Modern chemical warfare agents: the anesthesiologist’s perspective

Abstract

o M ecent events including the September 11, 2001 attacks in New York, Washington, DC, and ennsylvania have illustrated the vulnerability of he United States to terrorist activity. Many experts gree that a chemical or biological event is likely o occur within the continental United States durng our lifetime. The anesthesiologist, as well as he emergency medicine provider and critical care pecialist, will be integral to the initial recognition nd medical response to such an attack. A modern chemical attack on the United States ould involve many different agents including As, vesicants, CN compounds, and pulmonary rritants. In this situation, the anesthesiologist will e in a unique position to respond and affect paient outcome. Physicians trained in anesthesiology ossess expertise and knowledge in a variety of reas including airway protection, ventilation, oxgenation, pharmacology, CV physiology, and ulmonary physiology. It is this training that gives he anesthesiologist the flexibility to respond to a hemical threat more effectively than most other edical specialists. We present a history of chemical warfare as racticed in the modern era, focusing on the deelopment and history of the major chemical gents. Aspects of chemical agent insults in the erioperative setting, an area of particular interest o the anesthesiologist, are described.