poisoning/near drowning Flashcards

1
Q

where poisoning occurs

A
  • kitchen & bathroom
  • household items
  • soaps, cosmetics, detergents, plants, cleaners
  • medications (OTCs)
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2
Q

types of poisons

A
  • meds: analgesics, iron
  • lead
  • caustics: acids & alkalis
  • hydrocarbons
  • plants
  • *usually PO
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3
Q

primary mgmt of poisoning

A
  • ABCs
  • ID toxic substance: type, time, route, amt, symptoms
  • physical exam: VS, LOC, labs
  • decontaminate: prevent further absorption & reverse/eliminate effects
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4
Q

mgmt of poisoning

A
  • ipecac
  • gastric lavage
  • activated charcoal
  • cathartics
  • whole bowel irrigation
  • antidotes & antagonists
  • intubation & gastric tube
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5
Q

gastric lavage

A
  • insert orogastric tube

- instill & aspirate NS until clear

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6
Q

activated charcoal

A
  • insert orogastric tube

- deactivate the poison

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7
Q

whole bowel irrigation

A
  • golytely
  • massive ingestion
  • pts who don’t tolerate charcoal
  • hastens excretion
  • minimizes absorption
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8
Q

antidote to narcotics

A

narcan

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9
Q

antidote to acetaminophen

A

mucomyst

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10
Q

antidote to benzodiazepines

A

romazicon

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11
Q

antidote to carbon monoxide

A

oxygen

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12
Q

antidote to INH

A

pyridoxine

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13
Q

antidote to aspirin

A

vitamin K

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14
Q

plumbism

A
  • *lead poisoning
  • interferes with normal cell function (RBCs)
  • lead is deposited in blood, bone, & soft tissue
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15
Q

sources of lead

A
  • paint chips or dust
  • home glazed pottery
  • food (lead chromate)
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16
Q

symptoms of lead poisoning

A
  • CNS: irritability, lethargy, learning difficulty, seizures
  • GI: anorexia, abd pain
  • renal: glycosuria, proteinuria, renal failure
17
Q

screening for leading poisoning

A
  • blood lead determination >15ug/dl
  • CBC
  • xray of abd & long bones
  • UA, BUN/Cr
  • lumbar puncture
18
Q

treatment of lead poisoning

A
  • remove child from the source
  • levels >20ug/dL (use succimer)
  • levels >40ug/dL (hospital admission - use BAL & CaEDTA)
19
Q

commonly ingested toxic agents

A
  • corrosives (cleaners, detergents, bleach)
  • hydrocarbons (gas, furniture polish, thinner)
  • acetaminophen
  • salicylate
  • iron
20
Q

tx of corrosives

A
  • dilute toxin with water

- activated charcoal (no GT)

21
Q

tx of hydrocarbons

A
  • gastric lavage

- decontaminate skin

22
Q

tx of acetaminophen

A
  • induce vomiting or lavage

- charcoal and/or mycomyst

23
Q

tx of salicylate

A
  • induce vomiting
  • IV Na bicarb
  • Vit k
24
Q

tx of iron

A
  • induce vomiting
  • IVF
  • IV Na bicarb
  • chelation tx
25
Q

drowning

A

death due to suffocation from submersion in liquid within 24 hrs

26
Q

near drowning

A
  • submersion injury
  • requires emergency tx
  • survives the first 24 hrs
27
Q

incidence of near drowning

A
  • 2nd leading cause
  • boys>girls
  • infants (bathtubs)
  • 1-4 yrs old (artificial pools)
  • 21% will suffer perm brain dmg
28
Q

physiologic factors of drowning

A
  • inhale water
  • H2O enter larynx
  • asphyxia
  • larynx relaxes
  • aspiration
  • surfactant is dmged/gas exchange impaired
  • cardiac arrest
29
Q

mammalian diving reflex

A
  • neurological response triggered by immersion of face in cold water
  • lifesaving bradycardia
  • brain can function for 7-9 minutes
30
Q

s/s of drowning depend on…

A
  • length of time submerged
  • temp of water
  • salt vs fresh water
  • response to episode
  • tx at the scene
31
Q

s/s of drowning

A
  • CNS: decreased LOC, cerebral edema, increased intracranial pressure, seizures
  • resp: loss of surfactant, irregular respirations, acidosis
  • GI: gastric distention
32
Q

mgmt of drowning

A
  • CPR
  • airway/O2/circulation
  • intubation
  • monitor VS, ABG, electrolytes
  • monitor neuro status
  • restore normal body temp
  • orogastric tube
  • antibiotics
  • monitor for s/s of cerebral edema
  • seizure precations