PADIS Flashcards
(37 cards)
what is the PADIS team?
one of a few different poison centres across the country (5 now)
tox consultations across Canada
staffed by specially trained and certified healthcare professionals
- medical toxicologists
- tox fellows
- info specialists (pharmacists and RNs with subspecialty training)
PADIS roles
- exposure to drugs, chemicals or toxins via any route possible
- “I’ve done somhing I dont usually do”
- “Have I taken too much? I’m concerned I poisoned myself”
- “How can I prevent posioning?”
- “I am caring for an overdose/poisoned patient and I want to review maanagment”
day to day activities of PADIS team
- patient care (over telephone or bedside consulation)
- education (gneral public and HCPs)
- research/collab
- surveillance (tracking trends/outbreaks)
- prevention
toxicovigilance
the active process of identifying and evaluating the toxic risks existing in a community and evaluating the measures taken to reduce or eliminate them
toxicovigilance canada
antidote registry
reachback support
public outreach and communication
tox lab response network
Canadian surveillance system for poison info
situational awareness and early warning
risks of public health concern include poisoning outbreaks due to:
- contamination
- emergency use of new drugs
- mass chemical exposures/terrorist events
- unusual patterns or trends
1 drug PADIS sees
analgesis
- tylenol
- ibuprofen, etc.
2 drug PADIS sees
antidepressants
sedative/hypnotics/antipsychotics
non-drug exposures PADIS sees
household cleaning substances
cosmetics/eprsonal care producs
alcohols
foreignbodies/toys/misc
plants
chemicals
pesticides
fumes/gases/vapors
hydrocarbons
othr/unknown
majority of cases PADIS sees
unintentional and children
- only 1/4 intentional
- ingestion
telephone risk assessment
- what is patient’s current clinical status
- HPI = what did they take, when, intent, etc.
- physical xam
- initial investigations
toxic-specific questions in telephon risk assessment
what was ingested?
how much?
what was timeo f ingestion? staggered/all at once?
any coingestants?
access to toher meds?
any self-decontam events?
pill counts? how much was patient prescribed and when?
how has their clinical picture changed over time?
HEENT exam
head and neck exams
- pupils? = reactive, mydriatic, miotic
- rhinorrhea, secretions?
- temperature?
skin exam
flushed? dry? diaphoretic? discolered?
CNS exam
rigidity, spasticity?
clonus/hyper-reflexia?
altred mentation/delirium?
cerebellar signs?
GI exam
nausaea vomiting diarrhea?
ab pain? bowel sounds?
CVS exam
evidence of pulmonary edema? injury?
full set of vitals for tox exam
temp
glucose
HR
BP
RR
O2 sats
GCS
= what has the trend been?
process of preventing systemic absorption into the body
decontamination
- SDAC (charcoal), gastric lavage (stomach pump), WBI
process of speeding up metabolism and elimination of an already absorbed substance
enhance elimination
- can be ex- or in-vivo
- hemodialysis, MDAC, urinary alkalinization, intra-lipid (IV fat emulsion)
what is the difference between fever and hyperthermia?
fever = normal response of body; changes body thermometer to drive up inflammatory cascades
hyperthermia = thermometer broken and body cannot generate heat; generation of heat comes from external sources; DEADLY
this controls temp and muscle hyperactivity (H&B pt)
sedation
benzos!!!
also consider intubation and paralysis
what should be done aout elevated temperature?
tylenol??? NOOOOOO
not if thermometer is broken ; do other things to cool patient down
when do we stop cooling? what are our targets?
<39 C within 20 to 30 mins
this is a TRUE emergency
