extra Flashcards
cherry red skin management
Hyperbaric oxygen
CO poisoning
A 58-year old man presents to the Emergency Department with nausea and vomiting for the past two hours. He is known to the alcohol liaison service and his past medical history includes severe depression.
His wife states he has ingested a bottle of anti-freeze.
Examination is unremarkable and observations are stable.
An arterial blood gas (ABG) demonstrates a metabolic acidosis.- large anion gap
What is the most appropriate management in this case?
Fomepizole
Correct. Fomepizole inhibits alcohol dehydrogenase. At a sufficiently high concentration, ethanol saturates alcohol dehydrogenase, preventing it from acting on ethylene glycol, thus allowing the latter to be excreted unchanged by the kidneys. Historically, this has been done with intoxicating doses of ethanol. However, ethanol therapy is complicated by its own toxicity.
NAC can give anaphylactoid reactions what is the repsonse to stop this
Stop the infusion and give IV chlorphenamine
asprin overdose features
Tinnitus is a characteristic feature of an aspirin overdose. Other symptoms include vertigo, nausea, sweating, hyperventilation and confusion. The ABG shows a respiratory alkalosis that is secondary to hyperventilation induced by the drug stimulating respiratory centres in the brain-stem.
