Upcoming Grand Rounds

Speaker: Dr. Philip Bialek, CD, MD, CCFP, PGY3 - CCFP EM
Moderator: Dr. Scott Lucyk, MD, FRCPC, DABEM, Emergency Physician, Medical Toxicologist, Clinical Associate Professor, Poison and Drug Information Service (PADIS), Alberta Health Services - Calgary Zone

Title: From Fields to Battlefields: Organophosphate Poisoning and Beyond

Description: Organophosphate and Carbamate poisonings are high consequence, low frequency events. Moving past organophosphates, in an increasingly unstable world, chemical weapons have been used in recent years to carry out assassinations with dire consequences for the public. This presentation will review the toxicology of these chemicals and provide easy to remember strategies for assessing, stabilizing, and providing ongoing treatment to patients with organophosphate or nerve agent poisoning. 

Summary:
A.) Decontamination : AABCDE’s
- Airway
- Antidotes
- Breathing
- Circulation
- Disability
- Exposure
B.) Early treatment with antidotes and benzodiazepines is key.
C.) Antidotes:
- Atropine, 2mg, IV  - initial dose with serial dose doubling Q5mins. Target atropinization (no secretions/quiet chest and HR>80 BPM)
- Pralidoxime, 2g, IV loading dose
- Midazolam, 5mg, IV
D.) Early Airway capture: dual suction, dual set up, DAM activation. Avoid Succinylcholine, use 2mg/kg of rocuronium

DEM Academic Grand Rounds Evaluation  (1.0 Education Credits)

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