Approach to the Poisoned Patient

Question 1

Poison Prevention

Answer 1

child-resistant caps & containers
storage locations
environmental precautions
disposing of unused, expired drugs

Question 2

General Management

Answer 2

airway
breathing
circulation
dextrose / decontamination
EKG / elimination

Question 3

Whole Bowel Irrigation - Product & Dosing

Answer 3

polyethylene glycol + electrolytes
1-2 L / hr until rectal effluent is clear

Question 4

Anticholinergic Toxidrome - Clinical Presentation

Answer 4

increased BP
increased HR
increased temperature
dilated sluggish pupils
dry mucous membranes
absent bowel sounds

Question 5

Anticholinergic Toxidrome - Antidote

Answer 5

physostigmine
0.5-2 mg IV

Question 6

Sedative-Hypnotic Toxidrome - Clinical Presentation

Answer 6

drowsiness
responsiveness to painful stimuli
normal mucous membranes
present bowel sounds
mildly depressed respiration

Question 7

Adrenergic-Sympathomimetic Toxidrome - Clinical Presentation

Answer 7

increased HR
increased BP
increased temperature
increased RR
diaphoresis
dilated pupils
present bowel sounds
agitation

Question 8

Opioid Toxidrome - Clinical Presentation

Answer 8

decreased BP
decreased RR
pinpoint pupils
normal mucous membranes
hyporeflexia
absent bowel sounds

Question 9

Cholinergic Toxidrome - Clinical Presentation

Answer 9

decreased BP
decreased HR
pinpoint pupils
lacrimation
vomiting, diarrhea

Question 10

Cholinergic Toxidrome - Killer Bs

Answer 10

bradycardia
bronchorrhea
bronchospasm

Question 11

Cholinergic Toxidrome - Antidotes

Answer 11

atropine 1 mg IV and titrate to effect
2-PAM 30 mg/kg IV load, then 8-10 mg/kg/hr cont infusion

Question 12

Unintentional / Unknown Ingestion - Levels

Answer 12

salicylates
acetaminophen

Question 13

Activated Charcoal Does Not Bind:

Answer 13

ionized metals
alcohols
gasoline