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paramedic capstone subject - qut > Topic 10 - Posoning/Overdose > Flashcards

Topic 10 - Posoning/Overdose Flashcards

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1
Q

Toxidrome clinical manifestation summary (cholinergic, anticholinergic, opioid toxicity, serotonin toxicity, sympathomemetic toxicity)

A
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2
Q

Benzodiazapine overdose managment

A
  • 02
  • IPPV
  • IV access
  • IV fluid
  • Glucose
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3
Q

Beta blocker overdose management

A
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4
Q

Beta blocker cardiovascular and systemic affects

A

Cardiovascular:

  • Bradycardia
  • Heart block
  • Hypotension
  • Cardiogenic shock

Systemic effects:

  • Hypoglycemia/hyperglycemia
  • Hyperkalemia
  • Bronchospasm
  • Seizures
  • Coma
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5
Q

Calcium channel blocker cardiovascular and systemic effects

A

Cardiovascular:

  • Bradycardia
  • Heart block
  • Hypotension
  • Cardiogenic shock

Systemic affects:

  • Seizures
  • Coma
  • Hyperglycemia
  • Metabolic acidocis
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6
Q

Calcium channel blocker overdose management

A
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7
Q

Gamma-hydroxybutyrate presentation

A
  • Euphoria
  • Vomiting
  • Sweating
  • Miosis
  • Respiratoey depression
  • Coma
  • Bradycardia
  • Rapid onset of coma - rousable with stimulus
  • Spontaneous recover in 2-4 hours typical
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8
Q

Gamma-hydroxybutate managment

A
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9
Q

Paraqaut poisoning featurs (Early, delayed and late)

A

Immediate:

  • GI upset

Early hours:

  • Oral corrosive injury
  • Metabolic acidosis
  • Hypotension

Delayed (24-48 hours)

  • Progression of acidosis
  • Multi-organ failure
  • Coma
  • Seizures

If patient survives past 48 hours may develope pulmonary fibrosis

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10
Q

Paraquat poisoning management

A
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11
Q

Agents associated with Serotonin toxicity

A
  • Antidepressants/antiepileptics
  • Analgesics
  • Antiemetics
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12
Q

Clinical features of serotonin toxicity (neurological, autonomic, neuromuscular)

A

Neurological dysfunction:

  • Anxiety, agitation
  • Delirium
  • Seizure
  • Coma

Autonomic dysfunction:

  • Flushed skin, dilated pupils, diaphoresis
  • Tachycardia, hypertension
  • Hyperthermia
  • Diarrhoea

Nueromuscular dysfunction:

  • Tremor
  • Clonus
  • Hyperrflexia
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13
Q

Serotonin syndrome managment

A
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14
Q

Trycyclic antidepressant clinical features

A

Anticholinergic:

  • Agitation and delirium
  • Dilated pupils
  • Dry warm skin, flushed
  • Hyperthermia
  • Tachycardia

Neurotoxicity:

  • Sedation
  • Seizures
  • Coma

Cardiotoxicity:

  • Tachycardia
  • Hypotension
  • Broad comples arryhtmias
  • Bradycardia (late)

ECG changes:

  • Prolonged PR, QRT and QT interval
  • Large terminal R wave in aVR
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15
Q

TCA management

A
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16
Q

Symptoms suggesting severe systemic envenomation in large black spider or funnel-web spider bites (may occur within 10 minutes) - general, autonomic and neurological

A
  • General agitation, nausea, vomiting, headache
  • Neurological: muscle spasm, numbness/tingling in and around mouth and altered mental status
  • Autonomic: diaphoresis, tachycardia, salivation, piloerection, salivation, lacrimation
  • Cardiovascular: BP and HR out of nomral limit (up or down) and pulmonary oedema
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17
Q

Redback spider clinical features

A

Local:

  • Pain and fangs at injection site
  • Radiation of pain to proximal limb
  • Localised piloerection and redness
  • Localised diaphoresis

Systemic:

  • Nausea, vomiting headaches
  • Malaise and lethargy
  • Generalised pain
  • Less common: hypotension, irritability and agitation, fever, paraesthesia, muscle spasms, priaprism
18
Q

Spider bite managment

A
19
Q

Systemic effects and non-specific effects of snake bites

A

Non-specific:

  • Nausea
  • Vomiting
  • Headache
  • Abdominal pain
  • Diarrhoea
  • Diaphoresis

Systemic effects:

  • Neurotoxicity (facial drooping, drooling, paralysis)
  • Coagulopathy (bleeding from nose and gums etc)
  • Myotoxicity (damage to skeletal muscles)
  • Renal impairment/failure
20
Q

Snake bite management

A
21
Q

Corrosive Agent management

A
22
Q

Acid versus base burns

A

Acids cause damage via coagulative necrosis. The eschar formation limites the depth of penetration.

Alkali substances cause liquifactive necrosis resulting in an ongoing deeper penetration despite an initial benign appearance.

23
Q

Organophosphate/cholinergic poisons mechanism of action

A

Inhibit acetylcholinesterase, increasing the action of acetylcholine at parasympathetic and presynaptic sympathetic ganglion receptors - can lead to cholinergic syndrome.

24
Q

Effects of cholinergic poisoning

A

Muscarinic effects (DUMBBELS)

  • Diarrhoea
  • Urination
  • Miosis
  • Bronchorrhoea/bronchospasm
  • Bradycardia
  • Emisis
  • Lacrimation
  • Salivation

Nicotinic excess:

  • Fasiculations
  • Tremor
  • Muscle weakness
  • Respiratory msucle paralysis

Central effects:

  • Agitation
  • Seizures
  • Coma
25
Q

Cholinergic poisoning management

A
26
Q

Cyanide toxicity mechanism

A

Inhibits normal cellular processes. Coulorless gass above 26 degrees and has a faint bitter almond smell only able to be detected by certain induviduals

27
Q

Cyanide poisoning features

A
28
Q

Cyanide management

A
29
Q

Clinical features of carbon monocide poisoning - neurological, cardiovascular and respiratory

A

Neurological:

  • Headache, nausea, confusion
  • Atoxia, dizziness
  • Seizures
  • Coma

Cardiovascular:

  • Tachycardia
  • Hypotension
  • Myocardial ischemia
  • Arrythmia

Respiratory:

  • Pulmonary oedema
30
Q

Anticholinergic overdose features

A
31
Q

Anticholinergic management

A
32
Q

3 classifications of marine envenomations

A
33
Q

Box jellyfish - clinical features

A
  • Severe localised pain
  • Development of welts
  • Possible apnoea, DIB, hypotension, arrythmia, ALOC and cardio-respiratory arrest within 30 minutes of envenomation
34
Q

Irunaki syndrome - clinical features

A
  • Delayed sting and systemic symptoms
  • Catecholamine excess leads to restlessness, anxiety, diaphoresis, vomiting, abdominal chest and back pain, blood pressure lability and tachycardia
35
Q

Stonefish - clinical features

A
  • Immediate intense localised pain
  • Muscle weakness, paralysis and shock
36
Q

Puffer fish - clinical features

A
  • Weakness, numbness, dyspnoea, paralysis and cardio-respiratory arrest
  • Symptoms can be delayed up to 2 hours
37
Q

Ciguatoxin from tropical fish ingestion

A
  • GIT upset, neurological symptoms (hot and cold sensation, tingling in lips hands and feet)
  • Severe cases lead to paralysis, respiratory ot cardio-respiratory arrest
38
Q

Cone shell - clinical features

A
  • Pain at injection site
  • Numbness, weakness, ataxia, visual and speech disturbance, respiratory depression
39
Q

Blue-ringed octopus - clinical features

A
  • Painless sting but nubness and weakness within 10 minutes with dyspnoea, nausea and vomiting
  • Severe cases can lead to rapid paralysis and respiratory arrest due to tetrodotoxin.
40
Q

Marine envenomation management

A

paramedic capstone subject - qut (12 decks)

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