-
what are the ABCDs of initial stabilization
- Airway
- Breathing
- circulation
- dextrose
- decontamination
-
what do you give for hypoglycemia
25% dextrose in water
-
what do you give for alcoholics or malnourished patients?
B1 (thiamin) IV or IM or prevent Wernicke
-
what do you give for opiod overdose?
naloxone 0.2-0.4mg IV
-
hypertension results from
cocaine, amphetamines, peripheral actions of drugs
-
drugs that cause seizures
isosonazid, TCA, cocaine, antihistamines
-
drugs to give if have seizures
- protect airway, give O2
- check glucose
- give diazepam
- if consist-give phenobarbital
- if isozonazid-give B6
-
actions to take if hyperthemic
- sedate patient to not have over active muscles
- remove clothing and spray skin with tepid water, fan patient
-
txt for hypothermia
- external warming
- if severe-use aggressive measures: partial cardiopulmonary bypass
-
txt for rhabdomyolysis
- prevent further break down (possible sedatives)
- aggressive IV fluid expansion-urine output 200-300 cc/hour
-
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)
-
txt for acetaminophen OD
- oral charcoal
- get serum level after 4 hours and plot on Rumack-Matthew chart
- give acetylcysteine
-
min. acute toxic dose of acetaminophen
150-200mg/kg or about 7-10 g for adults
-
txt for OD w anticholinertgics or antihistamines
- activated charcoal
- physostigmine with anticholinergic toxicity and servere delirium
-
tx of anticoagulate OD
- charcoal and a cathartic-monitor PT
- if prolonged give vit. K
-
tx of beta blocker OD
- charcoal/cathartic
- if hypotensive: glucagone
- if glucagone fails-give epi
-
tx of calcium antagonist OD
- aggressive gut decontamination-charcoal
- tx hypotension with bolus of fluid, vasopressor, IV calcium chloride or calcium gluconate
-
tx of carbon monoxide poisoning
- remove from site
- give 100% o2
-
txt of cocaine/amphetamines/other stimulants
- diazepam
- HTN-phentolamine/nitropursside
- esmolol-short acting beta blocker may help
- wide complex dysrrhythmias-sodium bicarbonate
-
s/s of corrosive agents
burning pain erythema at site of exposure
alkali burns evolve over hours
-
tx of corrosive agents
- flush are with plain water and remove contaminated clothing
- small NG tube to remove contaminants
-
cyanide is found where
- in artificial finger nail remover
- cassava
- apricot pits
-
diagnose cyanide by
- almond odor
- lactic acidosis
- elevated O2 level >90% blood saturation
-
tx for cyanide poisoning
- tx immediately!
- oral charcoal or induce emesis
- give nitrites-sodium nitrate, sodium thiosulfate
-
tx of digitalis OD
- charcoal
- atropine
- digibind if severe
-
ethanol OD treatmetn
- supportive care
- protect airway
- give B1
- look for hypoglycemia
-
methanol/methylene glycol tx OD
- charcoal
- ethanol to block metabolism
- folic acid, B6, B1
-
y-hydroxybutyric acid is also known as
date rape drug
-
s/s of y-hydroxybutyric drug
- CNS and respiratory depression
- bradycardia, myoclonic movements, vomiting
-
tx with y-hydroxybutyric acid
- no antidote
- airway protection
-
tx for iron OD
- IV fluids
- chelation with deferoxamine
- need KUB-radiopaque iron tablets
-
tx for isoniazid
- charcoal
- seizures-diazepam
- B6
-
increased iron levels cause
anemia-microcytic with basophilic stippling
-
treatment of iron overload
IV calcium EDTA or oral succimer
-
OD on lithium if blood levels are over
1.2mEq/l
-
tx of lithium OD
- gut decontamination and fluids for acute
- hemodialysis if severe
-
tx of methemoglobinemia
methylene blue
-
two things that cause pinpoint pupils
- opiods
- organophosphates (pesticides)
-
acronym for s/s of organophosphates
- D=diarrhea
- U=urination
- M=miosis
- B=bronchospasm
- B=bradycardia
- E=excitation
- L=lacrimation
- S=salivation
-
treatment of organophosphates
- remove contaminated clothing and wash skin w soap and water
- if ingested-charcoal, atropine, 2-PAM
-
MC initial manifestation of salicylates
hyperventilation
-
tx for OD of salicylates
- charcoal
- alkalinazation of urine with sodium bicarbonate
- dialysis for patients who cannot take fluids
-
tx if OD on sedative-hypnotics: barbituates, benzos, buspirone, zolpidem, etc
- maintain airway, assist ventilation
- flumazenil IV
-
contraindication for flumazenil
if have history of seizures, will cause seizures
|
|
