Poisonings, Accidents, Child abuse Flashcards
Iron poisoning
- features
- dx findings
- tx
Initially:
- ab pain
- vomiting
- diarrhea
- hypotensive shock
- metabolic acidosis
Later:
- hepatic necrosis (days)
- pyloric stenosis (later)
Dx findings:
- AG metabolic acidosis
- radiopaque pills on Xray!
Tx
- whole bowel irrigation
- deferoxamine**
- supportive
- syrup of ipecac if no evidence gastroenteritis
Tx acetaminophen poisoning
Activated charcoal
N acetylcysteine (best 8-16h of ingestion)
When do you gastric lavage EtOH OD?
< 2 h
3 phases of salicylate ingestion
1
- respiratory alkalosis from direct stim of respiratory center
- K and bicarb excreted
- can look like diabetic ketoacidosis
2
- paradoxical aciduria as alkalosis continues
3
- metabolic acidosis 2/2 lactic acidosis
- dehydration
- hypokalemia
Tx caustics poisoning
Flush a lot with water
DO NOT GI lavage or emesis or charcoal
Organophosphate (anticholinesterase) poisoning - sx
Muscarinic
- salivation
- lacrimation
- urination
- defecation
- emesis
Nicotinic
- cramps
- fasiculations
- twitching
- weakness
- areflexia
- paralysis of voluntary muscles
- > occurs after Muscarinic effects; not seen in mild poisoning
CNS - anxiety - ataxia - HA - convulsions 0 coma
Dx organophosphate poisioning
decreased RBC cholinesterase
Clinical is best
Tx organophosphate (anticholinesterase) poisoning
If ingested:
GI lavage
Activated charcoal
If skin:
wash with water
+ atropine
+ pralidoxime (for nicotinic sx)
Tx antihistamine poisoning
Activated charcoal
Whole bowel irrigation if sustained release antihistamine given
Risk death from seizures if no tx
Main systems affected by TCA poisoning
CNS
Heart
Tx TCA posioning
Activated charcoal to –| more absorption
Na bicarb to prevent dysrhythmias
Tx dysrhythmias not responding with lidocaine
Tx anticholinergic OD
Physostigmine sulfate
Tx CO poisoning
O2
Tx cyanide poisoning
Amyl nitrite
then sodium nitrite
then sodium thiosulfate
Tx ethylene glycol poisoning
EtOH