Emergency Medicine Book

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Decontamination After Toxin Exposure

Aka: Decontamination After Toxin Exposure, Decontamination After Toxin Ingestion, Gastric Decontamination
  1. See Also
    1. Toxin Ingestion
    2. Toxin Antidotes
  2. Protocol: Gastric Decontamination
    1. Indications
      1. Severe ingestion cases as directed by poison control
      2. Gastric Decontamination is no longer recommended for most ingestions
    2. Techniques
      1. Gastric Lavage
      2. Activated Charcoal
      3. Cathartics
      4. Whole Bowel Irrigation
  3. Protocol: Skin Decontamination (e.g. chemical exposure)
    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
  4. Protocol: Enhancement of Elimination
    1. See Urinary Alkalinization for Indications
    2. Contraindicated or ineffective measures
      1. Acidification
      2. Forced Diuresis
  5. Protocol: Blood filtering
    1. See Hemodialysis for Indications
    2. Charcoal Hemoperfusion Indications
      1. Theophylline
      2. Diphenhydramine (Benadryl)
  6. References
    1. Chu (2002) Am J Respir Crit Care Med 166(1):9-15 [PubMed]
    2. Erickson (2007) Emerg Med Clin North Am 25(2):249-81 [PubMed]
    3. Mokhlesi (2003) Chest 123(2):577-92 [PubMed]
    4. Nicholson (1983) Med Clin North Am 67(6):1279-93 [PubMed]
    5. Jones (2002) Ther Drug Monit 24(1):150-5 [PubMed]

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