Replies

Your point about the speed needed is a good one. Cholinesterase inhibitors decrease breathing function and movement of skeletal muscle. They are particularly cruel, however, in that mental awareness is clear and unchanged. They simply don't allow muscles to work. Mental changes are from the lack of oxygen when the chest cannot rise and breathe.

There is a rare deficiency among some people to produce cholinesterase, enough at least, to recover from surgery, in which the inhibitors are used to paralyze the patient. I have seen the terror in the eyes of those who could not move and were fully aware, although breathing was being done for them. Thankfully fresh frozen plasma is a quick solution.

It is my hope that much fresh frozen plasma was on-hand for the hostages, if indeed a cholinesterase inhibitor was used. It could explain the numerous requests for help in the Russian media before the rescue operation - they were gathering and stocking plasma.

They are particularly cruel, however, in that mental awareness is clear and unchallenged.

Well, depends on method of ingestion [skin contact absorption or inhalation/ingestion] and dosage. But see the MSDS *here* for effects from US nerve agent VX: [at addendum *A*]which may have similar results, if differing chemically from Russian chemical agents.

*Exposure to high concentrations of nerve agent may bring on incoordination, mental confusion and collapse so rapidly that the casualty cannot perform self-aid. If this happens, the mabn nearest to him will give first aid.*

Effect of Russian agent, delivered via unknown means, into enclosed area, particularly affecting those near doorways and in open areas [thereby less diluted by being spread among several individuals] might be very different. But note also MSDS comments regarding repeated dosages to those afflicted. Not a problem for recovering hostages...but captured terrorists may have such a problem. And training videos made of such things would be nice morale boosters.

-archy-/-

It is my belief that the agent used was 3-Quinuclidinyl benzilate (BZ) (now called QNB) developed during the Cold War.

The chemical warfare agent 3-quinuclidinyl benzilate (QNB, BZ) is an anticholinergic agent that affects both the peripheral and central nervous systems (CNS). It is one of the most potent anticholinergic psychomimetics known, with only small doses necessary to produce incapacitation. It is classified as a hallucinogenic chemical warfare agent. QNB usually is disseminated as an aerosol, and the primary route of absorption is through the respiratory system. Absorption also can occur through the skin or gastrointestinal tract. It is odorless. QNB's pharmacologic activity is similar to other anticholinergic drugs (eg, atropine) but with a much longer duration of action.

It is my hope that much fresh frozen plasma was on-hand for the hostages....

Yes. Likewise HI-6 or 2PAM, as used for treatment of those exposed to organophosphorous insecticides in agricultural and industrial accidental overexposures. The U.S. military first-aid response is atropine, usually from spring-loaded hypodermic auto-injectors.

But that's also a good reason for the large numbers of troops in the area, already blood-group typed and ready for donations, should one of the hostages with a less common blood group require serological replenishment. Such treatment usually requires several weeks to several months duration, assuming, as in this case, no further exposure to the agent. ChemWar traetment may have been immediately available for all concerned [would help explain reported hypodermic marks on the dead terrorists] with transport to advanced treatment being carried out immediately upon rescue. Good chance for high numbers of recoveries of those minimally dosed, but also unfortunate liklihood that many of the seriously affected will not pull through.