1. what are the ABCDs of initial stabilization
    • Airway
    • Breathing
    • circulation
    • dextrose
    • decontamination
  2. what do you give for hypoglycemia
    25% dextrose in water
  3. what do you give for alcoholics or malnourished patients?
    B1 (thiamin) IV or IM or prevent Wernicke
  4. what do you give for opiod overdose?
    naloxone 0.2-0.4mg IV
  5. hypertension results from
    cocaine, amphetamines, peripheral actions of drugs
  6. drugs that cause seizures
    isosonazid, TCA, cocaine, antihistamines
  7. drugs to give if have seizures
    • protect airway, give O2
    • check glucose
    • give diazepam
    • if consist-give phenobarbital
    • if isozonazid-give B6
  8. actions to take if hyperthemic
    • sedate patient to not have over active muscles
    • remove clothing and spray skin with tepid water, fan patient
  9. txt for hypothermia
    • external warming
    • if severe-use aggressive measures: partial cardiopulmonary bypass
  10. txt for rhabdomyolysis
    • prevent further break down (possible sedatives)
    • aggressive IV fluid expansion-urine output 200-300 cc/hour
  11. txt to decontaminate after acute ingestion
    • oral charcoal
    • bowel irrigation with Colyte or GoLYTELY for large doses or that which charcoal can't absorbe (iron/lithium)
  12. txt for acetaminophen OD
    • oral charcoal
    • get serum level after 4 hours and plot on Rumack-Matthew chart
    • give acetylcysteine
  13. min. acute toxic dose of acetaminophen
    150-200mg/kg or about 7-10 g for adults
  14. txt for OD w anticholinertgics or antihistamines
    • activated charcoal
    • physostigmine with anticholinergic toxicity and servere delirium
  15. tx of anticoagulate OD
    • charcoal and a cathartic-monitor PT
    • if prolonged give vit. K
  16. tx of beta blocker OD
    • charcoal/cathartic
    • if hypotensive: glucagone
    • if glucagone fails-give epi
  17. tx of calcium antagonist OD
    • aggressive gut decontamination-charcoal
    • tx hypotension with bolus of fluid, vasopressor, IV calcium chloride or calcium gluconate
  18. tx of carbon monoxide poisoning
    • remove from site
    • give 100% o2
  19. txt of cocaine/amphetamines/other stimulants
    • diazepam
    • HTN-phentolamine/nitropursside
    • esmolol-short acting beta blocker may help
    • wide complex dysrrhythmias-sodium bicarbonate
  20. s/s of corrosive agents
    burning pain erythema at site of exposure

    alkali burns evolve over hours
  21. tx of corrosive agents
    • flush are with plain water and remove contaminated clothing
    • small NG tube to remove contaminants
  22. cyanide is found where
    • in artificial finger nail remover
    • cassava
    • apricot pits
  23. diagnose cyanide by
    • almond odor
    • lactic acidosis
    • elevated O2 level >90% blood saturation
  24. tx for cyanide poisoning
    • tx immediately!
    • oral charcoal or induce emesis
    • give nitrites-sodium nitrate, sodium thiosulfate
  25. tx of digitalis OD
    • charcoal
    • atropine
    • digibind if severe
  26. ethanol OD treatmetn
    • supportive care
    • protect airway
    • give B1
    • look for hypoglycemia
  27. methanol/methylene glycol tx OD
    • charcoal
    • ethanol to block metabolism
    • folic acid, B6, B1
  28. y-hydroxybutyric acid is also known as
    date rape drug
  29. s/s of y-hydroxybutyric drug
    • CNS and respiratory depression
    • bradycardia, myoclonic movements, vomiting
  30. tx with y-hydroxybutyric acid
    • no antidote
    • airway protection
  31. tx for iron OD
    • IV fluids
    • chelation with deferoxamine
    • need KUB-radiopaque iron tablets
  32. tx for isoniazid
    • charcoal
    • seizures-diazepam
    • B6
  33. increased iron levels cause
    anemia-microcytic with basophilic stippling
  34. treatment of iron overload
    IV calcium EDTA or oral succimer
  35. OD on lithium if blood levels are over
  36. tx of lithium OD
    • gut decontamination and fluids for acute
    • hemodialysis if severe
  37. tx of methemoglobinemia
    methylene blue
  38. two things that cause pinpoint pupils
    • opiods
    • organophosphates (pesticides)
  39. acronym for s/s of organophosphates
    • D=diarrhea
    • U=urination
    • M=miosis
    • B=bronchospasm
    • B=bradycardia
    • E=excitation
    • L=lacrimation
    • S=salivation
  40. treatment of organophosphates
    • remove contaminated clothing and wash skin w soap and water
    • if ingested-charcoal, atropine, 2-PAM
  41. MC initial manifestation of salicylates
  42. tx for OD of salicylates
    • charcoal
    • alkalinazation of urine with sodium bicarbonate
    • dialysis for patients who cannot take fluids
  43. tx if OD on sedative-hypnotics: barbituates, benzos, buspirone, zolpidem, etc
    • maintain airway, assist ventilation
    • flumazenil IV
  44. contraindication for flumazenil
    if have history of seizures, will cause seizures
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