How should suspected pesticide exposure involving vomiting be managed?

• A. Stabilize and discharge from the scene.
• B. Administer decontamination and IV fluids only.
• C. Protect airway, decontaminate, and transport for supportive care and antidotes as indicated by protocol.
• D. Induce vomiting to remove pesticide.

Answer: (C)

When vomiting occurs after suspected pesticide exposure, the highest priority is to protect the airway, thoroughly decontaminate the patient, and transport for advanced care. Protecting the airway is essential because vomiting can lead to aspiration and airway compromise, so provide airway support as needed and ensure patency. Decontamination helps reduce further absorption of the chemical and prevents secondary exposure to responders, which includes removing contaminated clothing and flushing exposed skin or eyes per protocol. Transport to a facility enables ongoing monitoring, supportive care (such as IV fluids and electrolyte management), and access to antidotes if indicated by the protocol for the suspected pesticide. Inducing vomiting is not used because it increases the risk of aspiration and can worsen the patient’s condition. Stabilization alone or decontamination with fluids without airway protection would not adequately address the immediate risks or the need for hospital-based antidotal therapy.