1 / 10

TOXICOLOGY APPROACH IN ED

TOXICOLOGY APPROACH IN ED. Y A MAMOOJEE. RESUSCITATION – A, B, C RISK ASSESSMENT SUPPORTIVE CARE INVESTIGATIONS DECONTAMINATION DELAYED ABSORPTION ENHANCED ELIMINATION ANTIDOTE DISPOSITION. RESUSCITATION. A – aspiration risk B – decreased LOC (GCS <12) C – hypotension

webbjames
Télécharger la présentation

TOXICOLOGY APPROACH IN ED

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TOXICOLOGY APPROACH IN ED Y A MAMOOJEE

  2. RESUSCITATION – A, B, C • RISK ASSESSMENT • SUPPORTIVE CARE • INVESTIGATIONS • DECONTAMINATION • DELAYED ABSORPTION • ENHANCED ELIMINATION • ANTIDOTE • DISPOSITION

  3. RESUSCITATION • A – aspiration risk • B – decreased LOC (GCS <12) • C – hypotension • DEFG – treat if <4 (agents?) • HYPERTHERMIA – treat if >38.5 • CONTROL SEIZURES – usually generalised, Midazolam first choice • CONSIDER SPECIFIC ANTIDOTES

  4. RISK ASSESSMENT • AGENT • DOSE • TOI • CLINICAL FEATURES • PATIENT FACTORS • Ask family members, paramedics, count tabs, check medical records • Usually a worst case scenario

  5. POISON CENTRE - 131126

  6. SUPPORTIVE CARE • Airway – Intubation • Breathing – oxygen and ventilation • Circulation – fluids, inotropes, control HTN, defib, antiarrhythmics • Sedation • Seizure control • Metabolic – bsl, pH • Fluids and electrolytes • Renal function – adequate hydration and fluid balance • General – nutrition, resp toilet, bladder care, pressure care, TE prophylaxis, mobilisation

  7. INVESTIGATIONS • ECG • PARACETAMOL • OTHER SPECIFIC – COHB, MetHb, ABG • Drug levels – Li, Fe, dig, CBMZP, toxic alcohols, salicylates

  8. BOWEL DECONTAMINATION • EMESIS • GASTRIC LAVAGE • ACTIVATED CHARCOAL • WHOLE BOWEL IRRIGATION

  9. ENHANCED ELIMINATION • SEVERE TOXICITY • POOR OUTCOME DESPITE GOOD SUPPORTIVE CARE AND ANTIDOTE ADMINISTRATION • SLOW ENDOGENOUS ELIMINATION RATES • SUITABLE PHARMACOKINETIC PROPERTIES

  10. ENHANCED ELIMINATION • MULTIPLE DOSE ACTIVATED CHARCOAL – CBMZP, DAPSONE, PHENOBARB, QUININE, THEOPHYLLINE • URINARY ALKALINIZATION – PHENOBARB, SALICYLATE • HAEMODIALYSIS – Li, Metformin lactic acidosis, K, salicylates, toxic alcohols

More Related