Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 55
Chemical Agents of Opportunity for Terrorism:
TICs & TIMs
Selected Toxidromes and Potential
Chemical Etiologies
Category
Severe gastroenteritis
Cholinergic crisis
Cellular hypoxia
Peripheral neuropathy
Mouth pain / ulcerations
MMWR 10/3/03
Clinical Syndrome
Abdominal pain, emesis
profuse diarrhea, shock
SLUDGE symptoms,
Fasciculations, weakness
N/V, headache, AMS, shock,
seizures, dec pH
Muscle weakness, sensory
loss
Lip / mouth / pharyngeal
ulcerations; burning pain
Potential Chemical
Etiology
Arsenic, Ricin, Colchicine
OP insecticides, nicotine
CN, SMFA, CO, Azide
Hg, As, Thallium, Lead,
Paraquat / diquat; caustics,
Hg
Module One – Toxic Warfare: Looking Beyond Conventional Chemical Weapons
55
Some chemicals cause a characteristic clinical syndrome. These syndromes (or
toxidromes) have symptoms/signs that are typical for that particular type of chemical
exposure. Some of these toxidromes include severe gastroenteritis, cholinergic crisis,
cellular hypoxia, neuropathy and mouth ulcerations. As you can see, a number of
chemicals can cause each toxidrome with the syndrome depicted on the slide. It is also
important to realize that these are the textbook descriptions and not all patients follow
the textbook script to the letter. These descriptions serve as guides and are not definitive
confirmation of a cause, particularly given the use of unusual agents.
December 2008 Version 2.0 Page 60