UK medics treated Skripals for opioid overdose until Porton Down tests showed nerve agent poisoning

The medical team at Sainsbury Hospital were treating the Skripals for opioid overdose without any extra precautions, until UK chemical weapon experts "confirmed" nerve agent poisoning and "advised" them on treatment, BBC reports.

Staff at Salisbury District Hospital say that former Russian spy Sergei Skripal and his daughter, Yulia, who were found unconscious on a bench in Salisbury on March 4, were initially treated for opioid overdose, a new documentary reveals.

"The evening that Yulia and Sergei were admitted, at that point we were led to believe that they have taken an overdose, so there was no mention of nerve agent poisoning," Sarah Clark, ward sister in charge of the shift on March 4, told BBC2's Newsnight in an interview broadcast on Tuesday. "They were needing their support with their breathing and support with their cardiovascular system."

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Some initial reports on the Skripals indicated that emergency services suspected the powerful drug fentanyl may have been involved. The highly addictive synthetic opiate has been linked to a sharp increase in overdoses in the US and has also resulted in dozens of deaths across the UK.

The medical staff was apparently so sure of the drug overdose diagnosis that they did not even consider taking special precaution to protect themselves against potential exposure to the deadly military grade chemical agent, which they were soon convinced caused the ailment of the Skripals.

"At first, when they first came in, there was no indication of the fact that it was a nerve agent. And therefore, we take our normal protection when any patient comes in but would have not at that point taken any extra precaution in terms of protecting ourselves," Clark said.

Things at the hospital began to slowly change when police told the medical staff on Monday morning that they were dealing with victims of a potential "targeted attack." Dr. Duncan Murray, the hospital's senior intensive care consultant, recalled how he discovered the identity of the Skripals at "six o'clock on a Monday morning," while Cara Charles Barks, chief executive at the hospital, said that only by 10am was the case declared an "external incident."

While the Skripals were first admitted to the hospital on Sunday evening, it was not until Tuesday that doctors realized they were seeing "symptoms typical of organophosphate" or nerve agent poisoning, the BBC investigation claims. This suspicion arose after Detective Sergeant Nick Bailey, one of the officers who had attended the scene but whose fate was not part of the BBC report, was admitted with "similar" symptoms.

While some of the symptoms exhibited by the Skripals were consistent with World Health Organization guidelines for opioid poisoning, it was not until a helping hand was extended by experts from the Defence Science and Technology Laboratory (DSTL) at Porton Down that the Salisbury medical team finally started treating the Skripals for nerve agent poisoning.

"Whilst a district general hospital laboratory cannot test specifically for a nerve agent, we are able to request tests for the effect of the nerve agent so we can measure anticholinesterase levels and see whether they have been affected. And it was our colleagues in Porton Down that helped us with the testing," Medical Director Dr. Christine Blanshard said.

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From that point on, doctors at Salisbury Hospital began to administer medical treatment, the details of which are kept secret due to medical "confidentiality" concerns. The hospital continued to receive advice from international experts, including the Porton Down chemical weapons research laboratory.

"Clinical decisions were ours, but we would be foolish not to take their advice, which we did. And I think that helped," intensive care consultant Dr. Jukes noted. "When we began seeing some improvements, it happened a lot quicker than anticipated. Certainly, when you look at these groups of nerve agents, the expectations from the textbooks, the journals suggested a much longer period of recovery."

Dr. Jukes, who did not initially believe the two would survive, said he was "exceptionally surprised" with the speed of their recovery. In fact, it happened so fast that he cannot easily explain it.

Dr. Murray of Salisbury District Hospital said their recovery is "attributable to the very good, generic, basic, critical care, excellent team care," and not some magic pill, in addition to "some input from really, really well informed international experts, which very fortunate, some of who have happened to be on our doorstep at Porton Down."

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