MBBS OSCE · Emergency / Toxicology
Organophosphate poisoning — resus OSCE
OSCE on cholinergic toxidrome, atropine titration, pralidoxime, decontamination and intermediate syndrome awareness.
10 min stationVerification in progress
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Exam tags
NEET-PGINICET
Candidate instructions
Recognise the toxidrome and initiate life-saving treatment. Verbalise doses and endpoints.
Candidate tasks
- PPE/decontamination; ABC with early airway for secretions/weakness.
- Give atropine and titrate to drying of secretions.
- Give pralidoxime as per protocol.
- Benzodiazepine for seizures; avoid succinylcholine if RSI discussed.
- Plan observation for intermediate syndrome / respiratory failure.
Examiner checklist
- Names muscarinic features (DUMBBELS/SLUDGE)
- Atropine doubling regimen to dry secretions (not pupils alone)
- Pralidoxime role (reactivate AChE before ageing)
- Staff safety / remove contaminated clothes
- Ventilatory failure anticipated
- Intermediate syndrome mentioned (24–96 h weakness)
Model standard
Airway first; atropine titrated to clear lungs; oxime early; supportive ICU care; watch for recurrent cholinergic crisis and intermediate syndrome.
Common errors
- Under-atropinisation
- Focusing on pupil size as sole endpoint
- No decontamination/PPE