Physiologic and chemical simulation of cyanide and sarin toxicity and therapy.

The possibility of mass terrorism has become increasingly apparent. Accurate and relevant teaching tools are needed for healthcare givers and emergency personnel of all experience. We describe one of these tools, BODY Simulation, and its use in training caregivers to respond to chemical terrorism. We have implemented two chemical agents--cyanide and sarin, the latter a nerve agent--in a detailed whole-body model and simulation. In the simulation, each agent was administered to a healthy young adult, first without therapy, then with therapy, for a total of four runs. We recorded several variables, each appropriate to the agent used. The recorded variables included physiological variables in addition to the blood and brain concentrations of each agent and its antidotes. In addition, for cyanide, the compounds that resulted as the byproducts of therapy (methemoglobin, for example) were plotted. The results were consistent with those described in the literature, including agent concentrations and pathophysiologic changes.