ed 3b

Question 1

MEDICATION OVERDOSE
deliberate

Answer 1

suicidal ideation; (commonly benzodiazepines, paracetamol, opioids)

Question 2

Accidental

Answer 2

• Child ingesting grandmothers medication?
• Nurse giving medications to the wrong patient -
  Confused patient ingesting wrong/too much medication

Question 3

PRESENTATION SIGNS AND SYMPTOMS medication overdose

Answer 3

‣ Dilated pupils (benzo’s)
‣ Pin point pupils (opioids)
‣ Decreased LOC
‣ Respiratory depression
‣ Anxiety, agitated, combative
‣ Hyperactive
‣ Diaphoretic, hyperthermic
‣ Slurred speech

Question 4

EMERGENCY STABILISATION

Answer 4

➤ AIRWAY
➤ BREATHING
➤ CIRCULATION
➤ DISABILITY
➤ EXPOSURE
➤ FLUIDS
➤ GLUCOSE
➤ SOCIAL

Question 5

medication antidotes
* Paracetamol
* Opiates
* Heparin
* Warfarin

Answer 5

• Paracetamol = Acetylcysteine (NAC)
• Opiates = Naloxone HCl
• Heparin = Protamine sulphate
• Warfarin = Vitamin K

Question 6

Cyanide
* Carbon Monoxide/Dioxide
* Organophosphate
* Benzodiazepines

Answer 6

Cyanide = Amyl nitrate
* Carbon Monoxide/Dioxide = Oxygen +/- hyperbaric
* Organophosphate = Atropine
* Benzodiazepines = Flumazenil

Question 7

PARACETOMOL OVERDOS

Answer 7

➤ Risk of liver damage
➤ Patients who present early should be given activated charcoal
➤ Patients at risk of hepatotoxicity should receive intravenous
(IV) acetylcysteine
➤ Paracetamol level on the blood test

Question 8

Paracetamol is one of the most commonly

Answer 8

used over-the-counter
analgesics in Australia. Although many health professionals assume that
patients know how to use paracetamol, overdose rates continue to rise.
Public misunderstanding about the safety or paracetamol is contributing
to misuse and accidental overdose. Easy access to large quantities of
paracetamol contributes to intentional overdose.

Question 9

The recommended maximum daily oral dose of paracetamol in
adults and children over 12 years

Answer 9

is 500–1000 mg every 4–6
hours, with a maximum of 4 g (4000 mg) in a 24-hour period.

Question 10

In children aged 1 month to 12 years, the recommended daily
oral dose of paracetamol

Answer 10

is 15 mg/kg (up to a maximum of 1 g)
every 4–6 hours as required, with no more than four doses (or
4 g) in a 24-hour period.

Question 11

CHARCOAL

Answer 11

The current consensus is to use activated charcoal in
significant poisonings when it is expected there is drug still in
the upper gastrointestinal tract, so long as the risk versus
benefit is considered. For most overdoses, this is within one
hour of the estimated time of ingestion.
If conscious and cooperative.
It absorbs most ingested toxins and prevents absorption from
the GIT.

Question 12

FOOD POISONING

Answer 12

Affects an estimated 4.1 million Australians each year. Most food
poisoning is caused by pathogens getting into food.

Question 13

The most common types of food poisoning are:

Answer 13

1. Bacterial (Eg. Salmonella, Campylobacter, E.Coli and Listeria
2. Viral (Eg. Norovirus, Rotavirus and Hepatitis A)

Question 14

COMMON
SYMPTOMS food poisoning

Answer 14

➤nausea
➤stomach cramps
➤diarrhoea
➤vomiting
➤fever
➤headaches

Question 15

Supportive treatment food poisoning

Answer 15

• IVF
• PRN analgesia and antiemetics

Question 16

PLANTS AND MUSHROOMS

Answer 16

There are many plants and mushrooms that can cause illness or be fatal if
ingested. Poisonous plants can be difficult to recognise.
Plants to be concerned about include:
Oleander
Foxgloves
Amanita mushrooms (fly agaric)
Angel’s trumpet (Jimsonweed)
Dumb cane (Dieffenbachia)
Asthma/stickweed