2.2 Investigation and Management
First of all, he was decontaminated by washing his hands with soap and
water and his clothing was removed. Since he had 2 episodes of vomiting
on the way to PHC, gastric lavage was not attempted which may increase
the chances of aspiration. Oxygen was attached at 2L/min and IV access
with 1L ringer lactate (R/L) was initiated. IV atropine 1 mg loading
dose was administered and was repeated every 5 mins until the signs of
atropinization appeared. Due to unavailability of 2- PAM, it could not
be given. In the meantime, routine blood investigations within the
domain of the facility were sent. Electrocardiogram (ECG) showed sinus
bradycardia with no other specific changes. Chest X-ray (CXR) was
unremarkable. Patient’s vitals were monitored with the help of a
monitor. His routine investigations during ED presentation were as
follows: