The manifestations of atropinization in organophosphorus poisoning are as follows: the patient’s pupils appear dilated compared to before, the skin of the mouth and lips appear dry, the secretion is significantly reduced, salivation, the white film secreted by the mouth and lips also decreases and disappears, the face is flushed, the wet rales in the lungs decrease or disappear, the heart rate increases, and the urine volume decreases, all of which should be considered when the patient appears atropinized. Special circumstances should be taken into account in the determination, for example, if the eye is contaminated with organophosphorus and a sufficient amount of atropinization is injected, the pupil can still shrink, and in patients who develop severe organophosphorus poisoning reflecting hypoxia in the late stage, the pupil will shrink instead. In patients with severe organophosphorus poisoning reflecting hypoxia, the pupils are dilated. After aspiration pneumonia, the wet rales in the lungs do not disappear. Patients in the late stage present with marked coma and may have no signs of skin flushing. Therefore, the parameters of the patient’s vital signs should be actively monitored in the event of atropinization, and the dose must be promptly reduced once atropinization is identified.