Basic Approach to Treatment of Poisoned Animals I (18) Flashcards
For every case of poisoning or suspected poisoning, you will consider the following steps:
- stabilize
- clinical evaluation
- decontamination
- enhance elimination
- antidote
- symptomatic and supportive care
What is the mnemonic for basic steps to treatment?
What is the goal of stabilization?
to keep the animal alive long enough to make a diagnosis and begin treatment
What are the ABCs? Which step?
airway, breathing, circulation, seizures
stabilization
What are examples of stabilization with airway breathing?
neuromuscular paralysis, airway occlusion, hypoventilation, severe respiratory distress
What is the goal of clinical evaluation?
determine the patient’s condition (including severity) and how to treat
begins as soon as you see the patient or talk to the owner; continues for the duration
When does clinical evaluation begin?
as soon as you see the patient or talk to the owner, continues for the duration
Physical examination is part of which step?
clinical evaluation
What do you do if the toxin is known?
- have the owner bring in the package or label
- text/email photos
- determine the exposure damage if possible
- determine when the exposure occurred
You should get samples [before/after] treatment if possible for later testing if needed
before
What is the goal of symptomatic and supportive care?
restore or preserve homeostasis
What is considered the major part of treatment for many poison cases?
symptomatic and supportive care - often is the only treatment possible
Which step is unique to poison cases?
decontamination
______ is a major part of treatment for many cases of poisoning where a known exposure has occurred
Decontamination - can make the difference between life and death
What is the goal of decontamination?
to decreased the total amount of toxin absorbed
hopefully to lessen the lethal dose
How do you decontaminate a poison?
- physically remove what you can
- attempt to bind up what you can’t remove
- speed removal of what is left in the system
What are the types of decontamination?
- ocular: flushing
- dermal: bathing, clipping, brushing, vacuuming
- oral: mucous membranes as opposed to GI
- GI: emesis, gastric lavage, activated charcoal, cathartics
What are less common GI contamination methods?
How must you flush regarding ocular decontamination?
copious flushing - warm saline or water, several liters
- 15 minutes or more and may need to give patient periodic rests, sedation
What should you do after ocular lavage?
stain the cornea and again after 24 hours
What is home treatment for ocular decontamination?
warm water, or 2 tsp mixed with 1 quart warm water - less irritating
How should you use soap with dermal decontamination?
mild hand soap or shampoo
NOT automatic dishwasher detergent or laundry detergent
avoid hypothermia
How do you do dermal decontamination with asphalt, tar, and sticky traps?
- shave
- hand degreasing agent
- butter, vegetable oil, peanut butter
What should you make sure to do with degreasers?
wash it off so the animal does not ingest it!
What is the caveat with brushing or vacuuming?
dry powders - but risk of inhaling toxin
What do you always need to consider with dermal decontamination?
need to consider if the animal groomed itself - often will also need GI decontamination
How can oral exposures cause several problems?
- absorption across mucus membranes of the mouth
- “taste” reaction - especially in cats
- contact irritation/corrosive burns
How do you decontaminate the mouth?
rinse mouth out thoroughly
What should you be mindful of with rodents and oral decontamination?
empty cheek pouches
What is this?
the “taste” reaction in a cat
What is the goal of gastrointestinal decontamination?
- to decrease the total amount of toxin absorbed
- hopefully to lessen the lethal dose
How do you treat GI poisoning?
- physically remove what you can
- attempt to bind up what you can’t remove
- speed of removal of what is left in the system
What is the controversy in human medicine regarding GI contamination?
When the dosage of the toxin ingested is unknown, _____
assume the worst
