Clinical Toxicology: Initial Evaluation & Management

<p>Maintaining respiration and circulation (C)</p> Signup and view all the answers

<p>Prescription and over-the-counter medications (C)</p> Signup and view all the answers

<p>Recognition that poisoning has occurred and identification of agents involved (B)</p> Signup and view all the answers

<p>The standard procedure for all cases of poisoning (B)</p> Signup and view all the answers

<p>By measuring and charting vital signs and reflexes (B)</p> Signup and view all the answers

<p>Accurate and early risk assessment (A)</p> Signup and view all the answers

<p>Family medical history (A)</p> Signup and view all the answers

<p>Competitive antagonists (B)</p> Signup and view all the answers

<p>Determining the specific agent(s) ingested (C)</p> Signup and view all the answers

<p>Forced diuresis (C)</p> Signup and view all the answers

<p>To form soluble, non-ionizable complexes for excretion (A)</p> Signup and view all the answers

<p>Time since ingestion (C)</p> Signup and view all the answers

<p>Loss of airway-protective reflexes (A)</p> Signup and view all the answers

<p>Washing skin with soap and water for at least 30 minutes (D)</p> Signup and view all the answers

<p>Securing the airway (D)</p> Signup and view all the answers

<p>Peritoneal dialysis (D)</p> Signup and view all the answers

<p>Providing isotonic saline or similar solutions (D)</p> Signup and view all the answers

<p>To identify rate and rhythm abnormalities (A)</p> Signup and view all the answers

<p>A resin or adsorbent material (C)</p> Signup and view all the answers

<p>Administer 50ml of 50% dextrose IV (A)</p> Signup and view all the answers

<p>Weight and co-morbidities (B)</p> Signup and view all the answers

<p>Prevent further absorption and increase elimination (C)</p> Signup and view all the answers

<p>Accurate and complete history from sources other than the patient (D)</p> Signup and view all the answers

<p>To identify potential cardiac arrhythmias (C)</p> Signup and view all the answers

<p>Elevated body temperature (B)</p> Signup and view all the answers

<p>Consider supplemental oxygen (A)</p> Signup and view all the answers

<p>GIT hemorrhage (B), Recent bowel surgery (D)</p> Signup and view all the answers

<p>To clean the GIT from non-absorbed ingested toxins (C)</p> Signup and view all the answers

<p>Chelators (A)</p> Signup and view all the answers

<p>Decreasing toxic metabolites conversion (A)</p> Signup and view all the answers

<p>Activated charcoal (B)</p> Signup and view all the answers

<p>Physical antidotes (D)</p> Signup and view all the answers

<p>Blocking the receptors for the poison (A), Competing with the poison for binding sites (B)</p> Signup and view all the answers

<p>Thiosulfate (B)</p> Signup and view all the answers

<p>To remove toxins from the stomach when emesis is contraindicated (C)</p> Signup and view all the answers

<p>Convulsions or a reduced gag reflex (D)</p> Signup and view all the answers

<p>The agent ingested is an alcohol (D)</p> Signup and view all the answers

<p>Within one hour after ingestion with specific risk factors (B)</p> Signup and view all the answers

<p>To increase motility and decrease toxin contact time (D)</p> Signup and view all the answers

<p>Corrosive substances like acids and alkalis (B)</p> Signup and view all the answers

<p>Patients under 6 months of age can safely be induced to vomit. (A)</p> Signup and view all the answers

<p>Gastric lavage with suction assistance (C)</p> Signup and view all the answers

The study of how drugs, chemicals, and other substances affect humans and animals, often focusing on poisonings.

Treat all poisoned patients as life-threatening, even if they seem normal, and follow a consistent routine approach for management.

Poisoning exposures result from various substances, including cleaning products, pesticides, and medications.

Reduce the poison's concentration by preventing its absorption and increasing elimination.

Prioritize the patient's health and well-being over identifying the exact toxin initially.

Identifying the specific substance(s) involved in a poisoning event.

Recognition that a poisoning event has occurred. Observing and evaluating symptoms for signs of poisoning.

Essential for maintaining respiration, circulation and vital functions during the treatment of the poisoned patient

A 5-step process to predict the likely outcome and complications of a poisoning, crucial for effective patient management.

Determining the potential severity of toxicity based on the ingested substance.

Calculating the intake in mg/kg body weight to predict potential toxicity.

Determining the likely clinical progress based on the time elapsed since ingestion.

Assessing the patient's symptoms and how they've changed to determine the impact of the ingestion.

Analyzing the patient's weight and health conditions to identify potential risks.

Remove contaminated clothing and wash the affected skin with soap and water for at least 30 minutes to prevent further absorption.

A crucial assessment used to deduce the likely ingested substances and identify possible complications.

Maintaining a clear airway is crucial, especially when there's a risk of airway obstruction due to factors like a flaccid tongue or aspiration of stomach contents.

Assess respiratory rate and oxygen saturation. If a monitor isn't available, but respiratory rate is elevated, give supplemental oxygen.

Quickly check vital signs, hydration (Blood pressure, pulse, rhythm), and establish IV access.

Check the patient's consciousness. Treat seizure episodes with proper medications (IV benzodiazepines), and check for low blood sugar levels.

Consider hyperthermia as a possible symptom and look for signs/symptoms related to it.

Identifying the specific poison involved is crucial to treatment. Obtain information from sources other than the patient (family, friends, etc.).

Collect all available information (time of ingestion and quantity ingested) relevant for the patient. Gather info from family, friends, pharmacists, and any available material (pill/bottle info).

A structured approach to evaluating a patient suspected of poisoning, covering Airway, Breathing, Circulation, Disability (neurological), and Exposure (temperature).

A procedure to clean the gastrointestinal tract (GIT) of non-absorbed toxins after ingestion.

A substance that counteracts the negative effects of a poison.

Antidotes are grouped based on how they work: chelation, detoxification acceleration, preventing metabolic conversion, receptor competition, blocking receptors, or bypass effects

Physical methods to neutralize poisons, not changing their chemical composition.

Chemical substances that counteract poisons using chemical reactions.

A substance that adsorbs toxins in the gastrointestinal tract.

Situations where whole bowel irrigation is not recommended due to potential risks.

Specific circumstances when a whole-bowel irrigation (WBI) procedure is appropriate.

Flush eyes with running water or normal saline for 20 minutes, and remove solid corrosives with forceps.

Methods to reduce poison absorption from the gastrointestinal tract: inducing vomiting, gastric lavage, activated charcoal, cathartics, whole bowel irrigation.

Induces vomiting to remove poison. Should be used within 30 minutes of ingestion; not recommended routinely at home.

Avoid inducing vomiting in patients with convulsions, corrosive ingestion, hydrocarbons, coma, or less than 6 months old.

Hospital procedure to remove stomach contents when vomiting isn't an option or is contraindicated. Effective within 4-6 hours after ingestion.

Binds to toxins in the GI tract. Effective one hour after ingestion if patient is at risk of significant toxic effects, but not airway compromise.

Avoid in cases of oral antidotes, seizures, coma, corrosive ingestion, or if the agent doesn't bind to charcoal (hydrocarbons, alcohols, corrosives).

Substances that speed up the passage of material through the GI tract, reducing poison interaction with digestive surfaces.

Pharmacological methods used to counter the effects of poisons by inducing antagonism or binding with the toxins to make them easier to excrete.

Substances that bind to metallic poisons, creating a soluble, non-toxic compound that's easily excreted.

A method to increase urine production to remove some types of poisons.

A process that uses a semi-permeable membrane to remove toxins from the blood when the kidneys aren't functioning properly.

A procedure that uses an adsorbent material (charcoal or resin) to remove toxins directly from the blood, similar to hemodialysis.