Check before giving

For patients older than 65, B-035 requires weight of at least 80 kg to receive an auto-injector.
Do not exceed 3 devices unless definitive medical care is available. Ensure scene safety and move to a safe area when possible.

Use in OCEMS

For possible/known organophosphate insecticide or nerve-agent exposure with a compatible cholinergic syndrome.
B-035 uses salivation, tearing, urination, defecation, GI upset, emesis, and constricted pupils to describe the syndrome.

Indication / route	Dose & limits
Respiratory distress with cholinergic findings	2 auto-injectors under the B-035 table.
Severe respiratory distress with agitation and cholinergic findings	3 auto-injectors under the B-035 table.
No signs/symptoms	Monitor for findings every 15 minutes; the table does not instruct prophylactic injection.

For patients younger than 12, B-035 requires a weight of at least 30 kg to receive an IM auto-injector.
For a smaller child, do not improvise a partial auto-injector dose; use the pediatric poisoning standing order and medical direction.

B-035: weight determines eligibility in children younger than 12; clinical signs determine the number of complete devices. Do not divide an auto-injector.

Age / weight	Clinical findings	IM auto-injectors
Younger than 12 and below 30 kg	Any findings	Not eligible under B-035; pediatric poisoning pathway/base direction
Younger than 12 and at least 30 kg, or age 12–14	Respiratory distress with SLUDGEM	2 devices
Younger than 12 and at least 30 kg, or age 12–14	Severe respiratory distress, agitation, and SLUDGEM	3 devices
Eligible child; no symptoms	No respiratory distress / SLUDGEM	Monitor every 15 minutes; no prophylactic dose

Use the mid-anterolateral thigh. Remove the safety release, apply the injector at 90°, and hold for at least 10 seconds as specified by B-035.
Control/dispose of the exposed needle safely. Document product, time, and site; seek medical evaluation after the incident.