Week 6 - Toxicology Intro - CBRNE Flashcards
Toxicology 101
What dose ABCDEF stand for?
What does RRSIDEAD
A =Airway
B = Breathing
C = Circulation
D = Decontamination
E = Elimination
F = Find the Antidote
R = Resuscitation
R = Risk Assessment
S = Supportive Care
I = Investigations
D = Decontamination
E = Enhance Elimination
A = Antidotes
D = Disposition
What does CBRNE vibes?
Chemical
Biological
Radiological
Nuclear
Explosive
WMD - Weapon of Mass Destruction
What’s the definition?
What are considered WMDs
A nuclear, radiological, chemical, biological, or any other weapon that can kill and bring significant harm to numerous humans or cause great damage to human-made sturctures, natural structures, or the biosphere
Toxic or poisonous chemicals
Disease organism
Radiation or radioactive material
What is the definition of terrorism?
The unlawful use of force and violence against persons or property to intimidate or coerce a government (the civilian population or any segment therof) to further political or social objectives/goals
What are the Standards to know in regards to CBRNE?
What are treatments to nerve agents?
What are examples of nerve agents?
Opioid Toxicity & Withdrawal
PCP Auxiliary
Cyanide Exposure (IV Autonomous)
Hydrofluoric Acid Exposure
Adult & Pediatric Nerve Agent Exposure
Symptomatic Riot Agent Exposure
Atropine
2-PAM - Pralidoxime Chlroride
SARIN
VX
Novichok
Organophosphate Insecticides
Cholinergic Crisis
What does SLUDGE M stand for?
S = Salivation
L = Lacrimation
U = Urination
D = Defecation
G = Gastrointestinal distress
E = Emesis
M = Miosis (pupil constriction)
Show me what the sympathetic and parasympathetic nervous sytem control
Antocholingeric Overdose
What’s the Toxidrome acronym?
MAD
HOT
BLIND
DRY
RED
Show me a list of drugs with moderate - strong anticholinergics effects.
Give me a quick overview of cholinergic vs anticholinergic syndrome presentation in a pt.
Types of gases
What is Silo Gas?
nitrogen dioxide, NO2 - this gas can be exposed to farmers
Types of gases
Sewer gas?
Mostly hydrogen sulfide gas (H2S) which is deadly at low concentrations.
What types of calls could involve CBRNE?
Industrial
Farm
Pediatric
Youth Risky Behaviors (Pill Parties)
Polypharmacy
Alcohol with anything and everything
Accidental exposure or ingestion
Intentional exposure of ingestion
Pills/medications
What are the top 6 questions/observations?
Date Prescribed (original bottle ?)
Dose
Frequency
Remaining amount
Co-Ingestion?
Alcohol?
Overdose Treatments
What’s the treatment for cocaine?
Heroine?
Show me the symptoms of cocaine overdose
Benzos - midazolam
narcan, support the breathing
Common overdoses
Show me waht medications have the most often/occuring overdoses
Tylenol overdose
?
What’s the treatment?
GREATER than 4000mg in 24h
N-acetylcysteine (NAC)
Mucomyst
Given within 8 hours of ingestion
4 Stages of Acetaminophen Toxicity
Define Stage 1?
Define Stage 2?
Characterized by
nausea vomiting
nonspecific right upper abdominal pain
These symptoms begin within a few minutes to
hours after Tylenol consumption.
This stage appears on days 2-3 with the initial symptoms decreasing and liver symptoms increasing (upper abdominal pain - increased liver enzymes)
4 Stages of Acetaminophen Toxicity
Define Stage 3? What are the symptoms?
Define Stage 4?
This stage occurs on days 3-4 where peak liver injury occurs further affecting other body organs (due to the lack of toxins being neutralized/excreted)
Brain dysfunction (encephalopathy)
Yellow color to eyes and skin (jaundice)
Inability to clot blood (coagulopathy)
Too much acid in the blood (metabolic acidosis)
Low blood glucose (hypoglycemia)
This is the stage in which people begin to recover IF they survive past stage 3
Activated Charcoal
What is it/and its use?
The administration can only occur when the position of the nasogastric tube is confirmed via chest x-ray.
It helps prevent the poison from being absorbed from the stomach into the body
