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ACUTE POISONING: GENERAL PRINCIPLES in emergency department

ACUTE POISONING: GENERAL PRINCIPLES in emergency department. S.R.Habibzadeh,MD Assistant professor of emergency medicine MUMS. General approach to poisoning. ABC & Resuscitation. Gathering of informations. Early Decontamination. Reevaluation& conservative Tx. Prophylaxis of relapse.

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ACUTE POISONING: GENERAL PRINCIPLES in emergency department

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  1. ACUTE POISONING: GENERAL PRINCIPLESin emergency department S.R.Habibzadeh,MD Assistant professor of emergency medicine MUMS

  2. General approach to poisoning ABC & Resuscitation Gathering of informations Early Decontamination Reevaluation& conservative Tx Prophylaxis of relapse

  3. ABC & RESUSCITATION

  4. Gathering of critical informations

  5. Gathering of critical informations

  6. Early decontamination

  7. Toxidromes Opioid Sympathomimetic Cholinergic Anticholinergic Sedatives-hypnotic Salicylate Hypoglycemic Hallucinogenic Serotonin Extrapyramidal

  8. Early decontamination Stop absorbtion Enhance elimination

  9. Gastric lavage

  10. Activated charcoal

  11. Early decontamination Stop absorbtion Enhance elimination

  12. GI DECONTAMINATION Enhance bowel transit 1- Cathartic -70% sorbitol 1gr/kg -1o% magnesium citrate : 250cc in adult 4ml/kg in child Contra indication: Age less than 5 Renal failure in magnesium solution Diarrhea induced agent Obstruction Caustic agent Complication: nausea, abdominal pain, fluid &electrolyte imbalance

  13. Whole bowel irrigation

  14. End point: clear rectal effluent

  15. Enhance eliminationhemodialysis/hemoperfusion Hemodialysis Barbiturates Salicylates Alcohol Lithium Theophylline Amanita Contraindication(relative): Unstability, very young children, profound bleeding diastasis

  16. Dermal decantamination

  17. General approach to poisoning ABC & Resuscitation Gathering of informations Early Decontamination Reevaluation& conservative Tx Prophylaxis of relapse

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