Observation and patient disposition after organophosphate and carbamate poisonings

Admit all patients who require atropine for organophosphate or carbamate poisoning to an intensive care unit.

Observe all patients after deliberate organophosphate or carbamate poisonings because they can deteriorate rapidly. Consider discharge if the patient remains asymptomatic for at least 24 hours after exposure and their cholinesterase activity is normal.

Observe all accidental organophosphate or carbamate ingestions for at least 12 hours because of the potential for late onset of symptoms. Discharge patients if they remain asymptomatic after the observation period.

Dermal and inhalational exposures only require observation if they are symptomatic.