Poisoning Flashcards
What are the most important steps in management of someone who comes in with a poisoning or overdose
ABCs
Consider second poison
Call poison control
What is the coma cocktail
Dextrose-50 mL of D50W (or glucagon 1mg IM)
Oxygen
Narcan (2 mg, if not life threatening can give 0.1 mg and double every 2 minutes up to 10 mg)
Thiamine (100 mg but make sure to give with the dextrose
List five important questions to ask on history
When was it taken How much was taken What else was taken How was it taken Why was it taken
What did someone take and what should you give them:
Tachycaric, enlarged pupils, sweating
They took a stimulant (cocaine, amphetamine, ecstacy
No antidoe
Can give Benzos
What did someone take and what should you give them:
Tachy, enlarged pupils, dehydrated, high temp, red
They took an anticholinergic (antipsyphotics, tricyclics)
Give Physostigmine
Give Bicarb in TCA overdose
What did someone take and what should you give them:
Normal vitals, pinpoint pupils, Sweating, drooling, tearing, diarrhea, emesis
They took a cholinergic
Mushrooms
Organophosphates
Insecticides
Give atropine
What did someone take and what should you give them:
Bradycardic, pin point pupils, low resp rate
Opioids
Give naloxone
What did someone take and what should you give them:
Bradycardic , lethargic
Sedative-hypnotic
Anti epileptics, barbituates, muscle relaxants
Supportive care
What did someone take and what should you give them:
Normal vitals but very lethargic
Benzoz Give flumazenil (watch for swizures) May need to intubate \
Unlikely able to give a GI decontamination due to risk of aspiration due to lethargy
What did someone take and what should you give them:
Low heart rate as only symptom
Beta blocker
Give glucagon and calcium channel agonists or calcium chloride
Consider atropine, vasopressor, insulin and glucose
A kiddo got into her moms iron because she thought it looked like candy
What do you give
Deferoxamine
When do you give gastric lavage
- Lethal dose
- NO known antidote
- Taken with in 2 hours
When do you use continuous bowel irrigation
SR/Long acting drug
Packers
When to use activated charcoal
- Within 1-2 hours
- Able to be bound by the charcoal
Unable to use AC
- Caustic acids and alkalis
- Alcohol
- Lithium
- Heavy metals
What labs would you get
CBC lytes, creat Osolarity Osmolar gap Quantitave drug levesl (tylenol, salicylates, ethanol, iron, lithium, digoxin etc) Pregnancy test ECG CVR (aspiration and pulmonary edema)
