Airway and breathing
Early airway intervention and ventilatory support are essential for severe organophosphate or carbamate poisoning. Intubate and ventilate patients if their level of consciousness compromises the airway or breathing.
The vagal response to intubation can precipitate profound bradycardia. Give atropine before intubation to block the vagal response, unless the patient is in cardiac arrest. Use:
atropine 0.6 mg (child: 0.02 mg/kg up to 0.6 mg) intravenously, as a single dose. organophosphate and carbamate poisoning - pre-intubation atropine
If patients have neuromuscular paralysis, ventilation is usually required for as long as 2 to 3 weeks.