Chloral Hydrate

Question 1

Describe the toxicology of chloral hydrate.

Answer 1

Action of the toxic metabolite TCE on CNS/CVS - mechanism is unclear. Results in dysrhythmias, decreased myocardial contractility, shortened refractory periods and coma.

Question 2

List the clinical features of chloral hydrate.

Answer 2

CNS: drowsiness, ataxia, coma, respi depression. CVS: dysrhythmias, hypotension. Others: hypothermia, GI/oesopheal necrosis, stricture formation

Question 3

List the resuscitative efforts for chloral hydrate in adults.

Answer 3

Intubation, beta-blockers (propranolol 0.5-1 mg + esmolol infusion), IV fluids, do not give catecholamines.

Question 4

What are two useful knowledge items with chloral hydrate toxicity.

Answer 4

Do not give catecholamines for hypotension and consider upper GI scope to look for corrosive injury