Toxicology - Treatments Only Flashcards
1
Q
General Treatment strategy for organophosphate/carbamate poisoning
A
- Consult Clinicall and DECONTAMINATE
- Supportive care/ABCs
- Manage Seizures
- Midazolam (2-5mg IV/IO, 5-10mg IV)
- Treat Dysrhythmias
- Standard care, except increased indication for MgSO4 if QTc is prolonged
- 2mg IV over 15 minutes
- Atropine for bradycardia/hypotension and secretions
- 1-2mg IV/IM initial dose
- repeat double doses q.5minutes to effect
2
Q
General Treatment strategy for calcium channel blocker poisoning
A
- BLS Care
- Atropine first!
- 0.6mg IV push to max dose of 0.04mg/kg (3mg in most pts.)
- CLINICALL PRIOR TO THE FOLLOWING THERAPIES
- Calcium Chloride
- 1-2g over 10 minutes
- Target reversal of bradycardia and hypotension
- Epinephrine
- IV infusion or PDP if refractory to CaCl2
- Pacing not included in CPGs, but may be appropriate
3
Q
General Treatment strategy for beta blocker poisoning
A
- BLS care
- Correct hypoglycemia
- D10W IV, 10-25g
- Treat Bradycardia FIRST
- Atropine (0.6mg IV)
- Transcutaneous pacing
- Seizure management
- Midazolam 2-5mg IV/IO or 5-10mg IM
- CLINICALL CONSULTATION PRIOR TO FOLLOWING THERAPIES
- Glucagon
- 5mg IV push
- Arhythmia management
- Epinephrine PDP or IV infusion
4
Q
General Treatment strategy for TCA OD
A
- BLS care
- 12-lead ECG
- wide WRS >100ms
- Tall R-wave in aVR
- deep S-waves in I, aVL
- Tachycardia
- CONSULT CLINICALL
- Sodium Bicarbonate
- 1meq/kg (2-3meq/kg may be required). Repeat 1/2 doses at 10-15 minute intervals
- Epinephrine PDP or IV infusion
- MgSO4 for tachydysrhythmia
- 2mg IV over 15 minutes
5
Q
From the standpoint of toxicology, which interventions require clinicall consultation prior to initiation?
A
- Anything outside of standard care
- NaHCO3 for TCA
- High dose atropine/glucagon
- Epinephrine for management of bradycardia/hypotension in;
- CCB OD
- B-blocker OD
