👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Medical, Obstetrics & Gynecology🔖 Free to read, print, and share
Also known as: antidotes · overdose · poisoning · naloxone · organophosphate · cyanide · tricyclic
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Use this quick-reference guide to recognise, treat and hand over Toxicology & Antidotes on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Depressants
Opioid → naloxone (ventilate first)
📌 Cholinergic
Organophosphate → atropine + pralidoxime
End point: dry secretions
📌 Gases
Cyanide → hydroxocobalamin
CO → high-flow oxygen · SpO2 lies
📌 Cardiac
Tricyclic, wide QRS → bicarbonate
Beta-blocker → glucagon
Calcium blocker → calcium
📚 Toxicology & Antidotes — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Most poisonings are treated with supportive care, but a handful have a specific antidote the exam expects candidates to pair with the poison. Airway and ventilation still come first, and the poison center is part of the plan.
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Key points
Understand these first
Opioids → naloxone, titrated to breathing; ventilate with a bag-mask first.
Organophosphates and nerve agents → atropine for secretions, plus pralidoxime.
Scene safety and decontamination before patient contact.
Support airway, breathing and circulation — the antidote is second.
Bring containers and contact poison control.
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Red flags — report now
Escalate immediately
Wide QRS or seizures after an ingestion
Excessive secretions with pinpoint pupils
Normal SpO2 in a smoke-exposed patient who looks sick
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Patient teaching
What patients must know
Pulse oximetry reads carboxyhemoglobin as normal — a normal SpO2 does not rule out CO.
Atropine end point in organophosphate poisoning is drying of the secretions, not the pupils.
❓ Toxicology & Antidotes: NREMT FAQs
What are the priority actions for Toxicology & Antidotes in the field?
Scene safety and decontamination before patient contact. Support airway, breathing and circulation — the antidote is second. Bring containers and contact poison control.
What findings in Toxicology & Antidotes change your plan or your transport decision?
Wide QRS or seizures after an ingestion. Excessive secretions with pinpoint pupils. Normal SpO2 in a smoke-exposed patient who looks sick.
What do I need to know about Toxicology & Antidotes for the NREMT?
Opioids → naloxone, titrated to breathing; ventilate with a bag-mask first. Organophosphates and nerve agents → atropine for secretions, plus pralidoxime. Cyanide → hydroxocobalamin; carbon monoxide → high-concentration oxygen. Tricyclic overdose with a wide QRS → sodium bicarbonate.
What should the crew communicate or document for Toxicology & Antidotes?
Pulse oximetry reads carboxyhemoglobin as normal — a normal SpO2 does not rule out CO. Atropine end point in organophosphate poisoning is drying of the secretions, not the pupils.
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Quick Tip
Opioids → naloxone, titrated to breathing; ventilate with a bag-mask first.