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©2013 UpToDate ® Print Email Capnography for management chemical terrorism agents Agent Effects Capnography Nerve gas Seizures, diaphragmatic weakening or paralysis, hypoventilation, respiratory depression, apnea, loss of consciousness/coma Accurate readings during seizure activity (RR, EtCO 2 , capnogram) Earliest indicator of respiratory compromise Direct measure of ventilatory status Tabun Sarin Soman VX Vesicants Airway edema, upper airway obstruction, bronchospasm Rapid identification of upper airway obstruction Rapid identification of bronchospasm Mustard gas Lewisite Choking agents Rapid, progressive, non-cardiogenic pulmonary edema and acute lung injury, bronchospasm, laryngospasm Earliest indicator of respiratory compromise Rapid identification of bronchospasm Rapid identification of laryngospasm Chlorine Phosgene Diphosgene Chloropicrin Ricin Cyanide Sudden loss of consciousness/coma, seizures, metabolic acidosis with tachypnea, apnea Direct measure of ventilatory status Accurate readings during seizure activity Earliest indicator of respiratory compromise Non-invasive identification of metabolic acidosis Incapacitating agents Laryngospasm, bronchospasm, respiratory failure Rapid identification of laryngospasm Rapid identification of bronchospasm Earliest indicator of respiratory compromise Lacrimators (Mace) Capsaicin Reproduced with permission from: Krauss B. Capnography as a rapid assessment and triage tool for chemical terrorism. Pediatr Emerg Care 2005; 21:493. Copyright © 2005 Lippincott Williams & Wilkins.