Lecture 09 - Poison Control Pt 1 Flashcards
How often are calls to the national poison data system regarding children
40%
How many poisoning incidents are unintentional
76%
How many poisoning incidents are intentional
19%
How many poisoning incidents are an adverse reaction
3%
What are the top exposures regarding children
household cleaners, analgesics, cosmetics/personal care, dietary supplements/herbals, toys
What are the top exposures regarding adults
analgesics, sedatives, antidepressants, cardiovasscular drugs, household cleaners
What is the fundamental approach to the poisoned patient
Airway
Breathing
Circulation
Decontamination
Elimination
Find an antidote
What is the airway step
protect the airway early and continually reassess
What can cause danger to the airway
sedation causing low airway smooth muscle tone, inhilation of toxin or vomit, increased secretions
What is the breathing step
if the breathing is poor you or a machine must breath for the patient (mouth to mouth, bag-valve-mask, advanced airway)
What drugs should you think about if breathing is poor
sedation drugs
What type of airways exist
oral airway, nasal airway, laryngeal mask airway, endotracheal tube
What do you evaluate for circulation
heart rate, blood pressure, skin temperature, pulse, urine output
What are signs of poor perfusion
- tachycardia
- tachypnea
- hypotension
- mottled skin
- altered mental status
- weak pulses
- delayed capillary refill
- cool skin
What is the treatment for poor circulation
IV fluids, medications (epinephrine, norepinephrine, dopamine, dobutamine)
What are the options for vascular access
IV, IO, PIC
What is the goal of decontamination
to prevent or minimize absorption
What are the options for decontamination
activated charcoal, emesis, whole bowel irrigation, gastric lavage
When is activated charcoal not a viable option
Pesticides
Hydrocarbons
Acids and Alkali
Iron
Lithium
Solvents
What it the goal of elimination
enhance excretion
What are the options for elimination
urine alkalization
hemodialysis
What is urine alkalization
administration of IV NaHCO3 to produce urine with a pH >/=7.5
What drugs does urine alkalization help eliminate
chlorpropaide
2,4- dichlorophenoxyacetic acid and mecoprop
fluoride
methotrecate
phenobarbital
salicylate
What drugs do hemodialysis help eliminate
Salicylates
Theophyline
Uremia
Methanol
Barbituates
Lithium
Ethylene glycol
