Nerve Agent Antidote Table

 

Adult & Older Children
> 90 lbs. (>41 kg)

Pediatric 40-90 lbs.
(18-41 kg)
4-10 y/o

Pediatric 15-40 lbs.
(7-18 kg)
6 m/o-4 y/o

Pediatric (Infant)
< 15 lbs. (< 7kg)
< 6 m/o

Moderate symptoms include:

  • Blurred vision
  • Excessive tearing or runny nose
  • Drooling
  • Mild shortness of breath/ wheezing
  • Vomiting
  • Diarrhea, Stomach Cramps
  • Muscle twitching or sweating at site of exposure

1 NAAA IM
[atropine 2mg + pralidoxime 600 mg IM]

1 Atropen
(Red) [atropine 1 mg IM]

1 Atropen
(Blue) [atropine 0.5 mg IM]

1 Atropen
(Yellow) [atropine 0.25 mg IM]

Severe symptoms include:

  • Altered Mental Status
  • Severe shortness of breath/ wheezing
  • General Weakness/ Severe muscle twitching
  • Incontinence (urine or feces)
  • Seizures
  • Unconsciousness

3 NAAA(s) IM [atropine 6 mg + pralidoxime 1800 mg IM]

AND

Anticonvulsant 1 CANA autoinjector [diazepam 10 mg IM]

OR

(see box below)

2 NAAA(s) IM

OR

3 Atropen (Red) [atropine 3 mg IM]

AND

Anticonvulsant
(see box below)

1 NAAA(s) IM (if > 2 y/o)

OR

3 Atropen (Blue) [atropine 1.5 mg IM]

AND

Anticonvulsant
(see box below)

3 Atropen (Yellow) [atropine 0.75 mg IM]

AND

Anticonvulsant
(see box below)

 

Adult Anticonvulsant Options
(Choose one)		   Pediatric Anticonvulsant Options
(Choose one)

Titrate until seizure stops

Lorazepam 1-2 mg IV/IO mg/kg, max 2 mg/dose); may repeat every 5 minutes until maximum of 4 mg

OR

Diazepam 5-10 mg IV/IO(0.01 mg/kg); may repeat every 5 minutes until maximum 0.3 mg/kg

OR

Midazolam 1-5 mg IV/IO (0.05 mg/kg); may repeat every 5 minutes until maximum of 0.1 mg/kg

  

Titrate until seizure stops

Lorazepam 0.1 mg/kg IV/IO/ IM (max 2 mg/dose) may repeat every 5 minutes until maximum of 4 mg

OR

Diazepam 0.3 mg/kg IV/IO/ IM Max 10 mg/dose IV/IO (0.5 mg/kg PR12) may repeat every 5 minutes until maximum of 0.6 mg/kg

OR

Midazolam 0.1 mg/ kg IV/IO Max 5 mg/dose IV/IO (0.15 mg/kg IM12) may repeat every 5 minutes until maximum of 0.2 mg/kg IV