Emergency and Intensive Care Management for Acute Poisonings and Toxicities

Document Type

Book Chapter

Publication Date

2024

Identifier

DOI: 10.1201/9781003449713-5

Abstract

Acute poisoning and toxicity refer to the rapid onset of symptoms caused by the ingestion of toxic substances, often leading to life-threatening complications. Prompt assessment, diagnosis, and management are essential to reduce morbidity and mortality. Initial medical assessment involves a two-pronged approach: addressing life-threatening emergencies and ordering diagnostic studies to identify the cause of the patient's condition. Management focuses on supporting the ABCs (airway, breathing, and circulation) and addressing immediate threats from ingested toxins. This may include interventions like intubation, mechanical ventilation, or administering antidotes. Shock resulting from toxins is managed with IV fluids and vasopressor medications. Specific antidotes, such as Digibind for digoxin toxicity or hydroxocobalamin for cyanide, may be used. Enhanced elimination techniques like hemodialysis or sodium bicarbonate drips can be employed for certain toxins. Diagnosis often relies on identifying toxidromes—distinct patterns of signs and symptoms associated with groups of pharmacologically similar drugs or toxins. Common toxidromes can includeopioid, sedative-hypnotic, sympathomimetic, anticholinergic, or cholinergic. Laboratory tests, including blood gases, electrolytes, glucose, and drug screening, play a crucial role in confirming the specific toxin or toxidrome.

Journal Title

Interpreting Laboratory Tests in Intensive Care

First Page

39

Last Page

47

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