What is the recommended EMS action sequence when a patient exposed to pesticides is vomiting?

• A. Induce vomiting to clear the agent and then transport.
• B. Protect airway, decontaminate, and transport for supportive care and antidotes as indicated by protocol.
• C. Decontaminate after patient is stable with no airway concern.
• D. Only provide suctioning and do not decontaminate.

Answer: (B)

When a patient exposed to pesticides is vomiting, the priority is to protect the airway first. Vomiting raises the risk of aspiration of toxic material, which can lead to choking or chemical pneumonitis, so ensuring a clear, protected airway is the immediate concern before doing anything else.

Next, proceed with decontamination. Removing contaminated clothing, washing exposed skin, and flushing any exposed eyes or mucous membranes helps limit further absorption of the toxic agent and reduces the risk of spreading contamination to responders and the environment. Decontamination should occur promptly once the airway is protected, not delayed until the patient is completely stable.

Then transport for ongoing monitoring, supportive care, and any antidotes as indicated by protocol. This sequence—airway protection, decontamination, and transport for care and antidotes—addresses both the patient’s safety and the public-health aspect of contamination.

Inducing vomiting is not recommended because it increases the risk of aspiration and does not improve outcomes in pesticide exposure. Providing suctioning alone without decontamination fails to reduce absorption and contamination.