ORGANOPHOSPHATE AND CARBAMATE INSECTICIDE TOXICITY

1. Identification -The substance has been positively identified.

2. Medical Control - On-line medical control has been established with Mercy Medical center and if needed the local receiving facility.

3. Rescuer Safety - The victim is thoroughly decontaminated and EMS personnel are in a safe environment.

4. Supportive Care - Basic and advanced life support measures are secured before consideration of antidotal therapy.  This includes high flow oxygen.

5. Assessment - The victim’s symptoms are appropriate for the toxin. This may include bradycardia, salivation, wet sounding lungs or respiratory difficulty.  Coma, seizures, or confusion may be present.

6. HAZMAT DRUG ADMINISTRATION

            a. Atropine - 2 mg IV push (5 ml of the 0.4 mg/ml solution present in the box).

            Monitor response.  repeat at 2 minute intervals until lungs are clear.

            b. FOR ORGANOSPHOSHATE ONLY

            Pralidoxime Chloride (2-Pam, Protopam) - 2 gm (2 diluted vials) each diluted by 20 ml sterile water - administered over 30 - 60 minutes in 200ml of saline.

7. Ongoing assessment

8. Continued contact with medical control

The protocol above is derived from Emergency care for Hazardous Materials Exposure, Ac Bronstein, PL Currance, 1994, CV Mosby

[ Northeast Wisconsin Regional Hazmat Team ] [ Protocols ] [ Drug Reference ]