Organophosphate Poisoning (Adult)

Status
Suspected organophosphate exposure
Stop
Avoid self contamination - wear PPE
Pt decontamination if possible
Confirm evidence of suspected poisoning:
Cholinergic effects: salivation, bronchospasm, sweating, nausea or bradycardia
The key word to look for on the label is anticholinesterase
Plus:
Evidence of excessive cholinergic effects:
Salivation compromising the airway or bronchospasm and /or
Bradycardia with Inadequate or Extremely Poor Perfusion

No excessive cholinergic effects Transport to nearest appropriate hospital Monitor for excessive cholinergic effects

Excessive cholinergic effects Atropine 1200mcg IV - Repeat Atropine 1200mcg IV, 5 minutely until excessive cholinergic effects resolve Consult with receiving hospital for further management if required The use of Suxamethonium is contraindicated in Pts with suspected Organophosphate Poisoning

Special Notes

Notification to receiving hospital essential to allow for Pt isolation.

The key word to look for on the label is anticholinesterase. There are a vast number of organophosphates which are used not only used commercially but also domestically.

If a potential contamination by a possible organophosphate has occurred, the container identifying trade and generic names should be identified and the Poisons Information Centre contacted for confirmation and advice.

General Care

Where possible, remove contaminated clothing and wash skin thoroughly with soap and water.

If possible minimise the number of staff exposed.

Attempt to minimise transfers between vehicles.