Overdose

Question 1

Initial assessment in overdose

-ABCDE.
o Assess ?, ? size and reaction to ?, evidence of ????.
? history.
Bloods.
o FBC, U&E, LFT, ?, ?.
o ?, paracetamol and ? levels.
o Further specific assays as guided by ? ? information
service.

Answer 1

GCS
pupil
light
IVDU
collateral
INR, ABG
glucose
salicylate
national poisons

Question 2

Reduce absorption.
o ? lavage.
• Rarely used, only within ? of overdose.
o Activated ?.
• Single dose of ?, in ? to reduce absorption of many
drugs, e.g. ?, salicylates.
• ? doses help blood ? of the same drugs.

Answer 2

gastric
60m
charcoal
50g
water
paracetamol
repeated
elimination

Question 3

Give antidote if there is one available;
o Paracetamol: ?
o Opiates: ?.
o Benzodiazepines: ?.
o Beta-blockers: IV ?, IV ? plus ?.
o TCAs: ? ?.

Answer 3

nac
naloxone
flumazenil
atropine
glucagon
dextrose
sodium bicarb

Question 4

Continue monitoring.
o ? levels.
o ?.
o ?/? function.
? assessment prior to discharge.
National Poisons Information Services: provides expert advice on acute and chronic
poisoning (toxbase)

Answer 4

plasma
obs
renal/hepatic
psych

Question 5

Alcohol Intoxication

? is a risk as alcohol ? gluconeogenesis.
0 This is more common in ?, or ? adults.
0 It is not responsive to ?, so IV ? is given.

Answer 5

hypose
inhibits
children
malnourished
glucagon
glucose

Question 6

Alcohol intoxication

As the blood alcohol concentration rises above ? mg/di, complications may
become more severe, with ? failure, ? and death.
If blood alcohol level is >?mg/di, ? may be considered

Answer 6

400
respiratory
coma
500
haemodialysis

Question 7

High Risk Factors;

? Age.
? sex.
Living ?.
Alcohol/? abuse.
Severe ? states.
Severe ? disorder.

Answer 7

increasing
male
alone
drug
pain
affective

Question 8

High Risk Factors;

Recent adverse ? ?.
Active ? intent.
Actual suicidal intent in the ? act;
o ? lethal mechanism.
o ? acts undertaken.
o Made attempts not to be ?

Answer 8

life events
suicidal
original
perceived
final
discovered

Question 9

Important history points;

Was there a clear ? for the event?
o Is that still ? or has it resolved?
Was it ? or impulsive?
o Is there still ? suicidal intent?

Answer 9

precipitant
ongoing
premeditated
continuing

Question 10

Important history points;

Did they leave a ? ? 
Did they make attempts not to be ?
What would they do if they went ? now?
o What's their ? ? like?
Do you have any ?symptoms?

Answer 10

suicide note
discovered
home
social support
psychiatric

Question 11

Important history points;

ASSESS mental state
-with mse - what are the parts?

Answer 11

A- ppearance and behaviour
S- peech
E- motions - mood + affect
P- erceptions - hallucinations
T- hought - Form + Content
I- nsight
C- ognition - time place person