Toxicology, Toxidromes, Opioids, Poisonings, Overdose & Withdrawal.

Poison

A substance that causes harmful effects when ingested, inhaled, or absorbed.

Drug abuse

The misuse of drugs for non-medical purposes, often leading to negative health consequences.

Physical dependence

A state where an individual's body requires a substance to function normally, leading to withdrawal symptoms when the substance is not available.

Psychological dependence

A psychological need for a substance, often characterized by cravings or compulsive use.

Tolerance

A condition where increasing amounts of a substance are needed to achieve the same effect.

Addiction

A chronic disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.

Withdrawal

A set of symptoms that occur upon the abrupt discontinuation of a substance that the body has become dependent on.

Routes of poison exposure

Four routes of exposure that must be understood: ingestants, inhalants, surface-absorbed agents, and injectants.

Toxidrome

A syndrome characterized by a specific set of signs and symptoms associated with a particular type of poisoning.

Cholinergic toxidrome

A toxidrome with specific environmental concerns, often associated with agents such as organophosphates.

Designer drugs

Synthetic substances designed to mimic the effects of known drugs, requiring recognition of their toxidrome for overdose management.

Excited delirium

A severe agitation often associated with substance use, requiring knowledge of its etiology, progression, and management.

Clandestine drug laboratories

Hidden facilities where illegal drugs are produced, posing unique safety concerns at a toxicology call.

Ingestants listed in AEMCA syllabus

Strong acids and alkalis, hydrocarbons, methanol, ethylene glycol, isopropanol, cyanide, organophosphates and carbamates, toxic plants, and food poisoning agents.

Food poisoning agents

Pathogens specifically named in the syllabus, including Salmonella, staphylococcal bacteria, Escherichia coli, and Clostridium botulinum.

Inhaled toxic agents

Toxins specifically listed such as carbon tetrachloride, ammonia, and hydrogen sulfides.

Surface-absorbed agents

Toxic materials that can be absorbed through the skin, mainly organophosphates and carbamates.

Injectants in toxicology

Venoms from reptiles, snakes, and toxins involving ticks, spiders, and insects.

Gastrointestinal decontamination methods

Methods such as activated charcoal, gastric lavage, and dialysis that are expected to be understood.

Methanol

A toxic alcohol whose metabolism results in harmful pathophysiological effects.

Chronic alcohol complications

Conditions resulting from chronic alcohol use, including clotting disorders and esophageal varices.

Delirium tremens

A serious condition resulting from alcohol withdrawal characterized by severe agitation and confusion.

Opioids

Natural or synthetic drugs acting on opioid receptors to relieve pain.

Signs of opioid overdose

Common indicators such as miosis and respiratory depression.

Cornerstone of opioid overdose management

Effective ventilation is vital to prevent hypoxemia and death.

Naloxone administration indication

Required for patient suspected of opioid toxicity.

Buprenorphine/naloxone for withdrawal

A medication used for managing opioid withdrawal with specific age and score requirements.

COWS score

Clinical Opiate Withdrawal Scale used to assess opioid withdrawal severity.

Contraindications to buprenorphine/naloxone

Includes allergy to buprenorphine and recent methadone use.

Environmental concerns with cholinergic agents

Need for heightened scene safety due to potential hazards associated with toxic exposure.

Anticholinergic toxidrome knowledge

Expected understanding of product sources, pathophysiological effects, and manifestations.

Adrenergic toxidrome knowledge

Required knowledge on product names, pathophysiological effects, and manifestations.

Sedative-hypnotic toxidrome knowledge

Understanding expected of product names, pathophysiological effects, and manifestations.

Hazardous-material resources

Resources such as CANUTEC and Material Safety Data Sheets that assist in identifying toxic substances.

Ambulance positioning at hazardous material scenes

Recommended positioning is upwind or upstream to ensure safety.

Decontamination methods

Includes removal of contaminated clothing, eye irrigation, and large-volume water irrigation where appropriate.

Nitrogen dioxide

Toxic gas associated with silo gas exposure.

Pathophysiological effects of carbon monoxide

Expected knowledge includes environmental information and treatment rationale.

AEMCA approach to a toxicological patient

Includes ensuring safety, identifying substances and routes, managing ABC threats, and appropriate transport and continuous reassessment.