Toxicological Emergencies and Envenomation Management

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Toxidromes

collection of symptoms associated with class/group of similar poisons

5 major toxidromes

1. Opioid

2. Sympathomimetics

3. Sedative-hypnotics

4. Cholinergics

5. Anticholinergics

Opioid Toxidrome

1. Respiratory depression

2. Pinpoint pupils

3. Decreased mental status

Sympathomimetic Toxidrome

1. Hypertension

2. Tachycardia

3. Elevated RR

4. Diaphoresis

5. Dilated Pupils

6. paranoia/agitation

Sedative/Hypnotic Toxidrome

1. Respiratory Depression

2. Drowsiness

3. Slurred Speech

4. Disinhibition

Cholingeric Toxidrome

DUMBBELLS

Diarrhoea

Urination

Miosis

Bradycardia

Bronchoconstriction

Emesis

Lacrimatoin

Lethargy

Salivation

Anticholingeric toxidrome

1. agitatoion/delerium

2. dry mucus

3. flushed skin

4. tachycardia

5. dilated pupils

Toxidrome chart

Carbon Monoxide

CO binds to hemoglobin stronger than O2

*consider hyperbaric capable facility

cyanide poisoning

cyanokit, 5g IV over 15 mins, can repeat 3 times

Antidepressants

Selective-Serotonin Reuptake Inhibitors (SSRIs)

lexapro

zoloft

prozac

celexa

effexor (SNRIs)

pristiq (SNRIs)

Acetaminophen

recent ingestions activate charcoal

Salicylates

Aspirin example
over 300 mg/kg severe toxivity

150-300 moderate toxivity

150 mild toxic

Envenomation no nos

Tourniquets are not recomended

Scorpion bites

splint and immobilize limbs

compression bandage from distal to proximal