, physical examination, and appropriate paraclinical studies to detect any physical abnormality and/or disorder. Given the presence of correlated data, we applied Generalized Estimating Equation (GEE) multivariable models to determine associations. RESULTS The overall frequency of detected physical abnormalities and disorders was significantly higher in the exposed group (19% vs. 11%, Odds Ratio [OR] 1.93, 95% Confidence Interval [CI], 1.37-2.72, P = 0.0002). This was consistent across sexes. Congenital anomalies (OR 3.54, 95% CI, 1.58-7.93, P = 0.002) and asthma (OR, 3.12, 95% CI, 1.43-6.80, P = 0.004) were most commonly associated with exposure. No single abnormality was associated with paternal exposure to mustard gas. CONCLUSION Our study demonstrates a generational effect of exposure to mustard gas. The lasting effects of mustard gas exposure in parents effects fertility and may impact child health and development in the long-term.
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Affiliation(s)
- Hassan Abolghasemi
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Mohammad H Radfar
- Urology & Nephrology Research Center, Shahid Beheshti University of Medical Sciences 9th Boostan Street, Pasdaran Avenue, Tehran, Iran
| | - Mehdi Rambod
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak, Tehran, Iran
| | - Parvin Salehi
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Hossein Ghofrani
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Mohammad R Soroush
- Janbazan Medical and Engineering Research Center (JMERC), Chemical Warfare Victims Research Unit, Velenjak, Tehran, Iran
| | - Farahnaz Falahaty
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Yousef Tavakolifar
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Ali Sadaghianifar
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Seyyed M Khademolhosseini
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Zohreh Kavehmanesh
- Research Center for Chemical Injuries, Baqiyatollah Medical Sciences University, Vanak Square, Tehran, Iran
| | - Michel Joffres
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Frederick M Burkle
- Harvard Humanitarian Initiative, Harvard School of Public Health, Harvard University, Boston, USA
| | - Edward J Mills
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Rabinowitz P, Wiley J, Odofin L, Wilcox M, Dein FJ. Animals as sentinels of chemical terrorism agents: An evidence-based review. Clin Toxicol (Phila) 2009; 46:93-100. [DOI: 10.1080/15563650701664905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Warden CR. Respiratory agents: irritant gases, riot control agents, incapacitants, and caustics. Crit Care Clin 2005; 21:719-37, vi. [PMID: 16168311 DOI: 10.1016/j.ccc.2005.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There are many chemical respiratory agents suitable for use by terrorists. They are the oldest chemical agents used and have caused the most casualties throughout the 20th century. Many are available in large quantities for industrial use and are susceptible to potential sabotage. This paper will concentrate on respiratory agents that are readily available and have the potential to cause a large number of casualties and panic. These agents have a lower rate of lethality when compared to other chemical agents but could produce many casualties that may overwhelm the emergency medical system.
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Affiliation(s)
- Craig R Warden
- Oregon Health & Science University, UHN52, Department of Emergency Medicine, 3181 SW Sam Jackson Park Road, Portland, OR 97201, USA.
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Abstract
Chemical warfare agents are toxic weapons and emergency prehospital medical care providers should be well prepared, trained, and equipped to give response. Personnel need to be aware of the following medical issues regarding prehospital management of a chemical attack, event recognition, incident medical command and control, safety and protection, decontamination, isolation of the incident area (hot zone, warm zone, and cold zone), sampling and detection, psychological management, communication, triage, treatment, transportation, recovery activities and fatality management. During prehospital response, healthcare responders should provide self protection by wearing proper protective equipment and ensuring that the casualty is thoroughly decontaminated. Medical first responders are also responsible for performing triage in each zone of the incident area. Victims are triaged into four categories based on the need for medical care; immediate, delayed, minimal, and expectant. Finally, a medical emergency planning should be completed, and exercises conducted to test the system before an event occurs.
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Affiliation(s)
- L Kenar
- Department of NBC Defence, Gulhane Military Medical Academy, Ankara, Turkey.
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