MbShea@PWP@English@UMCP

There exists a significant gap in current medical knowledge and training of medical professionals regarding sarin exposure. Even though sarin may not be a commonly encountered neurotoxin in the U.S., it is still crucial that medical professionals are prepared should they have to treat patients with sarin exposure, whether in the U.S. or abroad. The clinical presentation of sarin can be classified as acute, sub-acute, or chronic based on how much neurotoxin the patient has been exposed to. As an inhibitor of acetylcholinesterase, sarin targets the nervous system and leads to loss of control over the body’s muscles. Initial symptoms usually include a runny nose, watery eyes, hyperventilation and chest tightness. Symptoms of more severe exposure include diarrhea, nausea, vomiting, confusion, drowsiness and increased urination. Large dosages of sarin can cause loss of consciousness, paralysis, and spasms. Sarin is usually lethal due to loss of control over breathing muscles (respiratory failure), leading to bronchorrhea and bronchospasm, the most common causes of death due to sarin exposure. Treatment of the physiological symptoms of sarin poisoning include atropine, pralidoxime and other reversal agents. Much information concerning the exact range of sarin and correlation between dose exposure and symptoms remains unknown.

Reader's Profile: an american medical student who is not interested in traveling abroad or joining the armed forces.

Reader’s Response:
I think this presentation is fairly useless for us as medical students because the chances that we would encounter patients who have been exposed to sarin in the US are extremely low. Members of the armed forces would be a better audience for this information since they travel abroad to conflict zones where chemical weapons are used. There are so many other diseases and possible cases of poisoning that are more likely to occur in the US, so I think it would be a better use of our time to learn about those illnesses instead. I'm already running out of brain space, maybe I should just space out.

S -- not sure how to address this student really, though the medical school seminar format of 7-10 pages, with a focus on treatment is a good way to respect the busy-ness of the reader.

Good plan. I will read with interest and some sadness.