Emergency

Question 1

Methods of preventing/ reducing absorption of poison/ overdose

Answer 1

Activated charcoal

Whole bowel irrigation

Urine alkylisation

Question 2

Activated charcoal is indicated in poisoning when…

Answer 2

Ingestion was <1 hour ago

Question 3

Urine alkalinisation is used for ______ poisoning

Answer 3

Salicylate

Question 4

Features of acute alcohol intoxication

Answer 4

• Ataxia
• Dysarthria
• Nystagmus
• Drowsiness

Severe
- Coma, with hypotension and acidosis.

Question 5

Features of aspirin poisoning

Answer 5

• Hyperventilation
• Tinnitus, deafness
• Vasodilatation, sweating

Question 6

Management of aspirin overdose
- Including indications/ doses for severe intoxication

Answer 6

A-E

Reduce absorption
- If acutely ingested
- dose >125mg/kg

IV fluids

IV sodium bicarbonate
- After correcting any possible hypokalaemia (

Haemodialysis
- If concentration exceeds 700 mg/litre (5.1 mmol/litre)
- Severe metabolic acidosis.

Question 7

Features of paracetamol overdose

Answer 7

12-36 hours
- Abdominal pain, vomiting, nausea
- Metabolic acidosis

2-3 days
- AKI
- Acute hepatitis
- Hepatic encephalopathy

severe
- hepatocellular necrosis
- renal tubular necrosis

Question 8

_______ is the antidote for paracetamol poisoning

Answer 8

IV acetylcysteine
- Most effective when given within 8 hours of ingestion

Question 9

Serious toxicity is likely to occur in paracetamol toxicity of what dose, in adults?

Answer 9

> 75mg/ kg in <1 hour.

Question 10

State the 2 IV acetyl cysteine regimens:

Answer 10

Standard 21-hour regimen

modified 12-hour regimen

Question 11

_______ is indicated in benzo poisoning

Answer 11

IV flumazenil
- XC in convulsions and mixed overdose

Question 12

What is the name of the graph used to determine if IV NAC is needed for paracetamol overdose in the first 24 hiurs

Answer 12

Paracetamol nomogram

Question 13

In adults, serious paracetamol toxicity can occur when ingesting how much paracetamol in 24 hours?

Answer 13

150mg/kg