Perioperative care of children with nerve agent intoxication

Nerve agents (NA) present a major threat to civilian populations. When a ba llistic system is used for spreading poison, multiple trauma, as well as to xic trauma could be caused. Children are more susceptible, due to their sma ller physiological reserve. Urgent surgical intervention for combined intox ication in the multiple-traumatized child could be a tremendous task in vie w of the background of physiological instability. Nerve agents affect the a utonomic, as well as the central nervous system, leading occasionally to un expected interactions with agents normally used for resuscitation. This can cause additional instability, and possibly systemic collapse. This review presents and emphasizes points concerning treatment of a child who suffers from combined multiple and toxic traumas. The review is based on scant know ledge of a database of similar cases of pesticide organophosphate poisoning in children since these compounds are alike. We also extrapolated data fro m reports concerning episodic civilian exposure to NA.