Identify the toxidrome. Treatment is toxidrome-specific — call Poison Control (1-800-222-1222).
Steps by Cert Level
EMT: Airway protection first. Identify substance if possible — bring bottles to hospital. Activated charcoal ONLY if within 1 hour, airway intact, no caustic ingestion — contact medical control first.
AEMT: IV access. Treat vital sign abnormalities. Contact Poison Control.
PARAMEDIC: Opioid: Naloxone. Organophosphate (SLUDGE/DUMBELS): Atropine 2–4mg IV until secretions dry, then Pralidoxime 1–2g IV. Tricyclic antidepressant (wide QRS + hypotension): NaHCO3 1–2mEq/kg IV. Cocaine/stimulant: Benzodiazepines. Cyanide: Hydroxocobalamin 5g IV. Beta-blocker OD: Glucagon 5–10mg IV.