Term
| What type of stabilization procedures are usually performed when someone is brought in for poisoning? |
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Definition
| assess vital signs - give ventilation or circulation support |
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Term
| What things do you want to determine in a patient history? |
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Definition
| the extent and time of exposure to a toxic agent |
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Term
| Do you under or overestimate the dose of toxin receive if you're taking a history? |
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Definition
| overestimate - maximize the dose |
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Term
| Who else besides the patient might be able to give an exposure history? |
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Definition
| relatives, emergency personnel, pharmacist, employer |
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Term
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Definition
| a collection of clinical signs taken together that are associated witih exposure to specific classes of toxicologic agents |
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Term
| What are the signs for exposure to sypathomimetic agents - BP, pulse, temperature, pupils, neurologic? |
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Definition
| BP-increased*pulse-increased*temp - slightly elevated* pupils-mydriasis* neurologic-hyperalert |
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Term
| What are the signs for exposure to anticholinergic agents - BP, pulse, temperature, pupils, neurologic? |
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Definition
| BP-increased*pulse-increased*temp-increased*pupils-mydriasis*decreased bowel sounds*altered mental status |
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Term
| What are the signs for exposure to cholinergic agents - BP, pulse, temperature, pupils, lungs, abdomen, neurologic? |
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Definition
| decreased BP, decreased pulse, miosis pupils, increased bronchial sounds, increased bowel sounds, altered mental state |
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Term
| What are the signs for exposure to opoid agents - BP, pulse, temperature, pupils, neurologic? |
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Definition
| decreased BP, pulse, and temp * miosis*decreased bowel sounds and level of consciousness |
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Term
| What does categorization allow for? |
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Definition
| allows for initiation of treatment based on the most likely category of toxin responsible even if the exact toxin is unknown |
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Term
| Are the number of possible agents greater or lesser than what you can actually test for? |
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Definition
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Term
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Definition
| a guide for therapeutic intervention based on measured plasma concentration - it predicts the severity of poisoning |
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Term
| What are the requirements to make a salicylate nomogram? |
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Definition
| blood must be drawn at least 6 hours after ingestion and it had to have been a single acute ingestion - not multiple doses |
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Term
| Who established the salicylate nomogram? |
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Definition
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Term
| Who established the acetominophen nomogram? |
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Definition
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Term
| What does an acetominophen nomogram do for the clinician? |
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Definition
| predicts an outcome and guides them in deciding whether to administer N-acetyl cysteine |
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Term
| How long after ingestion can you draw blood for an acetominophen nomogram? What is critical to know when using an acetominophen nomogram? |
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Definition
| 4 hours * knowledge of ingestion, and ingestion must be a single dose |
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Term
| What is an anion gap? What will narrow down the list of suspects considerably if present? |
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Definition
| the difference in Na levels and Cl and HCO3 levels * metabolic acidosis |
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Term
| What is the acronym of agents that cause metabolic acidosis and anion gap? What does it stand for? |
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Definition
| AT MUD PILES * alcohol, toluene; methanol, uremia, diabetic ketoacidosis; paraldehyde, iron, lactic acid, ethylene glycol, salicylate |
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Term
| What is a normal ion gap? Normal osmol gap? |
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Definition
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Term
| What does an elevated osmol gap suggest? What substances can cause this? |
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Definition
| the presence of an osmotically active substance not accounted for by Na, glucose, or BUN * ethanol, ethylene glycol, isopropanol, and methanol |
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Term
| What radiographs are useful (what regions)? What substances are able to be visualized? |
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Definition
| chest and abdomen* lead, carbon tetrachloride/chloroform |
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Term
| What is ipicac syrup? When should you not use it? |
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Definition
| syrup used to induce vomiting * children under 6 months, caustic substances, depressed level of consciousness or gag reflex, significant risk of aspiration |
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Term
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Definition
| placing an orogastric tube into the stomach and aspirating until fluid is clear |
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Term
| What is activated charcoal? |
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Definition
| charcoal that has been processed to absorb more toxins - it has an increased surface area b/c there are small pores |
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Term
| What are the ways you can remove poisons once they are absorbed? |
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Definition
| alkalinization (helps eliminate weak acids), dialysis, hemoperfusion, hemofiltration, plasma exchange, and serial oral activated charcoal |
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