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Three female high school basketball players and two male scorekeepers entered the school gym before all other students. Soon after entering, all 5 began to have respiratory distress; after calling for help, the gym is sealed and the students transported to the ED. One student recalled seeing a large bowl with clear fluid and a small fan in the corner of the gym near where they entered. They do not recall any odor. The students have the following findings: alert and oriented except one female who is mildly sleepy, tachypnea and dyspnea, O2 sat high 80s to low 90s on room air, nausea, miosis, itchy eyes, and headache.
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April 17, 2024 at 7:56 pm
E) Chemical terrorism
The symptoms and exposure described are consistent with sarin, an organophosphorus nerve agent that was used in a terrorist attack on the Tokyo subway in 1995. Sarin is colorless and odorless, and very volatile such that vaporization occurs easily. It can also be aerosolized as part of an attack. Treatment includes oxygen, supportive respiratory care, bronchodilators, and atropine. Mass hysteria is not supported by the objective abnormal findings such as hypoxia. The symptoms are not consistent with cannabis (respiratory distress, hypoxia), nor opiate overdose (normal mental status, tachypnea instead of bradypnea). Anthrax would not result in such immediate symptoms.