Acute Care - Toxins + Ventilation Flashcards
what is an overdose of paracetamol classified as?
150mg/kg
so usually >12g/day
what are features of opiod overdose?
pinpoint pupils
low RR
decreased consciousness
what is an overdose of TCAs classified as?
10mg/kg
20-30mg/kg is lethal
features of TCA overdose?
warm skin brisk reflexes sedation urinary retention pupils poorly reactive and dilated (anticholinergic - sympathetic)
Ix for suspected overdose?
ABCDE FBC, U+Es, LFTs, coag BM ECG weight ABGs serum conc (known toxin)
Tx for TCA overdose?
IV sodium bicarbonate
Tx for opiod overodse?
naloxone
short half life so repeat dose every 30ish mins
Tx for paracetamol overdose?
IV N acetylcysteine (within 8hrs of dose)
after 4 hrs -> check paracetamol and salicylate levels
after 8hrs -> check again
what can be done if toxin ingested within 1hr?
charcoal decontamination
IV fluids
what is the Tx for benzos?
flumazenil
features of aspirin overdose?
tinnitus
vomiting
dehydrated
hyperventilation
Tx for Bb overdose?
glucagon
Tx for aspirin overdose?
supportive charcoal fluids <400 sodium bicarbonate >400 haemodialysis >700
features of salbutamol overdose?
agitated tremor tachy palps hypokalaemia
features of CO poisoning
headache malaise nausea vomiting erythema
anti freeze Ix and Tx of overdose?
osmol gap (on serum osmolality) alcohol + fomepizole
what are cholinergic side effects? what causes these?
miosis lacrimation drooling weakness bronchospams bradycardic
pesticides
what are anticholinergic side effects? what causes these?
mydriasis flushes dysarthria HR, RR and BP increase dry retention
TCA overdose
what are sympathomimetic (stimulant) side effects?
mydriasis
increased HR, RR, BP
sweating
what is CPAP?
one continuous airway pressure (helps oxygenation)
what is NIV?
two levels of continuous airway pressure
helps ventilation
what ventilation is used in type I RF?
CPAP
what ventilation is used in type II RF?
NIV
where is perfusion better in the lungs?
base
where is ventilation better in the lungs?
top
what is a shunt?
where there is more perfusion than ventilation
what is dead space in the lungs?
more ventilation than perfusion in an area of the lungs
in an MI, who should get oxygen?
if sats are above 94% no oxygen is required
what are ECG features of TCA overdose?
sinus tachy
broad QRS
long QT
features of a cholinergic toxidrome? causes?
pesticides
pin point pupils salivation warm runny nose/crying/urinating bradycardia
