Download as PDF, PPTX
More Related Content
Similar to Intoxicaciones: Epidemiología y tratamiento general
![INTRODUCTION AND VITAL STATISTICS [Autosaved].pptx](https://cdn.slidesharecdn.com/ss_thumbnails/introductionandvitalstatisticsautosaved-251220102737-b3440454-thumbnail.jpg?width=640&height=640&fit=bounds)
More from Sociedad Científica de Medicina Familiar y General de Chile
![ONFH[AVN HIP] -TRIPLE REGIME -A NOVAL SURGICAL CONCEPT .pptx](https://cdn.slidesharecdn.com/ss_thumbnails/onfhavnhip2026koaconcalicutdrgokuldevdrmashraf-260210064517-213ec005-thumbnail.jpg?width=640&height=640&fit=bounds)
![PERI-PROSTHETIC FRACTURE NAIL-PLATE CONSTRUCT [NPC].pptx](https://cdn.slidesharecdn.com/ss_thumbnails/drarunkumardrmohamedashrafperiprostheticfrasturenail-plateconstructnpc-260209164459-7e9d15a1-thumbnail.jpg?width=640&height=640&fit=bounds)
![CTEV [ clubfoot] DR ARUN LAL ,DR MOHAMED ASHRAF travancore medical college k...](https://cdn.slidesharecdn.com/ss_thumbnails/ctevclubfootdrarunlaldrmohamedashraftravancoremedicalcollegekollamkeralaindia-260208063247-18fc466c-thumbnail.jpg?width=640&height=640&fit=bounds)
Intoxicaciones: Epidemiología y tratamiento general
- 1. Epidemiología y Tratamiento generalde las intoxicaciones. XV Congreso Chileno Medicina Familiar. X Congreso Nacional Médicos Atención Primaria. Dr.Enrique Paris M. Director Centro Información Toxicológica Pontificia Universidad Católica de Chile CITUC.
- 2. The price oflife Acute respiratory infection 18% Other 24% Diarrhoea 15% Malaria 11% Measles 5% Human Immunodeficiency Virus (HIV) 4% Perinatal diseases (within 7 days of birth) 23% Deaths associated with malnutrition: 54% Annual expenditure on pet food in North America and Europe 1998 Annual cost of scaling-up vaccination, malaria prevention and essential treatment to reach every child in the developing world 2001 US$ 7.5 billion US$ 17 billion AUSTRALIA REP. KOREA DPR KOREA TIMOR-LESTE MICRONESIA, FED. STATES OF ANTIGUA & BARBUDA BARBADOS ST LUCIA TRINIDAD & TOBAGO PALAU ST KITTS & NEVIS ST VINCENT & GRENADINES BAHAMAS ZIMBABWE UGANDA TURKMENISTAN UZBEKISTAN TAJIKISTAN KYRGYZSTANGEORGIA AZERBAIJAN ARMENIA MADAGASCAR SRI LANKA JAMAICA CUBA DOMINICAN REP. BRUNEI DAR. M A L A Y S I A SAUDI ARABIA C H I N A M O N G O L I A VIET NAM CAMBODIA LAO PDR THAILAND I N D I A BHUTAN BANGLADESH ISL. REP. IRAN PAKISTAN AFGHANISTAN T U R K E Y IRAQ CYPRUS SYRIAN ARAB REPUBLIC LEBANON ISRAEL JORDAN BAHRAIN QATAR UAE OMAN KUWAIT YEMEN NEPAL K A Z A K H S T A N U S A C A N A D A ALGERIA NIGER CHAD S U D A N NIGERIA CENTRAL AFRICAN REPUBLIC DEM. REP. CONGO ETHIOPIA ANGOLA E G Y P T MOROCCO LIBYAN ARAB JAMAHIRIYA MAURITANIA SENEGAL GAMBIA CAPE VERDE SAO TOME & PRINCIPE GUINEA-BISSAU GUINEA LIBERIA CÔTE D’IVOIRE BURKINA FASO GHANA BENIN CAMEROONEQUATORIAL GUINEA GABON CONGO NAMIBIA BOTSWANA SOUTH AFRICA MOZAMBIQUE MALAWI ZAMBIA UNITED REP. TANZANIA BURUNDI RWANDA KENYA DJIBOUTI SOMALIA TOGO SIERRA LEONE SWAZILAND MALI LESOTHO ERITREA GUATEMALA EL SALVADOR MEXICO HAITI BOLIVIA PARAGUAY B R A Z I L VENEZUELA COLOMBIA HONDURAS NICARAGUA COSTA RICA PANAMA ECUADOR PERU GUYANA SURINAME BELIZE ARGENTINA URUGUAY CHILE PHILIPPINES NEW ZEALAND PAPUA NEW GUINEA I N D O N E S I A JAPAN R U S S I A N F E D E R A T I O N MAURITIUS MALDIVES COMOROS SEYCHELLES SINGAPORE DOMINICA GRENADA MYANMAR SOLOMON ISLANDS TUVALU MARSHALL ISLANDS NAURU TONGA SAMOA NIUE COOK ISLANDS KIRIBATI FIJI VANUATU TUNISIA CROATIA ITALY REP. MOLDOVA UKRAINE FYR MACEDONIA LITHUANIA LATVIA ESTONIA ALBANIA AUSTRIA HUNGARY BULGARIA ROMANIA GREECE SERBIA & MONTENEGRO POLAND SLOVENIA BELARUS RUSSIAN FED.UNITED KINGDOM IRELAND DENMARK FRANCE SPAIN ANDORRA S. MARINO PORTUGAL GERMANY SWITZ. BELGIUM LUX. NETH. ICELAND NORWAY FINLAND SWEDEN SLOVAKIA CZECH REPUBLIC MALTA MONACO BOSNIA & HERZEGOVINA Under-five mortality rate per 1000 live births 2000 Beacons of hope greatest improvement in child mortality rate 1970–2000 over 175 101 – 175 26 – 100 11 – 25 10 and under no data Child mortality rate Main causes of child mortality 2002 The biggest killers of children under five ProducedbyMyriadEditions O TheWorld’s Forgotten Children ver 10 million children under five die every year – 98 per cent of them in developing countries. Widespread malnutrition hampers children’s growth and development, opening the door to the biggest killers of children under five: perinatal diseases, pneumonia, diarrhoea, and malaria. This presents a sharp contrast to the situation in the industrialized world, where junk food and a sedentary lifestyle have triggered an unprecedented epidemic of obesity in children, leading to diabetes and heart disease in adult life. The last three decades have witnessed an impressive decline in child mortality, from 17 million a year in the 1970s. Yet these gains have not been enjoyed everywhere. In some countries of sub-Saharan Africa, child mortality is rising as wars and the ravage of the AIDS epidemic undermine the medical, social and economic structures of society. At the turn of the century, the world joined together in the fight against poverty, and committed itself to the Millennium Development Goals, adopted by the United Nations in 2000. “To reduce by two-thirds the under-five mortality rate between 1990 and 2015” may be the most ambitious of these goals. Aiko is safely delivered in Kumamoto, Japan, and can expect to live about 85 years. At the same time, Mariam comes into this world in one of the poorest areas of Freetown, Sierra Leone. She is underweight and vitamin-deficient, and has a 30% chance of dying before her fifth birthday. Today, 35% of Africa’s children are at higher risk of death than they were ten years ago. From Inheriting the World: The Atlas of Children's Health and the Environment © WHO World Health Organization "It is not enough to prepare our children for the world; we must also prepare the world for our children.” Luis J. Rodriguez (1954– ) Niños y Medio Ambiente.
- 3. A U ST R A L I A REP. KOREA DPR KOREA TIMOR-LESTE MICRONESIA, FED. STATES OF ANTIGUA & BARBUDA BARBADOS ST LUCIA TRINIDAD & TOBAGO PALAU ST KITTS & NEVIS ST VINCENT & GRENADINES DOMINICA BAHAMAS ZIMBABWE UGANDA TURKMENISTAN UZBEKISTAN TAJIKISTAN KYRGYZSTANGEORGIA AZERBAIJAN ARMENIA MADAGASCAR SRI LANKA JAMAICA CUBA DOMINICAN REP. BRUNEI DAR. M A L A Y S I A SAUDI ARABIA C H I N A M O N G O L I A VIET NAM CAMBODIA LAO PDR THAILAND I N D I A BHUTAN BANGLADESH I S L . R E P . I R A N PAKISTAN AFGHANISTAN T U R K E Y IRAQ CYPRUS SYRIAN ARAB REPUBLIC LEBANON ISRAEL JORDAN BAHRAIN QATAR UAE OMAN KUWAIT YEMEN NEPAL K A Z A K H S T A N U S A C A N A D A ALGERIA NIGER CHAD S U D A N NIGERIA CENTRAL AFRICAN REPUBLIC DEM. REP. CONGO ETHIOPIA ANGOLA E G Y P T MOROCCO LIBYAN ARAB JAMAHIRIYA MAURITANIA SENEGAL GAMBIA CAPE VERDE SAO TOME & PRINCIPE GUINEA-BISSAU GUINEA LIBERIA CÔTE D’IVOIRE BURKINA FASO GHANA BENIN CAMEROON EQUATORIAL GUINEA GABON CONGO NAMIBIA BOTSWANA SOUTH AFRICA MOZAMBIQUE MALAWI ZAMBIA UNITED REP. TANZANIA BURUNDI RWANDA KENYA DJIBOUTI SOMALIA TOGO SIERRA LEONE SWAZILAND MALI LESOTHO ERITREA GUATEMALA EL SALVADOR MEXICO HAITI BOLIVIA PARAGUAY B R A Z I L VENEZUELA COLOMBIA HONDURAS NICARAGUA COSTA RICA PANAMA ECUADOR PERU GUYANA SURINAME BELIZE ARGENTINA URUGUAY CHILE PHILIPPINES NEW ZEALAND PAPUA NEW GUINEA I N D O N E S I A JAPAN R U S S I A N F E D E R A T I O N MAURITIUS MALDIVES COMOROS SEYCHELLES SINGAPORE GRENADA MYANMAR SOLOMON ISLANDS WEST BANK AND GAZA TUVALU MARSHALL ISLANDS NAURU TONGA TOKELAU SAMOA NIUE COOK ISLANDS KIRIBATI FIJI VANUATU TUNISIA CROATIA ITALY REP. MOLDOVA UKRAINE FYR MACEDONIA LITHUANIA LATVIA ESTONIA ALBANIA AUSTRIA HUNGARY BULGARIA ROMANIA GREECE SERBIA & MONTENEGRO POLAND SLOVENIA B-H BELARUS RUSSIAN FED.UNITED KINGDOM IRELAND DENMARK FRANCE SPAIN PORTUGAL GERMANY SWITZ. BELGIUM LUX. NETH. ICELAND NORWAY FINLAND SWEDEN SLOVAKIA CZECH REPUBLIC MALTA How children are injured Causes of deaths worldwide due to unintentional injuries for children under 15 years 2002 Road traffic accidents boys girls Poisonings boys girls Falls boys girls 111 559 71 261 19 818 15 797 22 294 14 713 Fires boys girls 34 238 39 969 Drowning boys girls 89 955 55 104 Deaths due to road traffic accidents of children aged 0–14 years per 100 000 2002 by WHO sub-region 20.0 and over 10.0 – 19.9 5.0 – 9.9 2.5 – 4.9 under 2.5 no data Dying on the roads ProducedbyMyriadEditions Child Injuries are Preventable rowning is the most common cause of injuries for infants, killing approximately 60 000 children under five every year and leaving roughly the same number permanently disabled. Children also suffer burns from open fires and kerosene stoves, and are injured in falls at home, at school and at playgrounds. In older children, however, the overriding cause of injuries is road traffic accidents, killing approximately 180 000 children under 15 each year. Children are rarely the cause of road traffic accidents but suffer as pedestrians, cyclists and passengers. Boys, often given greater freedom to roam, are more likely to be injured than girls. Injuries are unnecessary and avoidable. The use of seatbelts and child car seats, and the wearing of helmets are essential to prevent the death of child passengers or cyclists. Traffic measures such as checking vehicle roadworthiness, enforcing speed limits and prosecuting drunk drivers are particularly important in developing countries, where roads tend to be poorly maintained and the number of vehicles is growing rapidly. Injuries from road traffic accidents already cost developing countries US$ 65 billion a year – more than the annual amount of development assistance they receive. D Emeka slipped while drawing water from the river near her village in Nigeria and did not return home . . . From Inheriting the World: The Atlas of Children's Health and the Environment © WHO World Health Organization Deaths from road accidents are projected to rise by 65% by 2020, mostly in developing countries.
- 5. LIFETIME EXPOSURES Birth 6m 1 yr 5 yr 16 yr 45 yr 65yr Intrauterine Breastfeeding Occupational exposure “Normal” food Soil: ingestion Soil: dermal Domestic environments Drinking water Air
- 6.
- 7.
- 8.
- 9.
- 10.
- 12. Intoxicaciones. ♦ Primeros Centros Toxicológicos60’. ♦ Formados por Pediatras. ♦ Campañas Masivas. ♦ Semana de la Prevención. ♦ Uso Responsable del Medicamento.
- 13. Intoxicaciones. ♦ CITUC. 6353 800 . ♦ Http://escuela.med.puc.cl ♦ Fundado 1992. ♦ Financiamiento: Ley de Donaciones. ♦ Llamadas diarias : prom. 90. ♦ Llamadas acumuladas : 310.000 ♦ Cituc@med.puc.cl - www.cituc.cl
- 14. Intoxicaciones. ♦ Personal y Basede Datos CITUC. ♦ 1 Secretaria. ♦ 5 Enfermeras. ♦ 4 Químicos Farmaceúticos.1 Dr. Tox. ♦ 16 Internos de Medicina y QF. ♦ 1 Médico Intensivista Pedíatra. ♦ 1 Médico Laboratorio. ♦ Micromedex. Intox.
- 15. Intoxicaciones. ♦ CITUC. ♦ Entregar una informaciónprofesional, oportuna, adecuada y actualizada, para contribuir al manejo del Paciente Intoxicado.
- 16.
- 17.
- 18.
- 19.
- 20. 0 1000 20003000 4000 5000 6000 7000 8000 9000 10000 Medicamentos Prod. Ind. Y Químicos Productos Aseo Fitosanitarios Animales Plaguicidas domésticos Cosméticos Metales Cuerpo Extraño Alimentos Gases Plantas Otro SUSTANCIAS MAS FRECUENTES Llamadas
- 21. 0 1000 20003000 4000 Sistema Nervioso Central AINES Sistema Respiratorio Antibióticos Sist. Hormonal Sist. Nervioso Autónomo Sistema Cardiovascular Vitaminas/Minerales Antisépticos/desinfectantes Agentes gastrointestinales Otros MEDICAMENTOS MAS FRECUENTES LLAMADAS
- 22. GRUPO MAS FRECUENTESNC 0 200 400 600 800 1000 BENZODIAZEPINAS ANTIDEPRESIVOS FENOTIAZINAS Y DROGAS RELACIONADAS ANTICONVULSIVANTES ANFETAMINAS OTRAS DROGAS SNC LLAMADAS
- 23. PRODUCTOS DE ASEO 0200 400 600 800 1000 CLORO DETERGENTES LAVALOZAS OTROS AGENTES LIMPIADORES LLAMADAS
- 24. PRODUCTOS INDUSTRIALES 0 200400 600 800 1000 1200 HIDROCARBUROS ALCOHOLES ACIDOS/ALKALIS PEGAMENTOS OTROS LLAMADAS
- 25.
- 26. Figure 1. A 21-‐year-‐old dental assistant a1empted suicide by injec8ng 10 ml (135 g) of elemental mercury (quicksilver) intravenously. She presented to the emergency room with tachypnea, a dry cough, and bloody sputum. While breathing room air, she had a par8al pressure of oxygen of 86 mm Hg. A chest radiograph showed that the mercury was distributed in the lungs in a vascular pa1ern that was more pronounced at the bases. The pa8ent was discharged aNer one week, with improvement in her pulmonary symptoms. Oral chela8on therapy with dimercaprol was given for nine months, un8l the pa8ent stopped the treatment;
- 27. Intoxicaciones. ♦ Diagnóstico. ♦ - Sospechar elDiagnóstico. ♦ - Anamnesis. ♦ - Examen Físico . Sindromes Tóxicos. ♦ - Examenes de Laboratorio.
- 28. Intoxicaciones. ♦ Sindromes Tóxicos. ♦ - SindromeAnticolinérgico. ♦ - Sindrome Colinérgico. ♦ - Sindrome Opiode Alcohólico. ♦ - Sindrome Catecolaminérgico.
- 29. Intoxicaciones. Síndromes Tóxicos. Síndrome Anticolinérgico. Causas. Antihistamínicos,antidepresivos tricíclicos antiespasmódicos, chamico, atropina.CBZ. Sintomatología. Taquicardia, vasodilatación, retención urinaria, silencio abdominal, alucinaciones y convulsiones.Midriasis.Mucosas secas.
- 30. Intoxicaciones. Síndromes Tóxicos. Síndrome Colinérgico. Causas. Hongos,carbamatos, órganofosforados, fisostigmina. Sintomatología. Depresión SNC, hipotonía, salivación, lagrimación, incontinencia urinaria y fecal, bradicardia y convulsiones.Miosis.
- 31. Intoxicaciones. Síndromes Tóxicos. Síndrome Opioidealcohólico. Causas. Codeína, morfina, barbitúricos, BDZ, etanol, clonidina. Sintomatología. Coma, depresión respiratoria, hipotensión, miosis, bradicardia, hipotermia, edema pulmonar, shock distributivo.
- 32. Intoxicaciones. Síndromes Tóxicos. Síndrome Catecolaminergico. Causas. Cocaína,amfetaminas, efedrina, cafeína, pseudoefedrina, fenilpropanolamina. Sintomatología. Taquicardia, hipertensión, hipertermia, diaforesis, midriasis, convulsiones y arritmias.Dolor anginoso.
- 33. Intoxicaciones. ♦ Tratamiento . ♦ Siempre tratarprimero al Paciente: ♦ ABC de la Reanimación. ♦ Después tratar al Tóxico. ♦ “ABC” de la Intoxicación.
- 34. Intoxicaciones. ♦ Tratamiento . ♦ Siempre tratarprimero al Paciente: ♦ ABC de la Reanimación. Via Aerea Permeable.Oxigenar. Asegurar una buena ventilacion. Dos vias venosas gruesas. Monitoreo Cardíaco. Saturación.
- 35. Intoxicaciones. ♦ “ABC” de laIntoxicación. ♦ - evitar la absorción. ♦ - favorecer la adsorción. ♦ - favorecer la eliminación. ♦ - antagonizar al tóxico.
- 36. Intoxicaciones. ♦ Evitar absorción :Lavado Gástrico. Solo en la primera hora post ingestión. Proteger la vía aerea si existe compromiso de Conciencia. Indicado principalmente en Tóxicos que comprometen gravemente la vida del paciente. Contraindicado en Caústicos e Hidrocarburos.
- 37. Intoxicaciones. ♦ Favorecer adsorción:Carbón Activado. Muy Importante. Dosis Unica. 2 a 3 gr /kg Niños. Dosis Secuenciales. 0,5 a 1 gr/ kg c/4, 6 u 8 hrs. Contraindicado en Caústicos y Obst.Intestinal Inutil en Litio y Fierro.
- 38. Intoxicaciones. ♦ Carbón Activado. Concomitantemente usarLactulosa. 10 a 15 ml con cada dosis de Carbón.
- 39. Intoxicaciones. ♦ Favorecer la Eliminación. Ventilacióndel lugar del accidente. Forzar diuresis. Alcalinizar o Acidificar orina. Lavado Gastrointestinal total. Solución de Colon. Oxigenar . Cámara Hiperbárica.
- 40. Intoxicaciones. ♦ Antagonizar al Tóxico. Usarun Antagonista no es la Panacea. Lo importante es Tratar al Paciente.
- 41. Intoxicaciones. ♦ Paradoja. Uso de flumazenilen Intoxicación Mixta de BDZ y Antidepresivos Tricíclicos. ¿ se debe usar flumazenil ?
- 42. Intoxicaciones. Antídotos. ♦ N-Acetilcisteína. ♦ Atropina. ♦ Benztropina. ♦ Difenhidramina. ♦ Digibind. ♦ Etanol. ♦ Fitomenadiona ♦ Glucagón. ♦ Flumazenil. ♦ Glucosa. ♦ Naloxona. ♦ Obidoxima. ♦ Oxígeno. ♦ Piridoxina. ♦ Succimer. ♦ Fomepizol.
- 43. Intoxicaciones. ♦ Prevención. ♦ - Educación atoda la Familia. ♦ almacenar correctamente los tóxicos. ♦ - Uso correcto del Medicamento. ♦ - Promover el Envase Seguro. ♦ - Promover los Centros de Información.
- 44.