Peds Emergency: Ods

Front 1

what is the tx for the symtoms of change in mental status, hypoventilation?

Back 1

airway support

Front 2

__ and __ are used to treat the symptoms of hypotension

Back 2

IV fluids and vasopressors

Front 3

for the symptoms of HTN and agitiation r/t overdose, what is the tx?

Back 3

sedatives and benzos

Front 4

what the is tx for HTN cause by overdose?

Back 4

CCBs, or beta blockers, with vasodilator

Front 5

what are the 2 ways to decontaminate the gut?

Back 5

NG tube; charcoal

Front 6

what is the way to decontaminate the blood?

Back 6

hemodialysis

Front 7

what is the most common overdose in the ED?>

Back 7

tylenol

Front 8

what organ is impacted the greatest with Tylenol OD?

Back 8

liver

Front 9

what are the lcinical symptoms of tylenol OD in the 1st few hours?

Back 9

NV, anorexia

Front 10

what symptom of tylenol OD occurs 8-24 hours after ingestion?

Back 10

asymptomatic period

Front 11

what occurs 24-48 hours after tylenol OD?

Back 11

subclinical hepatotox, increased LFTs, RUQ pain, NV

Front 12

what occurs after 48 hours since tylenol OD?

Back 12

fulminant hepatic failure, jaundice, renal failure, cerebral edema, hypotension

Front 13

what labs are required following a tylenol OD?

Back 13

cbc, chem 20, PT/PTT, tylenol level, tox screen

Front 14

how are anticholingeric Ods dx?>

Back 14

clinically, no tox lab for this

Front 15

what are the symptoms of anticholinergic OD?

Back 15

dry mouth, flushed dry skin, mydriatic & unreactive pupils, blurred vision, constipation, urinary retention, tachycardia, confusion, disorientation, hallucinations, sz, coma

Front 16

what is the mnemonic for anticholinergic Ods?

Back 16

Dry as a bone; mad as a hatter; red as a beat; hot as hades; blind as a bat

Front 17

what is the ED management for anticholinergic OD?

Back 17

IV access, start charcoal if w/in 4 hours; glucose levels; intubate if in coma; sz give lorazepam 0.05-0.1mg/kg IV or diapzepam 0.1-0.3 mg/kg IV; wide complex tachycardia give bicarb 1mEq/kg IV

Front 18

what is the ED management for tylenol OD?

Back 18

if < 4 hours after ingestion give charcoal; mucomyst 140mg/kg PO followed by 70mg/kg q 4 hours x17 doses of mucomyst; IV antiemetics

Front 19

the goal of ed management of tylenol OD is to have a level ____

Back 19

< 10 ug/mL and normal ASTs

Front 20

what are the side effects of SSRIs?

Back 20

drowsiness, dry mouth, blurred vision, constpation, urinary retention and less cardiac side effects

Front 21

what are the common side effects of SSRIs?

Back 21

NV; dyspepsia, sex dysfunc; HA; insomnia; dizzy; anxiety; agitiation; tremor; sweating

Front 22

what are the OD symptoms from SSRIs?

Back 22

extreme of side effects: tachy with drowsiness; extreme seizures, prolonged QT; tachyarrythmias

Front 23

what are the symptoms of seratonin syndorm?

Back 23

mental status change; restlesness; myoclonus; hyper reflexia; sweating; shivering; tremor; diarrhea; incoordination; fever

Front 24

what are the complications of seratonin syndrome?

Back 24

sz, severe hypethermia, rhabdomyalysis, DIC, resp arrest, death

Front 25

when can charcoal be given for SSRI overdose?

Back 25

within 1 hour of OD

Front 26

what is the length of time to observe a person with SSRI overdose?

Back 26

4-6 hours

Front 27

what is given for sedation for SSRI OD?

Back 27

Diazepam 0.1-0.3 mg/kg

Front 28

how many tabs of antipsychotics does it take to OD a child?

Back 28

1

Front 29

what are the neuro symptoms of antipsychotic OD?

Back 29

sedation; CNS depression; lowers sz threshold, dystonia; actue akasthesia

Front 30

what are the cardiac symptoms of antipsyhcotic OD?

Back 30

hypotension; tachycardia; prolonged QT-torsades; peripheral vasodilation

Front 31

when can charcoal be given for antipsychotic OD?

Back 31

w/in 1 hour of ingestion

Front 32

what condition can you not give charcoal following antipsychotic OD?

Back 32

> 1hour or encephalopathic

Front 33

what are the tx for antipsychotic OD?

Back 33

IV line, ecg, tox screen, ASA, tylenol level, CBC, chem 20, CPK, CXR if CNS depression

Front 34

how do you tx the hypotension cause by antipsychotic OD?

Back 34

IV NS, if persists give Epi or Norepi gtt

Front 35

what is the tx for prolonged QT caused by antipsychotic OD?

Back 35

mag sulfate

Front 36

how do you tx the sz caused by antipsychotic OD?

Back 36

benzos

Front 37

what are the worst of the worst drugs to OD on?

Back 37

tricyclics

Front 38

what are the common tricyclics?

Back 38

tofranil, elavil, sinequan (doxepin)

Front 39

what is the pathophysiology of tricyclic OD?

Back 39

induced direct myocaridal depression, inhibition of norepi uptake and anticholingeric activity

Front 40

what are the clinical anticholinergic effects of tricyclic OD?

Back 40

tachycardia and confusion

Front 41

what are the peripheral alpha blockage clinical symptoms from tricyclic OD?

Back 41

hypotention

Front 42

what causes the widened QT from tricyclic OD?

Back 42

sodium channel blockage

Front 43

the gaba inhibition caused by tricyclic causes __

Back 43

seizures

Front 44

ToF: acidosis is a clinical presentation of tricyclic OD

Back 44

TRUE

Front 45

what are the mental status changes that occur from tricyclic OD?

Back 45

combativeness, delirium, hallucinations, lethargy, coma

Front 46

how do the cardiac symptoms of tricyclic OD progress?

Back 46

start with tachycardia and HTN, then get hypotensive; tachyarrythmias are the common cause of death (ventricular arrythmias)

Front 47

when do you suspect an OD of tricyclics?

Back 47

pt presenting with acute change of mental status, seizures, abnormal vital signs or an arrhythmia

Front 48

is the QRS is > ____ ms &/or has a __ ___ __ most likely tricyclic has been ingested

Back 48

>100; right axis deviation

Front 49

if the QRS wave is > ___ms with a __ wave or more than __ mm tall, think tricyclic

Back 49

40ms; R; 3

Front 50

how many hours after ingestion of tricyclics can charcoal be given?

Back 50

4

Front 51

what is the management for tricyclic OD when QRS > 100ms?

Back 51

give 1-2mEW/kg of sodium bicarb over 2 mins and repeate q 5 mins til ORS narrows < 10ms

Front 52

ToF: you must tx the hypternsion that is caused by tricyclic OD

Back 52

fALSE!! They will always become hypotensive

Front 53

how do you tx the hypotension of tricyclic OD?

Back 53

20mL/kg boluses; Norepi gtt 0.1-0.2 ug/kg/min titrate to b/p;

Front 54

for life threatening ventricular arrhythmias from tricyclic OD give __-

Back 54

lidocaine

Front 55

ToF: you must tx SVTs caused by tricyclic OD

Back 55

false; you may need to pace patient.