Medical Management of Biological Casualties Handbook
U.S. Army Medical Research Institute of Infectious Diseases,Fort Detrick,
Frederick, Maryland
Peer Review Status: Internally Peer
Reviewed
Time to Symptoms Minutes Hours (12-48) Hours (1-6)
Nervous Convulsions, Progressive Headache
Muscle twitching paralysis Muscle aches
Cardiovascular Slow heart rate Normal rate Normal or Rapid
Heart Rate
Respiratory Difficult breathing, Normal, then Nonproductive cough
airways constriction progressive Severe cases;chest
paralysis pain/difficult breathing
Gastrointestinal Increased motility, Decreased Nausea, vomiting and/or
pain, diarrhea motility diarrhea
Ocular Small pupils Droopy eyelids May see "red eyes"
(conjuntival injection)
Salivary Profuse, watery Normal; difficulty May be slightly increased
saliva swallowing quantities of saliva
Death Minutes 2-3 days Unlikely
Response to Yes No Atropine may reduce
Atropine/2PAM-Cl gastrointestinal symptoms
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