Snapshot A 53-year-old farmer presents to the emergency room with shortness of breath and difficulty breathing. He reports dusting his crops with pesticide at the time of onset. On physical exam, he has excessive salivation, sweating, and lacrimation. His pupils are constricted and he has audible wheezes with each breath. He is immediately given atropine and decontaminated. Introduction Clinical definition login to view 1 more bullet Epidemiology Demographics login to view 2 more bullets Risk factors login to view 1 more bullet Etiology Insecticides login to view 1 more bullet Nerve gas login to view 1 more bullet Ophthalmic agents login to view 1 more bullet Herbicide login to view 1 more bullet Industrial chemicals login to view 1 more bullet Pathogenesis login to view 2 more bullets Presentation Symptoms login to view 4 more bullets Physical exam login to view 6 more bullets DUMBBELSS login to view 1 more bullet Studies Labs login to view 3 more bullets Making the diagnosis login to view 1 more bullet Differential Viral gastroenteritis login to view 2 more bullets Treatment Conservative login to view 4 more bullets Medical login to view 11 more bullets Complications Respiratory failure Seizures Prognosis Good with treatment, though patients may require intubation before stabilization