Emergency Medicine Book

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Toxin Ingestion ManagementAka: Unknown Ingestion Management, Gastric Decontamination, Decontamination After Toxin Ingestion

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  1. See Also
    1. Toxin Antidotes
  2. General Management
    1. ABC Management
    2. IV Access
    3. Oxygen Delivery
    4. Cardiac monitor
    5. Control Seizures
    6. Control dysrhythmias
  3. Protocol: Coma Cocktail (consider for unknown drug ingestion with Altered Level of Consciousness)
    1. Dextrose 25% to 50% (for Hypoglycemia demonstrated by Glucometer)
    2. Naloxone 0.4-2 mg IV (for possible Narcotic overdose)
    3. Thiamine (Alcoholic or malnourished patients)
    4. Flumazenil (for possible Benzodiazepine overdose)
  4. Protocol: Skin Decontamination
    1. Remove all clothing and wash skin with soap and water
    2. Protect health care workers from exposure
      1. Example: Organophosphates on clothing
    3. Irrigate eye exposures with Normal saline
  5. Protocol: Gastric Decontamination
    1. Syrup of Ipecac
    2. Gastric Lavage
    3. Activated Charcoal
    4. Cathartics
    5. Whole Bowel irrigation
  6. Protocol: Enhancement of Elimination
    1. Serum Alkalinization
    2. Contraindicated or ineffective measures
      1. Acidification
      2. Forced Diuresis
  7. Protocol: Blood filtering
    1. Hemodialysis
    2. Charcoal Hemoperfusion (Theophylline, Benadryl)

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