TL;DR

Toxicology (EMS): Poisoning and overdose management: substance identification, antidotes, decontamination.

By Valenke Exam Prep Team·Last updated 2026-06-02

Toxicology (EMS)

Definition

Poisoning and overdose management: substance identification, antidotes, decontamination.

Regulatory Context

Regulatory context for toxicology (ems) includes federal and state requirements. Healthcare facilities must comply with CMS Conditions of Participation, state licensure requirements, and accreditation standards (Joint Commission or AAAHC). Non-compliance can result in citations, fines, or loss of Medicare/Medicaid reimbursement.

Exam Focus Areas

On the Nremt Emt, Nremt Paramedic exam(s), questions about toxicology (ems) typically test:

Recognition of signs and symptoms requiring immediate intervention
Correct medication selection, dosing, and route of administration
Assessment findings that differentiate between similar presentations
Appropriate transport decisions and hospital notification criteria

Related Procedures

Procedures related to toxicology (ems) in the EMS setting:

STEMI protocol: 12-lead ECG within 10 min then aspirin 324mg then NTG if SBP >90 then notify cath lab then transport code 3
Trauma assessment: scene safety then MOI then primary survey (XABCDE) then rapid transport then secondary survey en route
RSI sequence: preoxygenation then sedation (etomidate 0.3mg/kg or ketamine 2mg/kg) then paralytic (succinylcholine 1.5mg/kg or rocuronium 1mg/kg) then intubation then confirm placement with waveform capnography

Equipment & Tools

Equipment used in toxicology (ems) assessment and treatment:

Waveform capnograph: Measures end-tidal CO2 continuously with waveform display. Available sizes: Mainstream (inline), Sidestream (sampling)
AED: Automated external defibrillator for VF/pVT. Available sizes: Adult pads (over 8yo or 25kg), Pediatric pads (under 8yo or 25kg)
Pulse oximeter: Measures SpO2 via infrared absorption through capillary bed. Available sizes: Finger clip, Earlobe, Pediatric wrap
IO drill: Intraosseous access device for emergent vascular access. Available sizes: EZ-IO: 15mm (peds), 25mm (adult), 45mm (obese)

Patient Communication

Communication about toxicology (ems) in the prehospital setting includes: explaining procedures to the patient in simple terms, obtaining informed consent when possible (implied consent for unresponsive patients), providing a calm and reassuring presence, and delivering a structured handoff report (SBAR: Situation, Background, Assessment, Recommendation) to the receiving facility.

Why It Matters

Toxidromes (cholinergic, anticholinergic, opioid, sympathomimetic) tested on EMT and Paramedic exams.

Practice This Topic

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Frequently Asked Questions

What medications are commonly associated with toxicology (ems)?▼

For toxicology (ems): epinephrine: 1:10,000 1mg IV/IO q3-5min (cardiac arrest), 1:1,000 0.3mg IM (anaphylaxis), route IV/IO, IM, ET, for Cardiac arrest, anaphylaxis, severe asthma. aspirin: 324mg PO chewed, route PO, for ACS/suspected MI.

What protocol applies to toxicology (ems) in prehospital care?▼

For toxicology (ems): Stroke recognition: Cincinnati Prehospital Stroke Scale (facial droop, arm drift, speech) then last known well time then transport to stroke center

What assessment tools help evaluate toxicology (ems)?▼

For toxicology (ems): SAMPLE: evaluates Signs/symptoms, Allergies, Medications, Past history, Last intake, Events; scoring is Mnemonic for patient history gathering. Cincinnati Stroke Scale: evaluates Facial droop, Arm drift, Speech abnormality; scoring is Any 1 positive = 72% probability of stroke.