Lecture 09 - Poison Control Pt 1

Question 1

How often are calls to the national poison data system regarding children

Answer 1

40%

Question 2

How many poisoning incidents are unintentional

Answer 2

76%

Question 3

How many poisoning incidents are intentional

Answer 3

19%

Question 4

How many poisoning incidents are an adverse reaction

Answer 4

3%

Question 5

What are the top exposures regarding children

Answer 5

household cleaners, analgesics, cosmetics/personal care, dietary supplements/herbals, toys

Question 6

What are the top exposures regarding adults

Answer 6

analgesics, sedatives, antidepressants, cardiovasscular drugs, household cleaners

Question 7

What is the fundamental approach to the poisoned patient

Answer 7

Airway
Breathing
Circulation
Decontamination
Elimination
Find an antidote

Question 8

What is the airway step

Answer 8

protect the airway early and continually reassess

Question 9

What can cause danger to the airway

Answer 9

sedation causing low airway smooth muscle tone, inhilation of toxin or vomit, increased secretions

Question 10

What is the breathing step

Answer 10

if the breathing is poor you or a machine must breath for the patient (mouth to mouth, bag-valve-mask, advanced airway)

Question 11

What drugs should you think about if breathing is poor

Answer 11

sedation drugs

Question 12

What type of airways exist

Answer 12

oral airway, nasal airway, laryngeal mask airway, endotracheal tube

Question 13

What do you evaluate for circulation

Answer 13

heart rate, blood pressure, skin temperature, pulse, urine output

Question 14

What are signs of poor perfusion

Answer 14

• tachycardia
• tachypnea
• hypotension
• mottled skin
• altered mental status
• weak pulses
• delayed capillary refill
• cool skin

Question 15

What is the treatment for poor circulation

Answer 15

IV fluids, medications (epinephrine, norepinephrine, dopamine, dobutamine)

Question 16

What are the options for vascular access

Answer 16

IV, IO, PIC

Question 17

What is the goal of decontamination

Answer 17

to prevent or minimize absorption

Question 18

What are the options for decontamination

Answer 18

activated charcoal, emesis, whole bowel irrigation, gastric lavage

Question 19

When is activated charcoal not a viable option

Answer 19

Pesticides
Hydrocarbons
Acids and Alkali
Iron
Lithium
Solvents

Question 20

What it the goal of elimination

Answer 20

enhance excretion

Question 21

What are the options for elimination

Answer 21

urine alkalization
hemodialysis

Question 22

What is urine alkalization

Answer 22

administration of IV NaHCO3 to produce urine with a pH >/=7.5

Question 23

What drugs does urine alkalization help eliminate

Answer 23

chlorpropaide
2,4- dichlorophenoxyacetic acid and mecoprop
fluoride
methotrecate
phenobarbital
salicylate

Question 24

What drugs do hemodialysis help eliminate

Answer 24

Salicylates
Theophyline
Uremia
Methanol
Barbituates
Lithium
Ethylene glycol

Question 25

What is the antidote for acetaminophen

Answer 25

NAC (N-Acetulcysteine)

Question 26

What is the antidote for anticholinergics

Answer 26

Physostigmine

Question 27

What is the antidote for benzodiazepines

Answer 27

Flumaxenil

Question 28

What is the antidote for Carbon Monoxide

Answer 28

Oxygen

Question 29

What is the antidote for Cyanide

Answer 29

Hydroxocobalamin, sodium nitrite and sodium thiosulfate

Question 30

What is the antidote for Digoxin

Answer 30

Digoxin-specific Fab

Question 31

What is the antidote for Ethylene Glycol

Answer 31

ethanol, fomepizole

Question 32

What is the antidote for Iron

Answer 32

Deferoxamine

Question 33

What is the antidote for Methanol

Answer 33

ethanol, Fomepizole

Question 34

What is the antidote for Methemoglobinemia

Answer 34

methylene blue

Question 35

What is the antidote for opioids

Answer 35

naloxone

Question 36

What is the antidote for organophosphates

Answer 36

atropine, pralidoxime