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Cholinergic poisoning: protect the team, then clear the air

Educational use only. Not clinically reviewed

46-year-old man for calm contamination, airway, secretion, neuromuscular-risk, antidote-boundary, reassessment, and handoff practice. About 6 simulated minutes.

What you will practise

  • Reconcile product, route, secondary contamination, secretions, breathing, weakness, CNS, and the whole patient.
  • Recognize the muscarinic, nicotinic, and CNS pattern without mnemonic- or cholinesterase-only closure.
  • Activate PPE, decontamination, airway, resuscitation, toxicology, and safety ownership.
  • Review supplied respiratory, neuromuscular, CNS, exposure, cholinesterase, and airway evidence.
  • Record bounded qualified antidote, airway, seizure, and surveillance intent, then review a strict later report.
  • Hand off recurrent secretions, bronchospasm, weakness, intermediate syndrome, exposure, seizure, and active risk.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • American Heart Association. Part 10: Adult and Pediatric Special Circumstances of Resuscitation. Section 21.12, life-threatening organophosphate or carbamate poisoning. Consulted 2026-08-26.
  • US Environmental Protection Agency. Recognition and Management of Pesticide Poisonings. Sixth edition, Chapter 5, Organophosphates. 2013.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.