Pediatric Sympathomimetic OD

Question 1

Pediatric Sympathomimetic OD - Toxidrome presentation?

Answer 1

Hypertension
Tachycardia
Euphoria / agitation / delusions / paranoia
Mydriasis / piloerection / hyperpyrexia / hyperreflexia
Seizures
Angina
Cardiac arrest

Question 2

Pediatric Sympathomimetic OD - Basic interventions

Answer 2

Remove the patient from a warm environment
Spray the patient with cool water
Apply ice packs to the groin, neck, and axilla

Question 3

Pediatric Sympathomimetic OD - S/S to consider treatment?

Answer 3

Chest pain
Symptomatic tachycardia
HTN
Agitation

Question 4

Pediatric Sympathomimetic OD - Sympathomimetic OD treatments?

Answer 4

Cool patient
ECG
Midazolam

Question 5

Pediatric Sympathomimetic OD - Symptomimetic OD treatment medications?

Answer 5

Midazolam 0.1 mg/kg IV single max of 2.5 mg q 5 x 1

Midazolam 0.2 mg/kg IM single max of 5 mg q 5 x 1

Question 6

Pediatric Sympathomimetic OD - Wide QRS > 0.12s treatment?

Answer 6

Sodium Bicarbonate 1 mEq/kg

Question 7

Pediatric Sympathomimetic OD - Midazolam indications

Answer 7

Symptomatic sympathomimetic overdose

Question 8

Pediatric Sympathomimetic OD - Midazolam dose

Answer 8

Midazolam 0.1 mg/kg IV single max of 2.5 mg q 5 x 1

Midazolam 0.2 mg/kg IM single max of 5 mg q 5 x 1

Question 9

Pediatric Sympathomimetic OD - Midazolam EMS contraindications

Answer 9

Hypersensitivity to benzodiazepines
Myasthenia gravis
Systolic BP less than 70 + (2 x age) mmHg

Question 10

Pediatric Sympathomimetic OD - Midazolam precautions

Answer 10

May cause respiratory depression and hypotension

Question 11

Pediatric Sympathomimetic OD - Sodium Bicarbonate indications

Answer 11

Sympathomimetic overdose with QRS greater than 0.12 seconds

Question 12

Pediatric Sympathomimetic OD - Sodium Bicarbonate dose

Answer 12

1 mEq/kg SIVP/IO

Do not repeat dose

Question 13

Pediatric Sympathomimetic OD - Sodium Bicarbonate EMS contraindications

Answer 13

Excessive chloride loss
Metabolic or respiratory alkalosis
Patients with hypocalcemia

Question 14

Pediatric Sympathomimetic OD - Sodium Bicarbonate precautions

Answer 14

CHF, severe renal impairment, concurrent corticosteroid treatment
Avoid extravasation due to the risk of tissue necrosis