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General Poisoning Management

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Abstract

A 24-year-old lady was admitted to the hospital, with history of consumption of some liquid at home followed by vomiting, altered mental status, and labored breathing. She was brought to the triage in the comatose state with pinpoint pupils, frothy secretions from her mouth, heart rate 58/min, and blood pressure 90/48 mmHg.

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Suggested Reading

  • American College of Medical Toxicology. ACMT position statement: interim guidance for the use of lipid resuscitation therapy. J Med Toxicol. 2011;7:81–2. A statement on the use of lipids in poisionings

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  • Boyle JS, Bechtel LK, Holstege CP. Management of the critically poisoned patient. Scand J Trauma Resusc Emerg Med. 2009;17:29. If a poisoning is recognized early and appropriate testing and supportive care is initiated early, it will improve outcome. It is important to understand the indications and contraindications of antidotes prior to its use

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  • Brooks DE, Levine M, O’Connor AD, French RN, Curry SC. Toxicology in the ICU: part 2: specific toxins. Chest. 2011;140(4):1072–85. A review article on approach to poisioning in ICU

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  • Ghannoum M, Roberts DM, Hoffman RS, Ouellet G, Roy L, Decker BS, Bouchard J. A stepwise approach for the management of poisoning with extracorporeal treatments (ECTRs). Semin Dial. 2014;27:362–70. A detailed understanding of the capabilities and limitations of the different ECTRs can be useful to select the most appropriate ECTR for a given clinical situation

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  • Lam SH, Majlesi N, Vilke GM. Use of intravenous fat emulsion in the emergency department for the critically ill poisoned patient. J Emerg Med. 2016;51(2):203–14. Intravenous Fat Emulsion may be an effective antidote in poisonings from various xenobiotics

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  • Levine M, Brooks DE, Truitt CA, Wolk BJ, Boyer EW, Ruha AM. Toxicology in the ICU: part 1: general overview and approach to treatment. Chest. 2011;140(3):795–806. A review article on approach to poisioning in ICU

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  • Levine M, Ruha AM, Graeme K, Brooks DE, Canning J, Curry SC. Toxicology in the ICU: part 3: natural toxins. Chest. 2011;140(5):1357–70. A review article on approach to poisioning in ICU

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  • Ouellet G, Bouchard J, Ghannoum M, Decker BS. Available extracorporeal treatments for poisoning: overview and limitations. Semin Dial. 2014;27(4):342–9. This articles discusses overview of extracorporeal treatments (ECTRs) like intermittent hemodialysis, sustained low-efficiency dialysis, intermittent hemofiltration and hemodiafiltration, continuous renal replacement therapy, hemoperfusion, therapeutic plasma exchange, exchange transfusion, peritoneal dialysis, albumin dialysis and cerebrospinal fluid exchange in poisionings

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Singh, O., Nasa, P., Juneja, D. (2020). General Poisoning Management. In: Chawla, R., Todi, S. (eds) ICU Protocols. Springer, Singapore. https://doi.org/10.1007/978-981-15-0902-5_14

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  • DOI: https://doi.org/10.1007/978-981-15-0902-5_14

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-0901-8

  • Online ISBN: 978-981-15-0902-5

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