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Nerve agent exposure (CBRN) — DIPIMC MCQ

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HardMajor Incident ManagementNerve agent exposure (CBRN)DIPIMCDipIMC

At a chemical release, several casualties present with constricted pupils, profuse salivation, excessive bronchial secretions and muscle fasciculations.

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Decontaminate the casualties and give atropine, with pralidoxime, for the cholinergic crisis

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · B = shown as D · A = shown as E

Miosis, salivation, bronchorrhoea and fasciculations form a cholinergic toxidrome consistent with nerve-agent or organophosphate exposure, treated by decontamination followed by atropine to dry secretions, with an oxime such as pralidoxime. Transporting contaminated casualties (C) spreads contamination to responders and the receiving hospital. Recognise the cholinergic picture and decontaminate before giving the antidote.

Reference: NHS England EPRR; CBRN guidance