Odessa national medical university Department of Anesthesiology Intensive

Acute poisoning – - ill status resulting from impact on the body of chemical

Diagnosis Poisonings (intoxications) may present important diagnostic problems: 1. Is the emergency caused by

Therapy Prevention of further exposure to poisons. 2. Basic vital support. 3. Gаstric lavage

TOXIC AGENT Acetaminophen Anticholinergics Anticoagulants Beta blockers Cyanide Digoxin Ethylene glycol Heavy metals Iron

Characteristic Findings in Selected Poisoning Acetaminophen Nil early, hepatic and renal failure late Alcohols

TOXIC AGENT 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

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Odessa national medical university Department of Anesthesiology, Intensive Care and Emergency medicine General principles of intensive care of acute poisonings

Acute poisoning – - ill status resulting from impact on the body of chemical agents, warfare or virulent poisoning substances of the other origin (industrial, vegetable, biological).

Diagnosis Poisonings (intoxications) may present important diagnostic problems: 1. Is the emergency caused by intoxication? 2. Which is/are the causative toxic agent(s)? 3. Is it possibly the result of a criminal act?

Therapy Prevention of further exposure to poisons. 2. Basic vital support. 3. Gаstric lavage 4. Ad-/absorption. 5. Neutralization. 6. Antidote therapy. 1.

TOXIC AGENT Acetaminophen Anticholinergics Anticoagulants Beta blockers Cyanide Digoxin Ethylene glycol Heavy metals Iron Methanol Narcotics Sympathomimetics Organophosphates ANTIDOTE N acetylcysteine Physostigmine Plasma, Vitamin K, Protamine sulphate Isoprenaline, glucagon Nitrites, EDTA, Thiosulphate Na Ethanol Dimercaprol. Iron Deferoxamine Ethanol Naloxone Adrenergic blockers Atropine, pralidoxime

Characteristic Findings in Selected Poisoning Acetaminophen Nil early, hepatic and renal failure late Alcohols Inebriation, coma, metabolic acidosis, osmolar gap Anticholinergics Dry mouth, mydriasis, agitation, hallucina tions, tachycardia, dysrhythm. Anticonvulsants Headache, behavioral change, ataxia, diplopia, nystagmus, drowsiness, hypotension Narcotics Respiratory depression, miosis, coma Organophosphates Salivation, urinary and fecal incontinence, miosis, bronchospasm, bradycardia, weak ness, anxiety, coma, convulsions Salicylates Tachypnea, tinnitus, agitation, coma, hy perchermla, metabolic acidosis, respiratory alkaiosis Sedative hypnotics Drowsiness, dysphasia, ataxia, coma, hypotension

TOXIC AGENT 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Acetaminophen Anticholinergics Anticoagulants Protamine sulphate Beta-blockers Cyanide Na Digoxin Ethylene glycol Heavy metals Iron Methanol Narcotics. Sympathomimetics ANTIDOTE N-acetylcysteine Physostigmine Plasma, Vitamin K, Isoprenaline, glucagon Nitrites, EDTA, Thiosulphate Ethanol Dimercaprol Deferoxamine Ethanol Naloxone Adrenergic-blockers

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