CDC - The Emergency Response Safety and Health Database: Nerve Agent: SARIN (GB) - NIOSH

ANTIDOTE: Atropine and pralidoxime chloride (2-PAM Cl) are antidotes for nerve agent toxicity; however, 2-PAM Cl must be administered within minutes to a few hours (depending on the agent) following exposure to be effective. There is also generally no benefit in giving more than three injections of 2-PAM Cl. Atropine should be administered every 5 to 10 minutes until secretions begin to dry up. If the military Mark I kits containing autoinjectors are available, they provide the best way to administer the antidotes to healthy adults. One autoinjector automatically delivers 2 mg atropine and the other automatically delivers 600 mg 2-PAM Cl. If the Mark I kit is unavailable, or the patient/victim is not an otherwise healthy adult, administer antidotes as described below:

Infant (0 – 2 yrs), for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 0.05 mg/kg IM; 2-PAM Cl at 15 mg/kg IM.

Infant (0 – 2 yrs), for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 0.1 mg/kg IM; 2-PAM Cl at 25 mg/kg IM.

Child (2 – 10 yrs), for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 1 mg/kg IM; 2-PAM Cl at 15 mg/kg IM.

Child (2 – 10 yrs), for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 2 mg/kg IM; 2-PAM Cl at 25 mg/kg IM.

Adolescent (> 10 yrs), for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 2 mg/kg IM; 2-PAM Cl at 15 mg/kg IM.

Adolescent (> 10 yrs), for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 4 mg IM; 2-PAM Cl at 25 mg/kg IM.

Adult, for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 2 to 4 mg IM; 2-PAM Cl at 600 mg IM.

Adult, for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 6 mg IM; 2-PAM Cl at 1800 mg IM.

Elderly, frail for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 1 mg IM; 2-PAM Cl at 10 mg/kg IM.

Elderly, frail for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 2 to 4 mg IM; 2-PAM Cl at 25 mg/kg IM.

Assisted ventilation should be started after administration of antidotes for severe exposures.

Repeat atropine (2 mg IM for adults or 0.05 to 0.1 mg/kg for children) at 5 to 10 minute intervals until secretions have diminished and breathing is comfortable or airway resistance has returned to near normal.

https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750001.html