MBBS OSCE · Emergency / Toxicology

Organophosphate poisoning — resus OSCE

OSCE on cholinergic toxidrome, atropine titration, pralidoxime, decontamination and intermediate syndrome awareness.

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Exam tags

NEET-PGINICET

Candidate instructions

Recognise the toxidrome and initiate life-saving treatment. Verbalise doses and endpoints.

Candidate tasks

  1. PPE/decontamination; ABC with early airway for secretions/weakness.
  2. Give atropine and titrate to drying of secretions.
  3. Give pralidoxime as per protocol.
  4. Benzodiazepine for seizures; avoid succinylcholine if RSI discussed.
  5. 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
Organophosphate poisoning — resus OSCE · MBBS OSCE · NeetVellum