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The use of atropine in a nerve agent response with specific reference to children: are current guidelines too cautious?
  1. E A Sandilands,
  2. A M Good,
  3. D N Bateman
  1. NPIS Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr E A Sandilands, NPIS Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; euan.sandilands{at}


This review examines the potential use of nerve agents by a terrorist organisation against a civilian population, which has become an increasingly apparent threat in the UK. Present guidelines for the use of atropine, particularly in children, following such an event are unclear. No precise agreement exists on the most appropriate dose of atropine, or the frequency with which it should be administered. This uncertainty leaves children vulnerable as potentially life-saving treatment may be crucially delayed. Guidelines must be standardised to allow rapid antidotal delivery and maximise the potential for survivors. This review examines the issues currently surrounding the use of atropine in children following a nerve agent attack and propose strategies for treating exposed children.

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  • Competing interests None.