Because botulinum toxin causes respiratory failure and paralysis, ventilators (breathing machines) may be used to assist in breathing. “Meticulous airway management is critical, as respiratory failure represents the most important threat to survival in botulism patients” (Chan-Tack, 2015 para. 11). Patients may also receive a tracheotomy to facilitate removal of secretions along with a Foley catheter to assist with incontinence. Whole bowel irrigation can also be used to eliminate botulinum toxin. “Dr. Zamani highlighted the role of whole bowel irrigation (WBI) with polyethylene glycol as an appropriate adjunctive gastrointestinal decontamination option in severe botulism poisoning” (Lonati, et al..,