Chemical weapons are a diverse range of substances that can be used to cause intentional death or harm through their toxic properties. They include nerve agents, vesicants, lung-damaging agents, cyanide, biological toxins, and riot control agents, as well as emerging threats such as the highly potent opioid carfentanil. Although infrequent, chemical weapons casualties can and have presented to civilian hospitals as the result of terrorist attacks, assassination attempts, and accidental exposure. Recognition of the potential chemical casualty is required to initiate specific treatment and appropriate personal protective measures. However, this is made challenging by a low index of suspicion, unclear history of exposure, limitations of field-testing equipment, and variable presentations that may be confounded by psychological symptoms, physical injuries, hyperthermia from personal protective equipment (PPE), and the side effects of antidotes.

This article gives a brief overview of how to identify and manage chemical incidents, the toxicology, symptomatology, and treatment of a selected number of chemical agents. Further detail can be found in the listed references.