Extended Operational and Trade Vocabulary

Shipboard Medical, Telemedicine and Seafarer Health glossary

The shipboard-medical vocabulary: the ABCDE primary survey, abandonment financial security for medical care, the International Medical Guide categories of ship medicine chests, telemedicine support, and the first-aid and emergency-care terms. Grounds each term in the MLC medical-care requirement or the shipboard clinical procedure it belongs to.

358 defined terms.

Showing 250 on this page (page 1 of 2).

A

AAOS: American Academy of Orthopaedic Surgeons; publishes Emergency Care and Transportation of the Sick and Injured used in shipboard first-aid training.
Abandonment financial security: Mandatory MLC 2006 Regulation 2.5.2 insurance covering repatriation, wages, and essentials when a seafarer is abandoned.
ABCDE assessment: Primary survey sequence (Airway, Breathing, Circulation, Disability, Exposure) used in shipboard trauma and medical emergencies.
ACEP Cruise Ship Medicine Section: American College of Emergency Physicians special-interest section publishing health-care standards for cruise ship medical facilities.
Acetaminophen: US English term for paracetamol; oral analgesic and antipyretic stocked in all IMGS ship categories.
Activated charcoal: Oral adsorbent for ingested poisons; listed in IMGS Annex IV and MFAG decontamination guidance.
Acute coronary syndrome (ACS): Suspected myocardial infarction or unstable angina; shipboard protocol calls for aspirin 300 mg chewable, oxygen if SpO2 < 94%, GTN, and TMAS consult.
Adrenaline auto-injector (EpiPen): 0.3 mg IM device for anaphylaxis carried in Category A and B ships' chests.
AED (Automated External Defibrillator): Portable defibrillator with adult and pediatric pad sets recommended for all merchant ships and required on cruise ships.
Aeromedical evacuation: Fixed-wing or rotary-wing transfer of a sick or injured seafarer to definitive care ashore.
Air splint: Inflatable limb-immobilization device listed in IMGS Annex V.
Albuterol: US English name for salbutamol metered-dose inhaler used for asthma and bronchospasm.
Allergic reaction protocol: Mild reaction managed with antihistamine (cetirizine); anaphylaxis treated with IM adrenaline 0.5 mg (0.3 mg auto-injector) and TMAS contact.
Amoxicillin: Beta-lactam antibiotic in IMGS Annex IV for respiratory and dental infections.
Amoxicillin-clavulanate: Co-amoxiclav, broader-spectrum oral antibiotic stocked on Category A vessels.
Ampoule register: Logbook recording each glass ampoule of injectable medication issued from the medical chest.
Anaphylaxis kit: Adrenaline, antihistamine, hydrocortisone, oxygen, and airway adjuncts grouped for rapid access.
Antiemetic: Drug class (ondansetron, metoclopramide, cyclizine) used for vomiting and seasickness.
Antimalarial chemoprophylaxis: Doxycycline, mefloquine, or atovaquone-proguanil (Malarone) regimens for crew calling at endemic ports.
Apostleship of the Sea: Catholic seafarers' welfare organization, now Stella Maris.
Appendicitis at sea: IMGS provides clinical algorithm; antibiotic cover (ciprofloxacin plus metronidazole) and MEDEVAC are first-line responses.
Aspirin 300 mg chewable: Antiplatelet dose given on suspected acute myocardial infarction per IMGS cardiac protocol.
Atovaquone-proguanil (Malarone): Daily malaria prophylaxis tablet suitable for short-stay port calls.
Audiometry: Hearing test conducted at pre-employment medical examination per ILO/IMO Guidelines on Medical Examinations of Seafarers.
Autoclave: Steam sterilizer for surgical instruments fitted on ships with hospital facilities.
Auxiliary medical attendant: STCW VI/4-2 trained officer designated to deliver onboard medical care.
Azithromycin: Macrolide antibiotic used for atypical pneumonia and traveler's diarrhea.

B

Bag-Valve-Mask (BVM): Manual resuscitator with reservoir for positive-pressure ventilation; IMGS Annex V item.
Beclomethasone: Inhaled corticosteroid for asthma maintenance therapy.
Benzodiazepine: Diazepam or midazolam stocked for seizure control under controlled-drug register.
Blood glucose monitor (glucometer): Capillary glucose testing device for suspected diabetes or hypoglycemia.
Blood pressure cuff: Manual aneroid or digital sphygmomanometer carried in all categories.
Body bag: Cadaver pouch held aboard for management of death at sea pending repatriation or burial.
Booster vaccination: Tetanus-diphtheria every 10 years and other intervals per WHO and flag-state schedules.
Britannia P&I: P&I club operating a Pre-Employment Medical Examination (PEME) scheme for entered crews.
Burial at sea: Last-resort disposal of remains under master's authority; flag-state and IMGS guidance on documentation.
Burn area estimation: Rule of Nines used shipboard to estimate total body surface area burned.
Burn dressing: Hydrogel dressings (e.g., Water-Jel) carried for thermal injuries from galley or engine room.
BVM with PEEP valve: Bag-valve-mask fitted with positive end-expiratory pressure valve for severe respiratory failure.

C

Cardiopulmonary resuscitation (CPR): Chest compressions and rescue breathing trained under STCW VI/1 and VI/4.
Cargo gas exposure: Hydrogen sulfide, benzene, ammonia, or chlorine exposure managed per MFAG Table reference.
Cargo Information (SOLAS VI/2): Master must receive cargo data including hazards relevant to MFAG application.
Category A ship: Polar Code ship designed for operation in at least medium first-year ice, which may include old ice inclusions.
Category B ship: Polar Code ship designed for operation in at least thin first-year ice, which may include old ice inclusions.
Category C ship: Polar Code ship designed for operation in open water or in less severe ice conditions than Categories A or B.
Cefixime: Oral third-generation cephalosporin listed in some flag-state ship chests.
Cefotaxime: Injectable third-generation cephalosporin for severe sepsis on Category A ships.
Centro Internazionale Radio Medico (CIRM): Rome-based TMAS founded 1935 by Guido Guida; provides free 24/7 medical advice in multiple languages.
Cervical collar (semi-rigid): Adjustable Stifneck-type immobilization collar in IMGS Annex V.
Cetirizine: Non-sedating oral antihistamine in shipboard chest.
Chain of evidence: Forensic chain custody procedures for samples taken on board in suspected assault or poisoning.
Charcoal canister respirator: Filter respirator for cargo gas exposure carried alongside SCBA.
Chemical antidote: MFAG-listed antidotes (e.g., atropine for organophosphates, naloxone for opioid overdose, hydroxocobalamin for cyanide).
Chickenpox isolation: Standard infection control measure aboard when crew member presents with varicella.
Chlorhexidine: Antiseptic solution and skin-prep wipes in medical chest.
Chloroquine: Antimalarial; restricted use today due to widespread resistance.
Chlorphenamine (chlorpheniramine): Sedating antihistamine; injectable form for severe allergic reaction.
Cholera vaccine (Dukoral): Oral vaccine occasionally recommended for crews calling at endemic ports.
Ciprofloxacin: Fluoroquinolone antibiotic for urinary, gastrointestinal, and respiratory infections.
CIRM medical record number: Unique case ID assigned by Centro Internazionale Radio Medico for each consultation.
CLIA Health Standards: Cruise Lines International Association guidelines on shipboard medical facilities, staffing, and outbreak response.
Clinical thermometer (digital): Oral or tympanic device replacing mercury thermometers per IMO recommendation.
Clinical waste: Sharps and infectious waste segregated in yellow rigid container per MARPOL Annex V garbage rules.
Co-amoxiclav: See Amoxicillin-clavulanate.
Codeine phosphate: Mild opioid analgesic; in many jurisdictions a controlled drug.
Cold chain: Continuous temperature-controlled supply chain from origin packing house to retail or end-use.
Communicable disease notification: Master notifies next port via Maritime Declaration of Health under IHR 2005.
Confined space rescue first aid: STCW competency including casualty handling after entry-rescue from tanks.
Controlled drug register: Bound logbook with signed entries for each issue or destruction of narcotics on board.
Controlled drug stowage: Double-locked steel cabinet within the medical locker, key held by master.
Coronavirus protocols: ICS/ISF guidance for COVID-19, MERS-CoV, and SARS aboard ships including isolation cabin assignment.
Coroner's report (death at sea): Documentation prepared by master for flag-state, port-state, and seafarer's home authorities.
Corticosteroid (hydrocortisone): Injectable 100 mg vial for anaphylaxis and severe asthma.
CPR mask with one-way valve: Pocket resuscitation mask for rescue breathing without mouth-to-mouth contact.
CROSS Gris-Nez: French Maritime Rescue Coordination Centre coordinating SAMU de Coordination Medicale Maritime medical consultations.
Cruise ship infirmary: Onboard clinic staffed by physician and nurses, sized per CLIA Health Standards based on passenger count.
Cruise ship physician: Licensed medical doctor employed aboard passenger vessels with more than 100 passengers per SOLAS V/14.
Cyanide antidote kit: Hydroxocobalamin (Cyanokit) or sodium thiosulfate plus amyl/sodium nitrite for cyanide poisoning per MFAG.

D

Dangerous Goods List (DGL): Main IMDG table by UN number with packing/segregation columns.
Death certificate at sea: Document drawn by master under flag-state law and recorded in Official Log Book.
Decompression illness: Diving casualty managed with 100% oxygen, fluids, and urgent recompression; relevant for diving-support vessels.
Defibrillator pads (adult and pediatric): Dual-set electrodes for AED units on passenger ships.
Dengue fever: Mosquito-borne viral illness encountered in tropical port calls; supportive shipboard care, MEDEVAC for severe cases.
Dental kit (emergency): Cavit temporary filling material, oil of cloves (eugenol), forceps for shipboard dental emergencies.
Diabetes management at sea: Glucometer monitoring; restricted-duty considerations under medical fitness regulations.
Diazepam: Benzodiazepine for seizures and severe anxiety; controlled drug requiring register entry.
Diclofenac: NSAID injectable for renal colic and severe musculoskeletal pain.
Diphtheria-Tetanus-Pertussis (Tdap): Booster vaccine in routine seafarer vaccination schedules.
Disability assessment: Glasgow Coma Scale (GCS) and pupillary response check in primary survey.
Doctor on board: Required by SOLAS V/14 for ships carrying more than 100 passengers on voyages exceeding 3 days.
Doxycycline: Tetracycline antibiotic also used for malaria prophylaxis and Lyme disease.
Dressing pack (sterile): Pre-packaged wound dressing materials in IMGS Annex V.
DSC distress alert: GMDSS Digital Selective Calling alert used to summon urgent medical advice via coast station.

E

ECG (12-lead): Electrocardiograph fitted on larger or passenger ships; tracing transmitted to TMAS by email or Inmarsat.
EMSA: European Maritime Safety Agency, supporting Paris MoU and EU Member States on PSC.
ENG 1 medical certificate: UK MCA seafarer medical fitness certificate issued by Approved Doctors under MSN 1839.
Enteric isolation: Cabin isolation for crew with infectious gastroenteritis (e.g., norovirus, salmonella).
EpiPen: Brand name for adrenaline auto-injector 0.3 mg IM device.
Epistaxis management: Anterior nasal packing or nasal tampon held in ship chest.
Erythromycin: Macrolide antibiotic alternative for penicillin-allergic patients.
ETCO2 monitor: End-tidal CO2 capnograph on advanced cruise-ship resuscitation trolleys.
European Manual of Maritime Medicine: Reference text for ship doctors and Approved Doctors.
Eye irrigation: Saline or Diphoterine irrigation for chemical eye exposure per MFAG.
Eye wash station: Mounted plumbed unit on tankers and chemical carriers near cargo handling areas.

F

Falck Healthcare Norway: Norwegian provider of maritime telemedical assistance and occupational health services.
Fatigue management: STCW VIII/1 and IMO Guidelines on Fatigue covering rest hours and watch arrangements.
Femoral pulse: Central pulse check used in unresponsive casualty assessment.
First aid kit (portable): Smaller satellite kit at bridge, engine room, and galley separate from main chest.
First aider on board: STCW VI/1 trained crew member competent in basic first aid.
Flag State Medical Regulations: National implementation of MLC 2006 medical certificate and chest requirements.
Fluconazole: Oral antifungal for systemic or persistent fungal infections.
Food handler certificate: Periodic stool testing and training for galley staff under flag-state requirements.
Food poisoning outbreak: Multi-casualty incident managed via cohort isolation and notification under IHR.
Foreign body in eye: IMGS protocol for irrigation, fluorescein staining, and TMAS consultation.

G

Galley hygiene inspection: Periodic inspection under MLC 2006 Regulation 3.2 food and catering.
Gauze swabs (sterile): Standard wound care item in IMGS Annex V.
Glasgow Coma Scale: Neurological assessment scoring eye, verbal, and motor response (3-15).
Glucagon kit: Emergency injection for severe hypoglycemia where oral glucose not possible.
Glucometer: Capillary blood glucose meter with test strips and lancets.
GMDSS Medico Call: Use of MF/HF DSC or Inmarsat for free medical advice under SOLAS Chapter IV.
GTN spray (glyceryl trinitrate): Sublingual spray for angina, contraindicated with hypotension and PDE5 inhibitors.

H

H2S exposure: Hydrogen sulfide poisoning treated with 100% oxygen and supportive care per MFAG Table 600 series.
Haemorrhage control: Direct pressure, tourniquet, and tranexamic acid where available.
Hand sanitizer dispensers: Standard infection control fixtures in mess, galley, and accommodation passageways.
Hazardous Materials Manifest: Reference document used with MFAG during cargo incident response.
Headache assessment: IMGS chapter differentiates tension, migraine, and red-flag neurological causes.
Heat stroke: Engine-room and tropical-deck risk; treated with rapid cooling, IV fluids, and MEDEVAC.
Helicopter Landing Officer (HLO): Trained crew supervising MEDEVAC helicopter operations.
Helicopter winch evacuation: Hi-line technique used by SAR aircraft to lift a casualty in Stokes basket.
Hellenic Centre for the Treatment of Sick Seafarers: Athens-based TMAS for Greek-flagged ships.
HEPA filter mask (FFP3/N95): Respiratory protection during infectious disease management on board.
Hepatitis A vaccine: Two-dose inactivated vaccine recommended for seafarers traveling internationally.
Hepatitis B vaccine: Three-dose recombinant vaccine for blood-borne pathogen protection.
Hospital cabin: Dedicated isolation cabin under MLC Standard A4.1 for ships with 15+ crew on voyages over 3 days.
HUET: Helicopter Underwater Escape Training, capsized cabin egress drill.
Hydrocortisone sodium succinate: 100 mg vial for IV/IM use in severe asthma and anaphylaxis.
Hydroxocobalamin (Cyanokit): 5 g IV antidote for cyanide poisoning.
Hygiene Officer: Designated crew on cruise ships overseeing public-health sanitation under VSP/USPH.
Hypothermia management: Passive and active rewarming protocols for cold-water casualties.

I

Ibuprofen: NSAID analgesic in oral and topical forms.
ICS Tanker Safety Guide: Industry guide referencing emergency response and MFAG application.
IHR 2005: International Health Regulations adopted by WHO, basis for the Maritime Declaration of Health.
Illness Log: Record of seafarer sickness, treatment, and outcome maintained by master/medical officer.
IMGS: International Medical Guide for Ships, 3rd edition, published by WHO 2007.
IMGS 2nd edition (1988): Earlier edition of the WHO ship medical guide, superseded but still found aboard older vessels.
IMGS Annex IV: List of medicines required on board ships by category.
IMGS Annex V: List of medical equipment required on board ships.
IMGS Annex VI: List of antidotes for medical first aid in chemical accidents.
IMGS Annex VII: Surface area nomogram and clinical reference tables.
IMGS Chapter 1: First aid, examination, and diagnosis chapter.
IMGS Quantification Addendum: 2010 WHO companion volume specifying medicine and equipment quantities per Category A, B, C ships.
Immunization record: Personal vaccination record carried by each seafarer alongside the ICVP yellow book.
Inmarsat FleetBroadband: Higher-bandwidth IP service.
Inmarsat SafetyNET: Free broadcast service for medical advice messages.
Inmarsat-C medical message: Free safety messaging service used to relay medical consultations to TMAS.
Insulin (human regular and isophane): Refrigerated insulin held for diabetic crew on Category A ships.
International Certificate of Vaccination or Prophylaxis (ICVP): WHO Yellow Card recording yellow fever and other vaccinations.
International Chamber of Shipping (ICS): Global trade association of national shipowner associations.
International Health Regulations 2005: WHO instrument governing port health, MDH, and ship sanitation certificates.
International Maritime Health (journal): Peer-reviewed journal of the International Maritime Health Association (IMHA), Gdynia, Poland.
International Maritime Health Association (IMHA): Professional body for maritime medicine practitioners.
International Medical Guide for Ships: Full title of IMGS; WHO/ILO/IMO joint product.
International Ship Sanitation Certificate (SSCC/SSCEC): IHR 2005 certificate issued at port of inspection, valid 6 months.
International SOS: Global medical and security assistance company providing maritime telemedicine services.
Iridium Certus: L-band satellite broadband service (GMDSS-recognized 2020).
ISGOTT medical first aid section: International Safety Guide for Oil Tankers and Terminals chapter on first aid for oil and chemical exposure.
ISM Code Section 7: Requires written procedures for shipboard operations including medical emergencies.
Isolation cabin: Designated cabin used for guests under medical isolation for communicable disease.
ISWAN: International Seafarers' Welfare and Assistance Network, registered UK charity.
IV cannula sizes: 14G to 22G cannulae stocked for Category A vessels.
IV fluid bags: 0.9% sodium chloride and Hartmann's solution per IMGS Quantification.

J

Joint Maritime Commission: ILO body addressing seafarer health, safety, and welfare.

K

Ketamine: Dissociative anesthetic; not standard on cargo ships, present on offshore-support vessels.
Ketorolac: Injectable NSAID for severe pain where stocked.

L

Laryngeal mask airway (LMA): Supraglottic airway device on cruise-ship resuscitation trolleys.
Laryngoscope: Direct or video device used by physicians on passenger ships.
Lifeboat first aid kit: Smaller kit in each survival craft per LSA Code.
Lignocaine (lidocaine): Local anesthetic for wound closure and minor procedures.
Loperamide: Antidiarrheal in shipboard chest.
Lorazepam: Benzodiazepine alternative to diazepam where authorized.
Lyme disease: Tick-borne illness with delayed presentation; doxycycline first-line treatment.

M

MAIB: Marine Accident Investigation Branch of the United Kingdom, established under the Merchant Shipping Act 1988 and operating from Southampton.
Malaria: Plasmodium infection acquired in endemic ports; rapid diagnostic test (RDT) and artemether-lumefantrine on Category A ships.
Malarone: Brand name for atovaquone-proguanil antimalarial.
Maritime Declaration of Health (MDH): IHR 2005 Annex 8 form submitted to port health authority on arrival.
Maritime Medical Centre (Aberdeen): UK provider of seafarer occupational health and TMAS services.
MARPOL Annex V medical waste: Garbage record book entries for clinical waste landed ashore.
Mass Casualty Incident plan: Ship-specific procedure for incidents exceeding routine medical capacity.
Master's authority over medical care: Master is ultimately responsible for seafarer health under MLC 2006 Standard A4.1.
MCA Approved Doctor: UK Maritime and Coastguard Agency physician authorized to issue ENG 1 certificates.
MCA MSN 1839: Merchant Shipping Notice on seafarer medical certification standards.
MedAire: Phoenix, Arizona-based provider of maritime telemedicine through MedLink Global Response Center.
MEDEVAC: Medical evacuation by ship, helicopter, or fixed-wing aircraft.
Medical Care (STCW VI/4-2): Higher-level STCW competency for officers in charge via Model Course 1.15.
Medical Care on Board Ship: Title of MLC 2006 Regulation 4.1 covering health protection and treatment.
Medical Certificate STCW I/9: Mandatory pre-employment and periodic fitness certificate per STCW Regulation I/9.
Medical chest: Lockable cabinet containing pharmaceuticals and equipment per flag-state and IMGS quantification.
Medical chest inspection: Annual inspection by flag-state-recognized pharmacist or doctor.
Medical First Aid (STCW VI/4-1): STCW competency at first-aid level via Model Course 1.14.
Medical fitness examination: Pre-employment and periodic examination per ILO/IMO Guidelines on Medical Examinations of Seafarers, 2013 revision.
Medical Log Book: Record of every medical event, treatment, and TMAS consultation on board.
MEDICO call: VHF or Inmarsat call requesting medical advice; addressed to coast radio station or TMAS.
MEDICOM Madrid: Spanish TMAS service operated by Instituto Social de la Marina.
MedLink: TMAS service operated by MedAire from Phoenix, Arizona.
Mefloquine: Weekly antimalarial; contraindicated with history of neuropsychiatric disorders.
Meningitis vaccine (ACWY): Required for crew on Hajj pilgrim ships and certain ports.
Mental Health Support Solutions (MHSS): German-based provider of 24/7 psychological support to seafarers.
MERS-CoV: Middle East Respiratory Syndrome coronavirus; relevant to Gulf-region port calls.
Metoclopramide: Antiemetic in IMGS Annex IV.
Metronidazole: Antibiotic active against anaerobes and protozoa.
MFAG: Medical First Aid Guide for Use in Accidents Involving Dangerous Goods; IMO publication supplementing IMDG Code.
MFAG 2024 edition: Current edition of the Medical First Aid Guide published by IMO.
MFAG Table Number: Numerical reference (e.g., 700, 725, 740) linking each UN cargo entry in IMDG Code to a treatment schedule.
Midazolam: Short-acting benzodiazepine for seizure or sedation; controlled drug.
Migraine medication: Triptans where authorized; otherwise simple analgesics and antiemetics.
Mission to Seafarers: Anglican seafarers' welfare society founded 1856.
MLC 2006 Regulation 4.1: Medical care on board ship and ashore.
MLC 2006 Regulation 4.2: Shipowners' liability for crew illness, injury, and death.
MLC 2006 Regulation 4.3: Health and safety protection and accident prevention.
MLC 2006 Regulation 4.4: Access to shore-based welfare facilities.
MLC 2006 Regulation 4.5: Social security for seafarers.
MLC 2006 Title 4: Health Protection, Medical Care, Welfare and Social Security Protection.
MMR vaccine: Measles, mumps, rubella combined vaccine in pre-employment schedules.
Morphine sulfate: Strong opioid analgesic; controlled drug requiring register entry.
Mouth-to-mask resuscitation: Recommended over mouth-to-mouth aboard ship using pocket mask with one-way valve.

N

Naloxone: Opioid antagonist for overdose reversal; IM or IN administration.
Naproxen: NSAID analgesic where stocked as alternative to ibuprofen.
Nasopharyngeal airway: Soft airway adjunct in shipboard airway kit.
National Maritime Center (NMC): US Coast Guard centre issuing medical certificates Form CG-719K.
Nebulizer: Compressor device for bronchodilator delivery in severe asthma where stocked.
Needle decompression: Emergency treatment of tension pneumothorax using large-bore cannula (advanced training required).
Neil Robertson stretcher: Canvas-and-bamboo wraparound stretcher used in confined-space and vertical extraction.
NMC Form CG-719K: US Coast Guard Medical Certificate for merchant mariners.
Non-rebreather mask: Oxygen mask with reservoir delivering 60-90% FiO2.
Norovirus outbreak: Common cruise-ship gastrointestinal outbreak managed with cohort isolation and reinforced sanitation.

O

OCIMF SIRE 2.0: Tanker inspection regime succeeding the SIRE program with a behavioral and cyber emphasis, launched 2024.
Ondansetron: 5HT3 antagonist antiemetic available in oral and injectable forms.
Opioid analgesic stewardship: Controlled drug register, double-lock storage, and master oversight per flag-state rules.
Oral rehydration salts (ORS): WHO-formula sachets for diarrheal illness; IMGS Annex IV.
Organophosphate antidote: Atropine plus pralidoxime per MFAG; relevant for pesticide cargo or fumigation.
Otoscope: Ear examination instrument in IMGS Annex V.
Oxygen cylinder: 200-400 L medical oxygen with regulator and flow meter per ship category.
Oxygen mask (Hudson): Simple face mask for low-to-medium-flow oxygen.
Oxygen saturation (SpO2): Pulse oximeter measurement; key triage parameter.

P

P&I Club PEME: Pre-Employment Medical Examination schemes operated by clubs including UK P&I, Britannia, Standard, Steamship Mutual, North/NorthStandard, West of England, and Skuld.
Paracetamol: Acetaminophen oral analgesic and antipyretic in all categories.
Paramedic-trained officer: Some offshore-support vessels carry a dedicated paramedic in addition to STCW-trained crew.
PEME: Pre-Employment Medical Examination required by many owners and P&I clubs.
Peritonitis at sea: Surgical emergency requiring antibiotics, fluids, analgesia, and MEDEVAC.
Pesticide poisoning: Treated per MFAG with atropine, pralidoxime, decontamination, and oxygen.