Poison Flashcards
Guy swallowed NAOH. Now what?
EGD to asses severity
OD with AMS, hypotension, dilated pupils (8mm), hyperthermia, intestinal ileu
QRS prolongation on EKG
TCA OD
Give sodium bicarb to improve BP, shorten QRS, prevent arrythmia
Anticholinergic syx
Initial tx for frost bite
Rapid rewarming with water
If a pt is ventilating slowly give
Naloxone
Decreased respiratory drive is highly suggestive of opioid OD regardless of pupil size.
oxalate kidney stone
AKI
AG acidosis
hypocalcemia
Ethylene glycol poisoning
Tx - fomepizole or EtOH to inhibit alcohol dehydrogenase, NaBicarb to alleviate acidosis, HD if severe acidosis or end organ damage
Pt presents with acetaminophen OD but is asymptomatic
Start charcol to decontaminate her stomach. Measure acetamenophen levels
What poisoning should be suspected in a pt with significant smoke inhalation?
CO
Put on 100% O2 non rebreather
syx - agitation, confusion, somnolence
Also cyanide toxicty, tx w/ hydroxocobalamin, sodium thiosulfate, nitrates
OD pt
dysphagia, severe pain, salivation
Caustic poisoning
Tx for heorine w/d
Methadone
How does bicarb help in TCA OD
Treats the cardiac toxicity
Increases serum pH and extracellular Na -> alleviates cardio-depressant action on sodium channels
Homeless
AG acidosis
Vision changes/eye stuff
Methanol
Ethylene glycol will target the kidneys, not the eyes
OD looks like opioid but NL pupils and regular rr
Benzo’s
Slurred speech, unsteady gait, drowsiness
Home distiller
GI syx
Neuropsych syx (forgetful, weakness, decreased DTR)
Microcytic anemia
Acute lead toxicity
Impairs heme synthesis
Hyperuricemia is also common
Brady cardia
miosis
fasciulations, salivation, lacrimation
Urination, defecation
Organophosphate poisoning
Get their clothes off, wash the skin
Give atropine
Carpenter
polyneuropathy
hypo and hyperpigmented lesions, hyperkeratotic
Pancytopenic, elevated LFTs
Arsenic poisoning
Dx - urine arsenic levels
