Skip to main content

Management of Medical Emergency-Poisoning!

MEDICAL EMERGENCY- POISONING


  • Management of the poisoned patient involves procedures designed to prevent the absorption, minimize the toxicity, and hasten the elimination to the suspected toxin. The prompt employment of appropriate emergency management procedures often can prevent unnecessary morbidity and mortality.
  • A Regional Poison Center is a practitioner's best source of definitive treatment information and should be consulted in all poisonings, regardless of the apparent simplicity of the case.
  • In all cases, every attempt should be made to accurately identify the toxin, estimate the quantity involved, and determine the time that has passed since the exposure.
  • These data, plus patient-specific parameters such as age, weight, sex, and underlying medical condition or drug-use will assist the person and the Regional Poison Center in designing an appropriate therapeutic plan for the patient.



POISONING BY TOPICAL EXPOSURES:

  1. Immediately irrigate affected areas with a copious amount of water, use soap only if a stubborn, oily substance is the contaminant. Skin should be gently washed, not scrubbed and special attention should be given to the hairs, skin folds, umbilicus, and other areas where the contaminant might be trapped.
  2. If the patients' clothes have been contaminated, remove them during the irrigation and clean them before they are worn again or destroy them.
  3. Do not attempt to "neutralize" the contaminant with another chemical (e.g: acids and alkalis). Attempts at neutralization waste valuable time, are of no benefit, and might be harmful.
  4. Do not cover the affected area with emollients. These can trap unremoved contaminant against the skin. Severely damaged skin may be temporarily covered with a light, dry dressing.
  5. Protect yourself from contamination. Gloves, Aprons, or a change of clothes might be necessary.
  6. After the irrigation is complete, contact a Regional Poison Center for definitive treatment information.


POISONING BY EYE EXPOSURES:

  1. Immediately irrigate the eye; damage can occur within seconds. The stream of water from the tap or a pitcher should strike the patient on the forehead, temple, or bridge of the nose and then flow into the eye.
  2. The eyelids should be open, with frequent blinking during the irrigation.
  3. The irrigation should continue for at least 15 minutes (by clock) to ensure adequate removal of the contaminant and normalization of the conjunctival pH. Body temperature water or saline may be substituted for tap water as the irrigation proceeds, but only if these can be obtained without interrupting the irrigation.
  4. After the irrigation is complete, contact a Regional Poison Center for definitive-treatment information.


POISONING BY INHALATION EXPOSURES:

  1. Remove the patient from the suspected contaminated area, regardless of its apparent safety. Carbon monoxide, a common inhaled toxin, cannot be detected by sight, smell or taste.
  2. Institute artificial ventilation, if necessary, and provide supplementary humidified oxygen, if available and needed.
  3. Protect yourself from contamination at all times.
  4. Contact a Regional Poison Center for definitive treatment information.



POISONING BY INGESTIONS:

  1. Remove any remaining contaminant from inside and around the mouth of the patient.
  2. Give a small amount of water to clear the mouth and esophagus.
  3. Contact a Regional Poison Center for definitive treatment information.
  4. In many cases, it will not be necessary to take additional steps. The following information can be used if additional care is recommended by the Regional Poison Center.
Labels:

Comments

Post a Comment

Popular posts from this blog

Diabetes Mellitus: Types!

TYPES OF DIABETES MELLITUS 1. TYPE1 DM Type 1 DM is usually diagnosed before age 30 years, but it can develop at any age. T1DM is an autoimmune disease in which insulin producing B-cells are destroyed. The presence of Human Leucocyte Antigens (HLAs ) is associated with the development of T1DM. In addition, these individuals often develop Islet cell antibodies , Insulin Autoantibodies or Glutamic Acid decarboxylase autoantibodies . At the time of development of diagnosis of T1DM, it is usually believed that most of the patients have 80-90%loss of beta cells. The remaining beta cells function at the diagnosis creates a " HONEYMOON PERIOD" during which the blood glucose levels are easier to control, and smaller amounts of insulin are required. after this, the remaining beta cells function is completely lost, and the patients become completely deficient of insulin and hence require exogenous insulin.  2. TYPE1.5 DM:  Also referred as Latent autoimmune diabetes in Adults (LAD)
Post a Comment
Read more

Diabetes Mellitus: Pharmacotherapy- Gliptins and a-Glycoside Inhibitors!

  PHARMACOTHERAPY:  Medications classifications include:  Sulfonyl Urea's Nonsylfonylurea Secretagogues (a-Glinides) Biguanides Thiazolidinediones a-Glucosidase Inhibitors Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Sodium-glucose co-transporter (SGLT) Inhibitors  Central-Acting Dopamine Agonists Bile Acid Sequestrants Insulin therapy 5. a-GLUCOSIDASE INHIBITORS Acarbose and Miglitol are a-glucosidase inhibitors currently approved in the United States. Mechanism of Action: An enzyme that is along the brush border of the intestine cells called a-glucosidase; breaks down the complex carbohydrates into simple sugars, resulting in absorption. The a-glucosidase inhibitors work by delaying the absorption of carbohydrates from the intestinal tract, which reduces the rise in postprandial glucose levels. Therapy: As a monotherapy , a-glucosidase inhibitors primarily reduce post-prandial glucose excursions.  Clinical Use: FPG concentrations have been decreased by 40-50mg/dL and A1c level
Post a Comment
Read more

GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD)!

MANAGEMENT OF GASTRO-ESOPHAGEAL REFLUX DISEASE  "GERD refers to the endoscopically determined esophagitis or endoscopy-negative reflux disease" . "GERD is the term used to describe any symptomatic clinical condition or histopathological alteration resulting from episodes of reflux of acid, pepsin and occasionally, bile into the esophagus from the stomach". Patients with uninvestigated "reflux-like" symptoms should be managed as patients with uninvestigated dyspepsia. There is currently no evidence that H.pylori should be investigated in patients with GERD. Symptoms: Heartburn is the characteristic symptom of GERD. Acid regurgitation Dysphagia Belching Upper abdominal discomfort Bloating and postprandial fullness Chest pain Hoarseness Cough Complications include: Esophageal ulceration Formation of specialized columnar-lined esophagus at the gastro-esophageal junction known as Barretts Esophagus . Mechanism of Acid Reflux: The mechanism of acid reflux is mu
Post a Comment
Read more