Multiple Ingestion

Question 1

Multiple Ingestion

ASAP:

Answer 1

ABCs, IVs, O2, monitor, VS, accu✓, EKG. Intubate PRN but may try Narcan first

Question 2

Multiple Ingestion

Hx:

Answer 2

Meds/drugs/chemicals, timing, amount, intentional vs accidental, N/V, meds @ home, SAMPLE hx

Question 3

Multiple Ingestion

Exam:

Answer 3

Pupils/nystagmus
GCS
Gross neuro
Seizures
CV/pulm
Pulses
Skin
Smells
Toxidromes

Question 4

Multiple Ingestion

Labs:

Answer 4

APAP, ASA, EtOH, CBC, BMP, LFTs, coags, osmolality, VBG, UA, UDS, hCG; levels of any known drug ingested

Question 5

Multiple Ingestion

Rads:

Answer 5

CXR, KUB

Question 6

Multiple Ingestion

Treatment:

Answer 6

Supportive care always If recent (<1-2 hrs) PO ingestion… AC 1gm/kg PO/NG/OG (ineffective for EtOH, hydrocarbons, acid/alk, iron, lithium). Pt must protect AW or intubate, give antiemetic.

Question 7

Multiple Ingestion

If malnourished or EtOH….

Answer 7

D50 1 amp IV, Thiamine 100mg IV, Mg 2 gm IV

Question 8

Multiple Ingestion

If sustained rel, iron, or body packer…

Answer 8

WBI w Golytely 500-2000 ml/hr via NGT til clear rectal effluent

Question 9

Multiple Ingestion

If known ingestion…

Answer 9

Use specific Antidote if available

Question 10

Multiple Ingestion

If in doubt (scared)….

Answer 10

Call Poison Control 1-800-222-1222