Protocol 2-374 - Exposure: Nerve Agents

CMH EMS & MIH Protocols

EMD:

• Dispatch a non-dedicated standby ambulance to all hazmat releases where emergency response is required by other agencies.

EMR:

• Consider hazmat and DECON. Refer to Protocol 2-924 - Universal Patient Care for decontamination protocols.
• Identify possible causes and substance(s) involved.
• Consider Oxygen 100%.
• Paraquat poisoning: Only administer Oxygen if SpO2 is less than 88%.
• Consider applying Cardiac Monitor limb leads.

EMT:

• Ensure completion of applicable items above.
• Perform Blood Sugar Check.
• Consider assisting ALS with Capnography.

AEMT:

• Ensure completion of applicable items above.
• Consider IV NS/LR.

RN:

• Ensure completion of all applicable items above.
• Contact POISON CONTROL at 888-268-4195.
• Consider IO NS/LR.
• Consider Atropine repeated until dry secretions. Likely to exceed 20 mg and may be as much as 2,000 mg.

• Adult:	Pediatric:
  1-2+ mg IV/IO. If intubation needed: 6 mg IV/IO.	0.02-0.05 mg/kg IV/IO Click "calculate" to get dose.

• Seizing: Refer to Protocol 2-792 - Seizure.

Medic:

• Ensure completion of all applicable items above.
• Consider Protocol 2-044 - Airway: RSI.

CP:

• Ensure completion of all applicable items above.

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