Efforts to achieve adequate ventilation should be made after at least initial administration of atropine to control airway secretions and bronchoconstriction ( Sidell, 1997). Even if the so-called ABCs of emergency treatment are followed, initial efforts to achieve adequate ventilation may be in vain.
Dr Fredrick Sidell (now deceased), an expert on chemical terrorism in the USA, advocated decontamination, drugs, airway, breathing, and circulation (DDABC) as the basic treatment for nerve agent poisoning. This difference in symptoms is attributable to the higher 70% concentration and active means by which the sarin was dispersed at Matsumoto, as opposed to the 33% concentration and passive means of dispersal employed in Tokyo.
