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  #1  
Old 07-06-2011
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Poison Nerve Gas First Step in Management!

56 year old military commander has been attacked with nerve gas....Presents with lacrimation salivation, Urination defacation and shortness of breath?
What is the first step in Management?
A..Atropine
B..Decontaminate..wash the patient
C..Remove his clothing
D..Pralidoxime

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  #2  
Old 07-06-2011
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Ya i had same kind of question , but didnt have anyother options other than removing clothes .
but I think here we give atropine first , because its action is very fast ,faster than pralidoxine ... but not sure ..
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Old 07-06-2011
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Quote:
Originally Posted by usmlekzz View Post
Ya i had same kind of question , but didnt have anyother options other than removing clothes .
but I think here we give atropine first , because its action is very fast ,faster than pralidoxine ... but not sure ..
well i understand u have to give pralidoxine first...but apparently everybook says first order of mgmt is to remove the caustiv substance first ..which would be the clothes he has on too...but master the boards says atropine first...Hate it when they dont agree...CK is hard with out a stepwise approach...
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Old 07-06-2011
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Quote:
Originally Posted by Kais_MD View Post
56 year old military commander has been attacked with nerve gas....Presents with lacrimation salivation, Urination defacation and shortness of breath?
What is the first step in Management?
A..Atropine
B..Decontaminate..wash the patient
C..Remove his clothing
D..Pralidoxime

it's atropine first, remove the contaminated clothes only after that
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Old 07-06-2011
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Remove the exposure first so with contaminated cloth then atropine
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Old 07-06-2011
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Quote:
Originally Posted by confident View Post
Remove the exposure first so with contaminated cloth then atropine
I agree, first remove a possible source of recontamination, then administer atropine.
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  #7  
Old 07-07-2011
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I agree with Remove the exposure first too..because you can absorb more through your skin from your clothing.... kaplan, crush and world says remove exposure....MTB insist upon atropine first.....arrrrrrrrrrrrrrg so confusing..Thats how pple loose points on ck
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Old 07-07-2011
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See this , it may help
http://bioterrorism.slu.edu/nerve/nerve.pdf
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  #9  
Old 07-07-2011
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Quote:
Originally Posted by amirh899 View Post
thanks that Helped...So does that mean disregard Master the Boards ..... God i hope i dont get this in Ck lol
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Old 07-07-2011
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Quote:
Originally Posted by Kais_MD View Post
thanks that Helped...So does that mean disregard Master the Boards ..... God i hope i dont get this in Ck lol
Guys guys , read the statement carefully , it NERVE GAS , most likely serin , Tabun , or soman all acetyc choline esterase inhibitors, so as being a gas it wnt be absorbed from the clothings , come on its a gas , not a spray .

Ans is Atrpoine first ,
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  #11  
Old 07-08-2011
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Quote:
Originally Posted by DrAJCH View Post
Guys guys , read the statement carefully , it NERVE GAS , most likely serin , Tabun , or soman all acetyc choline esterase inhibitors, so as being a gas it wnt be absorbed from the clothings , come on its a gas , not a spray .

Ans is Atrpoine first ,
hmmmm...that is a valid point...maybe thats why MTB insisted on atropine first. So i guess the removing clothes is only when its a farmer exposed to a pesticide in spray form.
Thanks for your insight...Helped alot...like always decoding the question is alot harder than answering the question....
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Old 07-08-2011
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In fact i am not sure if this is true. Most nerve agents are volatile fluids. So they both turn into gas and contaminate your cloths. Can see the Uptodate for more explanation.
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Old 07-08-2011
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A..Atropine 1st because he already has symptoms occurring
this q from MTB page 540
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  #14  
Old 07-08-2011
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Quote:
Originally Posted by miss patho View Post
A..Atropine 1st because he already has symptoms occurring
this q from MTB page 540
I know Ms patho...I saw it in MTB too..But uworld has the same set of questions and they want u to decontaminate first...i guess no one can agree ...lets just hope it doesnt come on exam lol.
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