6.3 First Aid and Decontamination

40 CFR 171.103(c)(2)(viii) requires commercial applicators to know first aid and other procedures after a pesticide mishap. On an Oklahoma job that competency is practical: a splash at a wheat-country load-out, a mist in the eyes on a still July fairway, a 7A technician who walked into a recently fogged storeroom, or a child who found a jug at the shop. The order of operations is the same in each case. Follow the label First Aid section first. Then get expert help. The nationwide Poison Help line 1-800-222-1222 routes you to the Oklahoma Poison Center (Oklahoma Center for Poison and Drug Information), which OSU pesticide first-aid training tells applicators to post by the phone and save in the cell phone. ODAFF's public pesticide page at ag.ok.gov/pesticides includes Poison Control among its listed links, alongside complaint and Worker Protection Standard resources. You are not expected to diagnose chemistry from memory while someone is seizing.

The label is the use law; the SDS is the extra medical packet

The pesticide label is the enforceable document under FIFRA and Oklahoma pesticide law. Its First Aid (formerly Statement of Practical Treatment) and Note to Physician are the instructions that match that formulation. Typical labeled lines, as National Core reproduces them, include: wash skin immediately with plenty of soap and clean water; flush eyes for 15 minutes and get medical attention; move the person to fresh air and give artificial respiration if needed; and, on older labels, directions about vomiting. Always read the actual label in the truck, because modern wording and Oklahoma Poison Center practice have moved away from routine vomiting.

The safety data sheet (SDS) is a HazCom/GHS document with composition, first-aid, fire, transport, and toxicology sections that hospital staff and emergency responders use. It does not replace the label for how the product may be applied, and it may describe a concentrate or a technical ingredient in GHS language that looks harsher or milder than the pesticide signal word. In an emergency, take the label (or a clear photo of the front panel, First Aid, and Note to Physician). Take the SDS too if it is in the file. If you can only grab one thing, grab the label of the product that actually contacted the person.

Call 1-800-222-1222 even when you are also calling 911. Poison specialists need the product name, EPA registration number, active ingredients, signal word, and what happened (route, amount, time, age, symptoms). Do not wait to "see if it gets better" through a harvest afternoon. Do not give alcohol "to counteract" a pesticide—National Core and every serious first-aid protocol reject that. Do not give anything by mouth to an unconscious person.

Route-by-route first aid

Skin. Speed matters. Remove contaminated clothing, shoes, and jewelry so the fabric does not keep dosing the skin. Wash with large amounts of clean water and soap; OSU notes that liquid detergent often outperforms bar soap for oily concentrates. Use a shower, hose, or, if that is the only water available, a stock tank or irrigation source—OSU's blunt warning is not to let someone die while you debate whether the water is pretty. Wash hair if it was in the spray. After the wash, dry and cover for warmth if the person is going into shock, but do not smear ointments, greases, or home remedies on chemical burns unless a clinician or the label directs it. Rescuers should put on PPE so they do not become the second patient. Bag the clothing as contaminated waste; do not send it through a family washing machine with the school clothes.

Eyes. Hold the eyelid open and gently rinse with clean running water for 15 minutes. Flush under the lid. If only one eye is hit, keep the contaminated runoff from entering the other eye. National Core's review item flags dripping a token amount of water into the eye as the wrong picture; this is a continuous flush, then medical care, with a clean cover over the eye for transport. Contact lenses come out if they are in the way of the rinse; do not delay the water to hunt for a lens case.

Inhalation. The first action is fresh air. Carry the person if they cannot walk. Do not enter an enclosed, contaminated space—a grain bin, a fogged restaurant basement, a fumigated railcar—without the respirator and PPE that would have been required for the application. Warn others. Loosen clothing, keep the person still, and start rescue breathing or CPR only if you are trained and the scene is safe. Artificial respiration on a contaminated face requires care not to poison the rescuer; professional responders should be on the way.

Mouth or swallowed. Rinse the mouth. Do not induce vomiting unless the label or Poison Control tells you to. OSU's pesticide first-aid fact sheet states that medical personnel and the Oklahoma Poison Center do not recommend inducing vomiting. Many liquid pesticides are emulsifiable concentrates or other petroleum-based formulations. Vomiting those products risks aspiration of solvent into the lungs, which can be worse than leaving the material in the stomach. Older Core manuals still show "how to induce vomiting if appropriate" because some labels historically said so; the live instruction is the current label plus 1-800-222-1222, not a reflex finger-down-the-throat. Never use salt water, mustard, or leftover ipecac from a drawer as a protocol.

Decontamination, transport, and shock

Decontaminate the person before transport when you can do it without delaying life-saving care. A still-soaked coverall in an ambulance contaminates EMTs and keeps dosing the patient. If the person is not breathing, has no pulse, or is in obvious heat stroke or seizure, airway, breathing, circulation, cooling, and 911 come first; rinse what you can while those steps happen. Tell responders it is a pesticide event and hand them the label.

Shock can kill even when the absorbed dose might not have. OSU describes pale, cold, clammy skin, weak rapid pulse, and vacant-looking pupils. Keep the person flat with legs raised if they are not vomiting or in respiratory distress, keep them warm enough not to shiver, and do not overheat. Call 911. A pesticide mishap on a remote ROW or a grain-bin site should include a plan for how an ambulance finds you.

Tell your clinic in advance which high-toxicity products your operation actually uses, as OSU recommends for commercial and large-volume users. That is preparation, not a substitute for the label in the moment.

Antidotes are not a glove-box medical kit

Some OP labels still discuss atropine and other drugs in the Note to Physician. Those sentences are for licensed medical personnel who can confirm the toxidrome, watch the heart and lungs, and dose correctly. Do not carry atropine autoinjectors as a do-it-yourself applicator protocol. Do not inject a coworker because a website said it is the OP antidote. Wrong drug, wrong dose, or treating heat stroke and pyrethroid irritation as OP poisoning can kill. Your job is decontamination, labeled first aid, Poison Help, and emergency medical care. The physician reads the Note to Physician.

If several people were exposed, treat it as a scene: stop the source, keep unprotected people out, and work through the same first-aid steps. 40 CFR 171.103(c)(2)(iv) and (v) pair this chapter with mishap prevention—closed mixing, labeled PPE, keeping people out of treated areas—but once the splash has happened, the exam still expects the rinse, the phone number, and the label in your hand.