Call the Poison Center. It is very helpful for patient management, but also important in terms of collecting statistics.

Objective: Discuss preventing and treating overdoses with parents.

Objective: Clarify consequences of overdose by calling Poison Center

What makes pills attractive to kids?

Bright colors - laundry pods now significant cause of exposures.

Taste - unlikely to ever see a zopiclone overdose in a child

Look like candy - vitamins, iron tablets.

Objective: Think about multiple substances in overdose.

Special concerns: alcohol, ASA, acetaminophen.

Screening ECG - looking for ?

Are all overdoses equally time sensitive?
Metabolized toxins
Methadone
Acetaminophen level timing

Objective: Take a good history regarding the timing and nature of the overdose.

What other questions are important?

What else could the patient have access to? (ie hand sanitizer)

“FARM”: Fever, Altered mental status, Rigidity, Myoclonus


The clinical picture of serotonin toxicity can best be described as a triad of cognitive, autonomic and somatic effects. In mild cases, the cognitive effects may simply consist of abnormal mood, such as hypomania, but in severe cases, mental status is altered and patients may experience severe agitation and hallucinations. The autonomic effects consist of diaphoresis, hypertension, hyperthermia, tachycardia and diarrhea. In severe cases, marked hyperthermia can give rise to additional complications, such as rhabdomyolysis, seizures, metabolic acidosis and disseminated intravascular coagulation. Finally, the somatic effects are essential for the diagnosis; these are myoclonus, tremor and hyperreflexia with clonus.

Objective: Assess, manage and reassess ABCs

Don't focus on antidotes and decontamination while ignoring the effects of the poisoning

Benzos for seizures. Or phenobarb. Avoid dilantin

Needs to be given in a 10:1 ratio

Massive surface area.

Disadvantages: messy, forms intestinal briquettes, aspiration, doesn't affect small molecules.

PEG at 2 L/hour until effluent clear

For drugs poorly absorbed by charcoal, very toxic ingestions, body packers.

Lower dose

Reverse hypercarbia before giving naloxone.

Common, toxic, available in large quantities.

Depends on metabolism for toxicity

Alcoholics at high risk for toxicity

Objective: Use poison control protocols that are current

www.thepoisonreview.com

http://lifeinthefastlane.com/tag/toxicology-conundrum/

#Foamtox

http://naturespoisons.com/

www.evernote.com/pub/drivmitchell/poison