Effects of Nerve Agents

The nerve agent's mechanism of action is to inhibit the enzyme acetyl cholinesterase. Inhibition of this enzyme allows the neurotransmitter. acetylcholine, to accumulate at the nerve endings where it causes excessive stimulation of the target organ. The parts of the body that are affected by excessive acetylcholine accumulation are as follows:

The primary concern of a first responder when treating the nerve-agent poisoned casualty is to provide correct, timely, and lifesaving care. The first step in providing this care is to understand the effects that a vapor- or liquid-nerve-agent exposure has on the casualty.

Understanding when these effects can most occur is critical in providing emergency care. The length of time a casualty may be in your care is unknown. It is best to understand what may occur and when, because being surprised by and unprepared for the reactions of a nerve agent poisoned casualty decreases chances for survival.

When a lethal or near-lethal exposure occurs, the time to onset of symptoms and maximal severity of symptoms may be extremely brief. If aggressive care is not given to the casualty exposed to a lethal concentration, death can result within five minutes after the appearance of symptoms.