An Approach to the acutely poisoned patient

AN APPROACH TO THE! ACUTELY POISONED PATIENT

Chris Nickson FACEM FCICM Intensivist, The Alfred ICU

Financial Conflicts of Interest NO !

http://litfl.org/CONCEPTOS

Photo by Incurable_hippie!

ResusRSI DEAD

ResuscitationRisk Assessment!Supportive care & monitoringInvestigations!DecontaminationEnhanced elimination!AntidotesDisposition!

Resuscitation is the priority!

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Airway!BreathingCirculation!Disability (Neuro)Glucose!SeizuresTemperature!Resuscitation antidotes

Risk assessmentis a distinct !

cognitive step!

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Drug(s)Dose(s)TimeClinical coursePatient factors

Supportive care & monitoringis the mainstay!

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Investigations are only done for specific reasons!

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Decontaminationonly if the benefits exceed the risks!

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Decontamination removes !toxic agents before !

complete absorption into the systemic circulation!

Enhanced elimination

has few !indications!

Photo by Cavin on Flickr!

Enhanced elimination removes !toxic agents from the body!after systemic absorption!

Antidotes are rarely used !

but can be important!

Photo by Cavin on Flickr!

Dispositionis guided by risk

assessment!

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Acute poisoning is often a “snapshot” of a pervasive !

psychosocial disorder

ResusRSI DEAD