Poisonings

Description

- Critical Care/ Emergency Flashcards on Poisonings, created by Christine K on 17/12/2017.
Christine K
Flashcards by Christine K, updated more than 1 year ago
Christine K
Created by Christine K almost 7 years ago
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Resource summary

Question Answer
Miosis miOsis = pinpOint pupils
Mydriasis myDriasis = Dilated pupils
Common causes of miosis COPS: Cholinergics, clonidine Opiates, organophosphates Phencyclidine, phenothiazine, pilocarpine Sedatives (barbiturates)
Common causes of mydriasis AAS: Anticholinergics (atropine) Antihistamines Sympathomimetics (amphetamine, cocaine, LSD, MDMA)
Initial Management of all poisonings ABCDs: Airway and antidotes, breathing, circulation, disability/decontamination - consider glucose and EKG
PE of carbon monoxide poisoning cherry red skin discoloration
PE of methemoglobinemia or hypoxemia cyanosis; results from OD of medications Tx: O2 and methylene blue
Anticholinergic poisoning Dry as a bone Red as a beet hot as a hare blind as a bat mad as a hatter; tachycardia, HTN, coma, Seizures
Toxidromes
Cholinergic Poisoning: muscarinic signs DUMBELS: Defecation Urination Miosis Bronchorrhea/spasm/bradycardia Emesis Lacrimation Salivation
Cholinergic poisonings: nicotinic signs Classic agents: insecticides (organophosphates/carbamate) and nicotine - muscle weakness, fasciculations, paralysis, CNS effects (respiratory depression, seizures, lethargy, coma), bradycardia
Opioid Poisoning CNS depression, miosis, respiratory depression/apnea, bradycardia, hypotension. Clonidine can mimic these sx
Sympathomimetic poisoning agitation, tremors, hallucinations, seizures, tachycardia, HTN, mydriasis, diaphoresis
Prolonged QRS Tricyclic antidepressant poisoning
Elevated serum osmolal gap (greater than 10) (Calculates expected serum osmolarity, for comparison to measured osmolarity to detect unmeasured compounds in the serum: (2 x Na) + glucose + urea Toxic alcohol ingestion
High Anion Gap MUDPILES: methanol, uremia, DKA, phenols, iron, INH, ethanol, ethylene glycol, salicylates
Radiopaque on Xray CHIPES: chloral hydrate, calcium, heavy metals, iron, phenothiazines (thorazine), enteric-coated preparations, salicylates, sustained-release tablets
Acetaminophen Toxicity - when to get acetaminophen levels - when should antidote be started - trend which labs - consider activated charcoal for children - check acetaminophen levels within 4 hours of ingestion - use Rumack-Matthew Normogram - N, acetylcysteine antidote to be given 8 hours after ingestion, but can be up to 20 hours after - trend AST, ALT, PT/PTT (not acetaminophen levels)
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