The Poison Review

Toxic chemical effects that might present in the ED. Goffman TE.  Am J Emerg Med 2009 Nov;27:1149-54.

This is a review of the various chemical agents that might cause a mass-casualty incident, including nerve agents, vesicants, pulmonary toxins. and cyanide.  It is an important topic, but unfortunately this letter is so poorly written and edited that it is really not worth reading or referring to.  It also contains numerous errors. For example, the author confuses phosgene (a choking agent) with phosgene oxime (a vesicant).  He also claims that in the Tokyo sarin exposure incident in 1995, none of the patients seen at the closest hospital (St. Lukes) lost their lives.  In fact, the very article that is referenced states correctly that two of the St. Lukes patients died, one in the emergency department and the other on day 28 of hospitalization (South Med J 1997;90:587).