General Management Of Poisoned Patients

Jason B. Hack Robert S. Hoffman

Emergency Department Management of Poisoned Patients ABCs

Toxidromes

Decontamination Gross. .Decontamination

Eyes

Gastrointestina!.. Decontamination

Gastric ..Emptying Emesis

Orogastri£.Layage

Adsorption. of.the..Io.xi,n..ln., theGut. Lumen Activated .Charcoa!

M1uiltiple-Dosei.Actiyated..C,harcoal Cathartics

Irrigation of.. the.B.owel Lumen Whole .Bowel.. Irrigation

Enhanced. . Elimination

Hemodialysis Initia!...Interyentions Chapter. References

The perception that most people have of a poisonous substance is consistent with common definitions. Mofenson and colleagues established guidelines that must be fulfilled for a substance, and its subsequent exposure, to be categorized as nontoxic ( Table 151.il).1,2 A poisoning is an event where a living organism is exposed to a chemical that adversely affects the functioning of that organism. The exposure to the toxin may be occupational, environmental, recreational, or medicinal. A poisoning may result from varied portals of entry, including inhalation, insufflation, ingestion, cutaneous and mucous membrane exposure, and injection. Toxic exposures commonly occur, for example, when substances are tasted or swallowed. Toxins may be in the form of gas or vapors or in a suspension such as dust. Caustics, vesicants, or irritants may affect the skin. A toxin may enter the body transdermally and affect internal structures. Parenteral exposure is also common through intravenous or subcutaneous injection of medications or drugs of abuse.

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