1. On presentation, this patient’s overdose has resulted in the following symptoms: bradycardia, bradypnea, hypotension, hypothermia, hypoxia, and non-responsive to pain. For this patient, an endotracheal tube would be placed to protect the airway and start mechanical ventilation, since the patient is having difficulty maintaining spontaneous ventilation. This will also protect the airway from potential aspiration. Continuous oxygen therapy at 100% to help improve the patient’s hypoxia. Intravenous fluid therapy would also be initiated to help increase blood pressure and cardiac output. It is also necessary to warm the patient up using warming blankets, a Bair hugger, or warmed IV fluids if available.
2. Due to the possibly of co-ingestion …show more content…
8. Another important management step is to order a CT scan of the head to check for any underlying injury to the brain since the patient is non-responsive to pain stimulus, which indicates that the pain stimulus perceived by the sensory receptors that should normally travel up to the dorsal horn of the spinal cord and to the cerebral cortex where it is perceived as pain is not functioning properly.
9. Enhanced elimination techniques that could be applied to this patient include hemodialysis, urinary alkalinization, or multiple dose activated charcoal (MDAC). Hemodialysis is used in severe cases of phenobarbital toxicity when the patient requires intubation and mechanical ventilation. Urinary alkalinization can increase the excretion of long acting barbiturates like phenobarbital. MDAC may be beneficial in this case because it can increase elimination of phenobarbital by 50% to 80% as demonstrated in clinical studies. When using this method, the clinician must weight the benefits versus the risks and ensure the airway is
2. Due to the possibly of co-ingestion …show more content…
8. Another important management step is to order a CT scan of the head to check for any underlying injury to the brain since the patient is non-responsive to pain stimulus, which indicates that the pain stimulus perceived by the sensory receptors that should normally travel up to the dorsal horn of the spinal cord and to the cerebral cortex where it is perceived as pain is not functioning properly.
9. Enhanced elimination techniques that could be applied to this patient include hemodialysis, urinary alkalinization, or multiple dose activated charcoal (MDAC). Hemodialysis is used in severe cases of phenobarbital toxicity when the patient requires intubation and mechanical ventilation. Urinary alkalinization can increase the excretion of long acting barbiturates like phenobarbital. MDAC may be beneficial in this case because it can increase elimination of phenobarbital by 50% to 80% as demonstrated in clinical studies. When using this method, the clinician must weight the benefits versus the risks and ensure the airway is