How should I approach the management of a suspected botulism case in a primary care setting before hospital referral?

Management of suspected botulism in primary care before hospital referral:

• Recognise the urgency: Botulism is a medical emergency requiring immediate hospital assessment and treatment.
• Do not delay referral: Arrange urgent transfer to hospital without delay once botulism is suspected.
• Supportive care: While awaiting transfer, monitor the patient’s airway, breathing, and circulation closely, as botulism can cause progressive muscle weakness including respiratory failure.
• Avoid interventions that may delay transfer: Do not attempt to administer antitoxin or other specific treatments in primary care; these are hospital-based interventions.
• Inform receiving hospital: Notify the hospital in advance about the suspected botulism case to ensure prompt specialist assessment and treatment on arrival.

These steps prioritise patient safety and rapid access to specialist care, which is critical in botulism management.