EM Quick Hits Video on Organophosphate poisoning with Emily Austin

  • Poisoning with an organophosphorus compounds can presents with signs and symptoms of excess acetylcholine in the parasympathetic nervous system, the CNS, at the neuromuscular junction, and at nicotinic receptors in the sympathetic nervous system.
  • Cholinergic symptoms tend to dominate: think DUMBELS (diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation) or SLUDGE (salivation, lacrimation, urination, diarrhea, GI upset, emesis), but more importantly the “Killer Bs” of bradycardia, bronchoconstriction and bronchorrhea.
  • Treating these patients involves aggressive supportive care, and antidote therapy with atropine as well as pralidoxime.
  • Atropine is the most important antidote to give. It should be dosed at 1-2 mg IV to start, and then given at double the dose every 5 minutes until your patient has a clear chest and is hemodynamically stable. Then start an infusion at 10-20% of the total dose of atropine given per hour.

The Podcast: EM Quick Hits 2 – Organophosphate Poisoning, TXA for Hemoptysis, Metacarpal Fracture Rotation, Abdominal Stab Wounds, Pediatric IV Cannulation

In each EM Quick Hits Video, our team hand picks an EM Quick Hits podcast segment and curates a video to enhance you multimodal learning.

Our EM Quick Hits Video team is: Lara Murphy, Yajur Iyengar and Jonathan Whittall