Aemt Toxicology Emergencies (Mwn)

Front 1

Difference between a toxin and a poison

Back 1

A poison is toxic by nature.
A drug can have some therapeutic effect if given in appropriate circumstances and dose...or be a toxin

Front 2

National Poison Control Center hotline:

Back 2

1-800-222-1222

Front 3

Toxins enter the body in four main ways:

Back 3

Ingestion
Inhalation
Injection
Absorptio

Front 4

TX considerations for poisoning by absorption

Back 4

Avoid contaminating others.
Remove the substance from patient.
Remove contaminated clothing.
Irrigate the contact area with water.
Unless poison reacts violently with water

Front 5

Major Toxidrome

Back 5

Stimulants
Narcotics
Sympathomimetics
Sedatives and hypnotics
Cholinergics
Anticholinergics

Front 6

scene size up in toxicological emergencies includes:

Back 6

Determine:
Nature of illness/mechanism of injury
Number of patients involved
Need for additional resources
Whether spine stabilization is required
Use the appropriate PPE, and remember patients may be dangerous.
look for clues.
Medication bottles?
Alcoholic beverage containers?
Syringes or drug paraphernalia?
Unpleasant or odd odor?
Any suggestions of a drug lab?

Front 7

History Taking in toxicological emergencies
I

Back 7

Ask what agent the patient was exposed to, when the patient was exposed to it, how much was involved, whether anything else was taken, over what time period the patient was exposed to the substance, whether interventions were performed, and the patient’s weight.

Front 8

Activated charcoal is not indicated for patients:

Back 8

Who have ingested an acid, an alkali, or a petroleum product
Who have a decreased level of consciousness and cannot protect their airway
Who are unable to swallow

Front 9

Side effects of activated charcoal

Back 9

Black stools
Vomiting, if patient has ingested a poison that causes nausea (Dose will have to be repeated)
Nausea
Possible airway problems

Front 10

Medical problems associated with alcoholism

Back 10

Look for signs of head trauma, toxic reactions, uncontrolled diabetes
Death from respiratory depression and/or aspiration of vomitus or stomach contents
Physical dependence and/or withdrawal - Delirium tremens
Hepatitis and cirrhosis

Front 11

Tx delirium tremens

Back 11

Keep patient calm.
Administer oxygen.
Manage hypotension.
Maintain dialogue.

Front 12

opiate vs opoid

Back 12

Opiate = natural drug derived from opium
Opioid = non–opium-derived synthetic

Front 13

S&S Opoids

Back 13

Euphoria
Hypotension
Respiratory depression
Pinpoint pupils
Vomiting
Coma
Seizures

Front 14

Tx Opoid overdose

Back 14

Establish and maintain patent airway.
Provide adequate ventilation.
Establish IV access.
Monitor patient closely and transport promptly.

Front 15

S&S Stimulants

Back 15

Excitement and delirium
Tachycardia
Hyper- or hypotension with fast pulse
Dilated pupils
Tremors and seizure

Front 16

Stimulant examples

Back 16

Cocaine - Local anesthetic and CNS stimulant
Quickly absorbed across all mucosal membranes
Applied topically, swallowed, snorted, injected
When effects wear off, user experiences a “crash”
Amphetamines - Legitimate clinical applications
Methamphetamine is low-cost, long-acting, extremely addictive.

Signs and symptoms of stimulant abuse
Wild-eyed, thin-as-a-rail appearance
Nervous or jittery
Increasing paranoia

Front 17

Complications associated with cocaine include

Back 17

Seizures
Stroke
Apnea
Hyperthermia

Front 18

Treatment for stimulants

Back 18

Maintain maximum oxygen saturation levels.
Prevent seizures with adequate sedation.
Monitor serial vital signs.
Establish IV access and manage hypotension.
Apply the pulse oximeter.
Consider paramedic backup.

Front 19

Hallucinogens include

Back 19

LSD (classic)
Psilocybin mushrooms
PCP
Ketamine
Mescaline

Front 20

tx Sedatives and Hypnotics

Back 20

Airway management is first priority.
Call for paramedic backup.
Administer high-concentration oxygen.
Establish venous access.
For shock, rapid infusion of 1- to 2-L boluses of normal saline may be needed.

Front 21

5 cardiac med examples

Back 21

Antiarrhythmics
Beta-blockers
Calcium channel blockers
Cardiac glycosides
Angiotensin-converting enzyme inhibitors

Front 22

S&S Methyl alcohol and Ethylene glycol
poisoning

Back 22

Tachypnea, blindness, renal failure

Front 23

Cholinergics include organophosphates and nerve gases, which overstimulate normal body functions controlled by _______________

Back 23

parasympathetic NS

Front 24

A 30-year-old male, who ingested an unknown substance, begins to vomit. You should:

Back 24

collect the vomitus and bring it to the hospital.

Front 25

How much activated charcoal should you administer to a 55-pound child who swallowed a bottle of aspirin?

Back 25

25 g

The usual dose of activated charcoal for adults and children is 1 g of charcoal per kg of body weight. To convert a patient’s weight from pounds to kilograms, simply divide the weight in pounds by 2.2. Therefore, a 55-pound child should receive 25 g of activated charcoal (55 [pounds] ÷ 2.2 = 25 [kg]). The average pediatric dosing range for activated charcoal is 12.5 to 25 g.

Front 26

A 21-year-old male was found unconscious in an alley. Your initial assessment reveals that his respirations are slow and shallow, and his pulse is slow and weak. Further assessment reveals that his pupils are bilaterally constricted. His presentation is MOST consistent with an overdose of:

Back 26

an opioid.

Opioids are central nervous system depressant drugs; when taken in excess, they cause respiratory depression, bradycardia, and hypotension. Another common sign is miosis (constricted [pinpoint] pupils). Cocaine, stimulant drugs (uppers), and methamphetamine have the opposite effect; they stimulate the central nervous system and cause tachycardia and hypertension