Poisoning

So in our Toxidrome Roadside to Resus episode we covered the initial management of a poisoned patient, some of the constellation of features to look out for and the specific management. But what about specific agents and circumstances that require particular knowledge and management both in the prehospital environment and in ED?

Well in this episode we’ll cover these by running through;

• Paracetamol poisoning and treatment
• Calcium channel blocker overdose
• Beta blocker overdose
• High dose insulin euglycaemic therapy
• Activated charcoal
• Intralipid therapy
• Cardiac arrest due to toxicology

We’d love to hear any comments or feedback you have and make sure to take a look at the references and resources below.

Enjoy!

Simon, Rob & James

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References

EMCrit;Tox-hound idromes

RCEM 2019; Drug Misuse and the Emergency Department

RCEM; Induction book 2 Toxicology

RCEM; paracetamol nomogram

Pharmacokinetics of N-acetylcysteine in man. Borgström L European Journal of Clinical Pharmacology. 1986

Management of the critically poisoned patient. Jennifer S Boyle. Scand J Trauma Resusc Emerg Med. 2009

Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review.Cave G. Acad Emerg Med. 2009

Lipid resuscitation for local anesthetic toxicity: is it really lifesaving? Leskiw U. Curr Opin Anaesthesiol. 2009

Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Sirianni AJ Ann Emerg Med. 2008

Toxbase

The Role of Sodium Bicarbonate in the Management of Some Toxic Ingestions. Aibek E. Mirrakhimov. Int J Nephrol. 2017

LITFL; Calcium channel blocker toxicity

VICE; Heroin Users Who’ve OD’d Talk About Being Brought Back from the Brink