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Emergency medicine > Poisoning + overdose > Flashcards

Poisoning + overdose Flashcards

1
Q

What are the features of cyanide ingestion?

A

N+V
Rapid loss of conc
Apnoea
Seizure
Cardiac arrest

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2
Q

What are the features of opiate overdose?

A

Confusion
Pinpoint pupils
Resp depression
Cyanosis

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3
Q

What are the features of organophosphate ingestion?

A

Salivation
Lacrimation
Urination
Diarrhoea
Small pupils
Brady
Fasiculations

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4
Q

What the features of MDMA overdose?

A

Agitation
Tachycardia
Hyperthermia
Acute renal failure
BP probs
Mydriasis

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5
Q

What are the complications of MDMA overdose?

A

Hyponatraemia
Hypertonia and hyperreflexia - rhabdomyolysis
HTN
SVT
Haemorrhagic stroke
Hyperthermia

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6
Q

What is the management of MDMA overdose?

A

Benzos
Cool down
Avoid b blockers
Electrolyte correction

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7
Q

What are some CF of aspirin overdose?

A

N+V
Tinnitus
Fever
Confusion
Tachy
Resp alkalosis -> met acidosis

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8
Q

What is the management of aspirin overdose?

A

Activated charcoal if <1 hour since ingestion
IV fluids, Na bicarb and KCl
Dialysis
Monitor renal func

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9
Q

What are some causes of CO poisoning?

A

Faulty boilers
Car exhaust
Fireplace
CO binds to Hb in blood and prevents delivery of O2 to tissues = hypoxia

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10
Q

What are the CF of CO poisoning?

A

Confusion
N+V
Cherry red skin
Tachy
100% O2 sats because device can’t differentiate between oxygenated and carboxyhb Hb

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11
Q

What are the ix into CO poisoning?

A

VBG or ABG
CXR
ECG
CK

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12
Q

What is the management of CO poisoning?

A

100% O2 via non rebreathe mask
Hyperbaric O2 therapy - controversial but gold standard

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13
Q

What is ethylene glycol and what are the features of poisoning?

A

Anti freeze
Early - intoxication, N+V, haematemesis, seizures, ataxia, papilloedema, ophthalmoplegia
Late - ATN, hypoCa, hyperK, hypoMg

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14
Q

What is the management of ethylene glycol poisoning?

A
  1. Gastric lavage or NG aspiration if less than 1 hour
  2. Fomepizole or ethanol - prevent metabolism of ethylene glycol into toxic metabolites
  3. Haemofiltration
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15
Q

What is the management of paracetamol poisoning?

A

<1 hour = activated charcoal
< 4 hours = wait until 4 hours, take a level then N acetylcysteine
>4 hours - N acetylcysteine
Staggered overdose = N acetylcysteine

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16
Q

What is a dosage for paracetamol overdose?

A

> 150mg/kg

17
Q

What are the CF of TCA overdose?

A

Long QT
Drowsy and confused
Seizures
Vomiting
Flushing
Dilated pupils

18
Q

What is the management of TCA overdose?

A

ITU
IV Na bicarb
Activated charcoal
Invasive ventilation
IV fluids

19
Q

What are the antidotes for reversing anticoagulation?

A

Heparin - protamine
Warfain - IV VitK 5mg and prothrombin conc complex, FFP
DOAC - andexanet

Emergency medicine (8 decks)

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