The basic emergency department management of any poisoned patient includes general supportive care, treatment of specific complications of toxicity, prevention of further drug absorption, enhanced drug elimination, antidote administration, and safe disposition ( Table 16.8-2). Patients with intentional or accidental ingestions may present with no symptoms. Still, life-threatening complications of toxicity should be anticipated. The management of the asymptomatic patient should focus on preventing drug absorption and closely monitoring for development of toxicity. Continuous cardiac monitoring, intravenous access, and frequent reevaluations should be provided for any patient with a potentially toxic ingestion of digitalis. Toxicity may not develop for several hours after an acute ingestion; therefore, extended observation (12 h) is required for anyone with a confirmed ingestion. 8 Admission to the intensive care unit and frequent reassessment is required for any patient developing signs of toxicity.
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