Poisoning/Overdose 

Symptoms-DUMBELS

  • Diarrhea
  • Urination
  • Miosis/Muscle weakness
  • Bronchospasm/Bronchorrhea/Bradycardia (the killer B’s)
  • Emesis
  • Lacrimation
  • Salivation/Sweating

Clinical Management Options

EMT-B
• Place in position of comfort
• Oxygen target SpO2 92% – 96%  
• Remove the patient from exposure, remove clothing if contaminated
Paramedic
• IV / IO access as appropriate for patient condition 
• EKG
• atropine and pralidoxime
• May require multiple doses of atropine for respiratory symptoms
Consult Online Medical Control as Needed

Pearls

  • Be aware of the environment, particularly closed spaces
  • Decontaminate the patient prior to transport to avoid contaminating providers