Management of the critically poisoned patient

被引:37
作者
Boyle, Jennifer S. [1 ]
Bechtel, Laura K. [1 ]
Holstege, Christopher P. [1 ,2 ]
机构
[1] Univ Virginia, Sch Med, Dept Emergency Med, Div Med Toxicol, Charlottesville, VA 22908 USA
[2] Univ Virginia, Sch Med, Dept Pediat, Div Med Toxicol, Charlottesville, VA 22908 USA
关键词
POSITION PAPER; QT-INTERVAL; GAPS; ACETAMINOPHEN; OSMOLALITY; ANION; DIAGNOSIS; OVERDOSE; METHANOL; DRUGS;
D O I
10.1186/1757-7241-17-29
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Clinicians are often challenged to manage critically ill poison patients. The clinical effects encountered in poisoned patients are dependent on numerous variables, such as the dose, the length of exposure time, and the pre-existing health of the patient. The goal of this article is to introduce the basic concepts for evaluation of poisoned patients and review the appropriate management of such patients based on the currently available literature. Methods: An unsystematic review of the medical literature was performed and articles pertaining to human poisoning were obtained. The literature selected was based on the preference and clinical expertise of authors. Discussion: If a poisoning is recognized early and appropriate testing and supportive care is initiated rapidly, the majority of patient outcomes will be good. Judicious use of antidotes should be practiced and clinicians should clearly understand the indications and contraindications of antidotes prior to administration.
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页数:11
相关论文
共 61 条
[1]   OSMOLAL AND ANION GAPS IN PATIENTS ADMITTED TO AN EMERGENCY MEDICAL DEPARTMENT [J].
AABAKKEN, L ;
JOHANSEN, KS ;
RYDNINGEN, EB ;
BREDESEN, JE ;
OVREBO, S ;
JACOBSEN, D .
HUMAN & EXPERIMENTAL TOXICOLOGY, 1994, 13 (02) :131-134
[2]   VALUE OF RAPID SCREENING FOR ACETAMINOPHEN IN ALL PATIENTS WITH INTENTIONAL DRUG OVERDOSE [J].
ASHBOURNE, JF ;
OLSON, KR ;
KHAYAMBASHI, H .
ANNALS OF EMERGENCY MEDICINE, 1989, 18 (10) :1035-1038
[3]  
BAER A, 2005, J TOXICOL-CLIN TOXIC, V43, P536
[4]  
Bast RP, 2000, SOUTH MED J, V93, P397
[5]   TOXICOLOGIC ANALYSIS IN PATIENTS WITH DRUG OVERDOSE [J].
BRETT, A .
ARCHIVES OF INTERNAL MEDICINE, 1988, 148 (09) :2077-2077
[6]   Diagnostic use of anion and osmolal gaps in pediatric emergency medicine [J].
Chabali, R .
PEDIATRIC EMERGENCY CARE, 1997, 13 (03) :204-210
[7]  
Chyka P A., 2005, Clin Toxicol (Phila), V43, P61, DOI DOI 10.1081/CLT-200051867
[8]   Naloxone in opioid poisoning: walking the tightrope [J].
Clarke, SFJ ;
Dargan, PI ;
Jones, AL .
EMERGENCY MEDICINE JOURNAL, 2005, 22 (09) :612-616
[9]   Delayed admission for ethylene glycol poisoning: lack of elevated serum osmol gap [J].
Darchy, B ;
Abruzzese, L ;
Pitiot, O ;
Figueredo, B ;
Domart, Y .
INTENSIVE CARE MEDICINE, 1999, 25 (08) :859-861
[10]   Measuring plasma paracetamol concentrations in all patients with drug overdose or altered consciousness: Does it change outcome? [J].
Dargan, PI ;
Ladhani, S ;
Jones, AL .
EMERGENCY MEDICINE JOURNAL, 2001, 18 (03) :178-182