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Y2 T1 Toxicology 200 > emergency toxicology > Flashcards

Flashcards in emergency toxicology Deck (18)
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1
Q

Incidence

A

Poisoning is the leading cause of injury related death
(US Statistics)
• Patients aged 35 to 54 years accounted for the highest
number of poisonings
• 28.3% required management at a health care facility
• 7.9 % required hospital admission

2
Q

Challenges in Managing the Poisoned Patient

A

Limited ingestion/exposure history
• Potential for several toxins to be involved
• Agitated/Aggressive patients
• Trauma/Underlying Medical Issue

3
Q

what are the hazards to the paramedic

A
Limited History
• Hazards (example at the farm /worksite)
– Exposure to toxins
– Agitated patients/bystanders
• Limited Diagnostics
4
Q
  • Scene Survey

* Scene Clues (Aid in determining substance involved)

A
Scene Survey
– Hazards (fire)
• Toxins
• Upset/Agitated Patients or Bystanders
• Scene Clues (Aid in determining substance involved)
– Drug Paraphernalia
– Pill Containers
– Physical Assessment
– Vomitus
5
Q

Toxidromes

A

toxic and syndrome
- heart pressure changes (opium)
electrocardiogram
- ultrasounds (internal fuid/ blood)

6
Q

iSTAT

A

little machine that

• Point of care testing
– Blood Gas
• Toxic Alcohols
• ASA
• Tricyclic Anti-depressants
– Electrolytes
• Rule out other causes of altered LOC
7
Q

Opioids

A
Morphine
• Codeine
• Dilaudid
• Oxycodone
• Demerol
• Fentanyl
• Methadone
• Heroine

• Stimulate opioid receptors (μ, κ, σ) in the central and
peripheral nervous system and modulate pain
sensation
• No difference between opioids in mechanism of action
• Differences are in adverse effects, onset of action and
duration of action

8
Q

clinical feature of opiate toxidrome

A
• Clinical Features of Opiate Toxidrome
– Decreased Level of Consciousness
– Respiratory Depression
– Pupil Constriction
– Low Blood Pressure
– Nausea and Vomiting
9
Q

Treatment

A

– Protect the Patient’s Airway
– Oxygenate/Ventilate
– Ensure Adequate Blood Pressure
– Antidote

10
Q

Naloxone (Narcan)

A

Competitive Narcotic Antagonist (antidote)
• Commonly used to reverse narcotic toxicity
• Complications;
– Agitation/Aggressiveness
– Vomiting

11
Q

Stimulants

A
Class of Toxins that includes:
– Cocaine
– Caffeine
– Amphetamines
– Ephedrine
• Cocaine
– Commonly abused stimulant seen frequently in OD
scenarios
12
Q

what does cocoaine do

A

blocks the dopamine reuptake transporter

13
Q

• Clinical Features of Stimulant Toxidrome

A
– Euphoria
– Anxiety
– Agitation
– Restlessness
– Seizures
– High Blood Pressure
– High Heart Rate
– Cardiac Arrhythmias
– Chest Pain/Heart Attack
14
Q

Treatment

of a stimulant

A
Ensure;
– Airway
– Breathing
– Circulation
• Sedation
– Benzodiazepines
• Cardiac Monitoring
15
Q

Cholinergic Toxidrome

A

from pestisides blocks ach esterase signaling

16
Q

muscarinic symptoms

A

SLUDGE

17
Q

nicotinic symptoms

A

MTWTF

18
Q

Treatment OF CHOLINERGIC TOXIDROME- 3 STEPS

A
• Ensure
– Airway (can be copious secretions)
– Breathing (fasiculations/seizures may impair)
– Circulation (Bradycardia/Hypotension)
• Antidotes
– Atropine
– Pralidoxime
• Control Seizures