Chemical Weapons in the Iran-Iraq War (1980–1988). 6. Accumulated Experience in the Treatment of Lesions with Poisonous Nerve Agents

The Iran-Iraq war (1980–1988) was the first modern war in which chemical weapons were used. The purpose of this work is to summarize the experience of treating victims, affected by nerve agents. The publications of Iranian authors in different scientific journals were used for the preparation of the article. The first use of chemical weapons by the Iraqi army occurred in August 1983 in Kurdistan (sulfur mustard). Nerve agent (tabun) was first used on February 29, 1984 in the battles for the Majnun Islands. In total, 140 tons of tabun and about 600 tons of sarin / cyclosarin were used against Iranian troops during the war. Around 5.5 thousand servicemen died directly from the nerve agents. For one dead from tabun, there were at least 7 poisoned people who needed qualified toxicological assistance; lethal outcomes among servicemen affected by the herd amounted to at least 15%. Military personnel without protective equipment, who received large doses of nerve agents, lost consciousness within 30 seconds and died in positions within a few minutes. The most sensitive to such agents were women, children and the elderly, who accidentally fell under a chemical attack. The use of nerve agents by the enemy was accompanied by panic in the troops and the arrival of a huge number of military personnel in critical condition at medical stations. Sweating, fasciculations and miosis were the first clinical signs by which those affected by such toxic agents were recognized. The effectiveness of antidote therapy (atropine + oxime + diazepam) depended on the time of medical care. The most effective was the use of atropine by titration (fractional intravenous drip) to achieve ease of breathing, absence of bronchospasm, disappearance of secretions from the respiratory tract and heart rate >80 beats/min. The oximes turned out to be not effective in the treatment of those poisoned by tabun. The most effective was degassing by physical removal of toxic chemical. Degassing of the affected had to be carried out by washing with sea or river water, using solutions of chlorine-containing household chemicals, and sprinkling with dry earth.

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