Acute Chemical Poisoning: Emergency Treatment Protocol

1. Stabilization (ABCs)

• Airway, Breathing, Circulation; O₂, intubation if needed
• Cardiac monitoring, IV access

2. Identification

• History, containers, SDS, tox screen
• Call Poison Control (1-800-222-1222)

3. Decontamination

• Dermal: Remove clothes, irrigate 15+ min
• Ocular: Irrigate 15+ min, Morgan lens
• Ingestion: No routine emesis; activated charcoal (1 g/kg) if <1 hr, not caustic/hydrocarbon
• Inhalation: Fresh air, bronchodilators, consider cyanide/CO protocols

4. Antidotes (Specific)

• N-acetylcysteine (acetaminophen), naloxone (opioids), flumazenil (benzodiazepines), fomepizole (methanol/ethylene glycol), hydroxocobalamin (cyanide), atropine/pralidoxime (organophosphates)

5. Supportive Care

• IV fluids, electrolytes, vasopressors, dialysis, hyperbaric O₂ (CO)

Continuous reassessment; ICU admission for severe cases.