Key takeaway
Anticholinergic: dry, flushed, hot, dilated pupils, tachycardic, retaining urine.
Key points to remember
- Anticholinergic: dry, flushed, hot, dilated pupils, tachycardic, retaining urine.
- Cholinergic: wet everywhere, constricted pupils, bradycardic, fasciculating.
- Opioid: depressed respirations with pinpoint pupils — ventilate before the antidote.
- Sympathomimetic: agitated, dilated, tachycardic, but DIAPHORETIC — the sweat splits it from anticholinergic.
Field priorities
- Cholinergic kills through secretions — airway and suction first.
- Opioid death is respiratory — ventilation precedes naloxone.
Coaching the patient
- Sweat is the single finding that separates sympathomimetic from anticholinergic.
Red flags: act now
- Fasciculations with copious secretions
- Hot dry skin with agitation and retention
Toxidromes: FAQs
What are the priority actions for Toxidromes in the field?
Cholinergic kills through secretions — airway and suction first. Opioid death is respiratory — ventilation precedes naloxone.
What findings in Toxidromes change your plan or your transport decision?
Fasciculations with copious secretions. Hot dry skin with agitation and retention.
What do I need to know about Toxidromes for the NREMT?
Anticholinergic: dry, flushed, hot, dilated pupils, tachycardic, retaining urine. Cholinergic: wet everywhere, constricted pupils, bradycardic, fasciculating. Opioid: depressed respirations with pinpoint pupils — ventilate before the antidote. Sympathomimetic: agitated, dilated, tachycardic, but DIAPHORETIC — the sweat splits it from anticholinergic.
What should the crew communicate or document for Toxidromes?
Sweat is the single finding that separates sympathomimetic from anticholinergic.
Study Toxidromes in the app4,600+ NREMT-style questions, clinical judgment scenarios and timed mock exams.See how CinnaEMS works
Start free Was this helpful?