This document discusses various aspects of poisoning management, including classification, routes of poisoning, signs and symptoms of specific poisons like acids, benzodiazepines, lead, and snakes. It also covers management strategies like gastric lavage, ipecac syrup, activated charcoal, whole bowel irrigation, forced alkaline diuresis, and chelation therapy. The goal of management is removal or neutralization of toxins while stabilizing the patient.
poisoning, its types and emergent management.bhartisharma175
it explain about definition, causes, types of poison, severity , diagnostic evaluation, complication of poisoning, emergent management, supportive management and nursing management.
Poisoning
Poison
Medicinal Poisoning
Environmental Poisoning
Factors Affecting Environmental poisoning
Drug Poisoning
Role of Pharmacist to Prevent Poisoning
Diagnosis
Treatment
Poisoning is a lethal disruption of body’s physilogical machanism by the induction of an exogenic biological or chemical agent.
A poison is any substance that is harmful to your body.
Poisons may include-
Prescription or over-the-counter medicines taken in doses that are too high
Overdoses of illegal drugs
Carbon monoxide from gas appliances
Household products, such as laundry powder or furniture polish
Pesticides
Indoor or outdoor plants
Metals such as lead and mercury
poisoning, its types and emergent management.bhartisharma175
it explain about definition, causes, types of poison, severity , diagnostic evaluation, complication of poisoning, emergent management, supportive management and nursing management.
Poisoning
Poison
Medicinal Poisoning
Environmental Poisoning
Factors Affecting Environmental poisoning
Drug Poisoning
Role of Pharmacist to Prevent Poisoning
Diagnosis
Treatment
Poisoning is a lethal disruption of body’s physilogical machanism by the induction of an exogenic biological or chemical agent.
A poison is any substance that is harmful to your body.
Poisons may include-
Prescription or over-the-counter medicines taken in doses that are too high
Overdoses of illegal drugs
Carbon monoxide from gas appliances
Household products, such as laundry powder or furniture polish
Pesticides
Indoor or outdoor plants
Metals such as lead and mercury
Poisoning is one of the very alarming topic now a days. This presentation will give you a basic idea on poisoning, drug poisoning, animal poisoning, plant poisoning, household poisoning, industrial poisoning, treatment of poisoning e.t.c
cerebrovascular accident, commonly known as stroke is one of the most common health problems of the world. in the developing world, its increasing incidence is a matter of concern among the health workers across the globe. thus adequate knowledge about this medical condition is a must to deal with it effectively.
A brief yet comprehensive description of a very common problem faced in KSA especially during hajj season. It is meant to enhance the awareness among ER and ICU physicians.
Poisoning is one of the very alarming topic now a days. This presentation will give you a basic idea on poisoning, drug poisoning, animal poisoning, plant poisoning, household poisoning, industrial poisoning, treatment of poisoning e.t.c
cerebrovascular accident, commonly known as stroke is one of the most common health problems of the world. in the developing world, its increasing incidence is a matter of concern among the health workers across the globe. thus adequate knowledge about this medical condition is a must to deal with it effectively.
A brief yet comprehensive description of a very common problem faced in KSA especially during hajj season. It is meant to enhance the awareness among ER and ICU physicians.
millions of poisoning cases are seen every year with several hundred dying but several more are unreported. A poison may be defined as any substances which if administered or comes in contact with living being produces ill-health.
a emergency treatment of poisoning.describe of ingested poisons,inhaled poisons,absorbed poison,food poisoning,injected poisoning,snake bite. management of treatment
In biology, poisons are substances that can cause death, injury or harm to organs, tissues, cells, and DNA usually by chemical reactions or other activity on the molecular scales, when an organism is exposed to a sufficient quantity.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. The development of dose related adverse effects
following exposure to chemicals, drugs or other
xenobiotics.
Poisoning occurs when any substance interferes with
normal body functions after it is swallowed, inhaled,
injected, or absorbed.
POISONING
11. ACID POISONING
Superficial burns after only 1 second of contact
Full thickness burns after 30 seconds
SIGNS & SYMPTOMS
Swollen lips, brown or black streaks
Edematous tongue
Pharyngeal pain, hoarse & husky voice, chalky-white
teeth
Corrosion of mucous membranes of mouth, throat,
esophagus
15. SIGNS AND SYMPTOMS
MILD: Drowsiness , Ataxia , Weakness
MODERATE TO SEVERE :Vertigo , slurred
speech, nystagmus, lethargy , hypotension,
respiratory depression, coma (stage 1 & 2 ).
16. COMA 1 (Stage 1): Responsive to painful
stimuli but not to verbal or tactile stimuli, no
disturbance in respiration or BP
COMA 2 (Stage 2):Unconscious, not
responsive to painful stimuli
17. LEAD POISONING
Clinical symptoms- >70µg/100ml in blood
Normal adult ingest- 0.2 to 0.3mg of
lead/day
All lead compounds are toxic
MOST Dangerous- lead arsenate,lead
oxide,lead carbonate.
Least toxic-lead sulphide.
19. MANAGEMENT
Saline purge (remove lead from the gut)
d-penicillamine(promote Pb excretion in urine)
Substitution
Isolation
Good housekeeping
Periodic medical examination of workers
20. SNAKE BITE
Snake venom is a Combination of enzymes & Non-
Enzymatic polypeptides.
Acidic
CLINICAL FEATURES
Burning pain
Swelling and discolouration
Serosanguinous discharge
22. MANAGEMENT: LOCAL
Tourniquet: Between wound & heart, Pressure
adequate to occlude lymphatics only, Released for
few seconds every 10 minutes.
Immobilize affected limb: Elastocrepe bandage may
be applied
Clean with Normal Saline
if bite <1hr old: Short skin incision and suction
23. SPECIFIC MANAGEMENT
Antivenom is immunoglobulin purified from the
serum or plasma of a horse or sheep that has been
immunised with the venoms of one or more species
of snake
ASV IN INDIA: Polyvalent
COBRA
KRAIT
RUSSEL’S VIPER
SAW SCALED VIPER
25. Others:
-Local swelling involving more than half of the
bitten limb.
-Rapid extension of swelling.
-Development of an enlarged tender lymph
node draining the bitten limb
26. TIMING OF ASV
Best effects are observed within
four hours of bite
Efficacious even 6-7 days after the
bite from vipers
27. MECHANICAL VENTILATION
If patient has respiratory distress or bulbar
paralysis- intubate and ventilate.
If delayed can cause aspiration or hypoxia and
cardiac arrest.
Even if the facility for MV is not available
ambuing can save the day.
This helps even during transport.
30. TREATMENT
Symptomatic treatment should be done
Salmonella: we can provide ciprofloxacin
Fluid replacement and electrolyte
replacement should be done
Streptococcus: penicillin, erythromycin
E. coli: ciprofloxacin
34. MANAGEMENT
Initial resuscitation & stabilization:
First priorities are ABC’s
I/V access – I/V fluids
Endo tracheal intubation - to prevent
aspiration
Unconscious patients
Respiratory depression/ failure
Convulsions- give anticonvulsants
35. Management for a responsive patient
• Execute a Primary Survey
(Inquire as to what poison was consumed, the
amount and how long ago it was taken )
• Reassure the victim
• Monitor the vital signs of the victim
• Don’t encourage vomiting
• Contact Poisons Information Centre; 1800 116
117 / 26589391 / 26593677
(Get medical advice or assistance)
36. An unconscious or unresponsive patient
Seek an ambulance immediately on 102 or 108
Execute a Primary Survey
(Try to determine what poison was consumed, the
amount and how long ago it was taken)
Monitor the vital signs of the victim
If available give patient supplemental oxygen
37. Management of Ingested Poisons
Swallowed poisons may be corrosive. Corrosive poisons
include alkaline and acid agents that can cause tissue
destruction after coming in contact with mucous
membranes. Control of airway, ventilation, and
oxygenation are essential
Syrup of ipecac to induce vomiting in the alert
patient( never use with corrosive poisons)
Gastric lavage for the obtunded patient, gastric
aspirate is saved and sent to the laboratory for
testing
38. Activated charcoal is administered only if the
poison is adsorbed by charcoal
(phenobarbital, carbamazepine)
Cathartic, when appropriate.
e.g. lactulose
39. GASTRIC LAVAGE
It is the aspiration of stomach contents and
washing out of the stomach by means of large
bore gastric tube
It is contraindicated:-
After acid or alkali ingestion
In the presence of seizures
Recent esophageal / gastric surgery
Unconscious patient
40. Done with water ,1:5000 potassium
permanganate , 4% Tannic acid, saturated
lime water or starch solution with
orogastric or Ewald’s tube
Performed until clear fluid is obtained or
a maximum of 3 L
42. Lavage decreases ingestant absorption by an
average of :-
• 52 % if performed within 5 min of ingestion
• 26 % if performed at 30 min
• 16 % if performed at 60 min
43. CAUTION; GASTRIC LAVAGE
Gastric lavage is not without hazard. Death due to
inadvertent pulmonary placement of the tube and
subsequent instillation of lavage fluid may occur
Epistaxis commonly occurs when the tube is
inserted nasally; oral placement is preferred
Gastric lavage is employed when emetic therapy
can’t be used
44. IPECAC SYRUP INDUCED EMESIS
Administered orally
Dose :-
30 ml – adults
15 ml – children
10 ml – small infants
Contraindications:
Corrosives
CNS depression or seizures
Rapidly acting CNS poisons ( cyanide, strychnine )
45. Caution; ipecac solution
Home remedy methods of inducing vomiting such
as manual stimulation of the posterior pharynx
Drinking salt water or mustard water, eating raw
eggs
These measures are often unsafe and ineffective,
The only recommended method of producing
emesis is administration of syrup of ipecac
46. Always ascertain that the gag reflex is intact before
giving ipecac
Frequently re assess the person; someone who was
awake when the ipecac was administered may be
obtunded when emesis occurs, and aspiration may
result
47. ACTIVATED CHARCOAL
Charcoal adsorbs ingested poisons within gut lumen
allowing charcoal- toxin complex to be evacuated
with stool or removed by induced emesis / lavage
Dose – 1 g/kg body wt.
Given orally as a suspension ( in water ) or through
NG tube
Contraindications:
Mineral acids, alkalis, cyanide, fluoride ,iron
48. WHOLE BOWEL IRRIGATION
Administration of bowel cleansing solution containing
electrolytes & polyethylene glycol
Orally or through gastric tube
Rate – 2 L/hr. ( 0.5 L /hr. in children)
End point- rectal fluid is clear
Position – sitting
Contraindications :
Bowel obstruction
Unprotected airway
49. FORCED ALKALINE DIURESIS
Infusion of large amount of NS+NAHCO3
Used to eliminate acidic drug that mainly
excreted by the kidney
e.g. salicylates
Serious fluid and electrolytes disturbance may
occur
Need expert monitoring
50. EXTRACORPOREAL REMOVAL
Dialysis
– Acetone, Barbiturates, Bromide, Ethanol, Ethylene
glycol, Salicylates, Lithium
– Less effective when toxin has large volume of
distribution (>1 L/kg), has large molecular weight, or
highly protein bound
Peritoneal Dialysis
– Alcohols , long acting salicylates, Lithium
51. CHELATION
Heavy metal poisoning
Complex of agent & metal is water
soluble & excreted by kidneys
Eg. British antileucyte, EDTA,
• BAL – Arsenic, Lead, Copper, Mercury
• EDTA- Cobalt, Iron, Cadmium
52. GUT LAVAGE
used in managing selected poisonings, e.g.
herbicides
The procedure involves instillation of warmed
electrolyte solution into the stomach via a tube
regulated by a peristaltic pump delivering
approximately 75 ml/min
the goal of gut lavage is to rid the bowel of toxic
substances
53. CATHARTICS
Administered to hasten excretion of a toxic
substance and thus minimize further absorption
from the bowel
Commonly used cathartics are magnesium sulfate,
sodium sulfate, and magnesium citrate
Oil-based cathartics (castor oil) are contraindicated
because of the danger of aspiration pneumonitis
54. NURSING ADVICES
Keep syrup of ipecac readily available in all house
holds where children live or visit. It is important to
know and understand direction for the use of syrup
ipecac.
Give phone number of the nearest poison control
center or other appropriate care facility.
Encourage adults to move dangerous substances to
high shelves and childproof locks on doors of these
cabinets.
55. Advise adults that many house, garden, and wild
plants are poisonous and should be removed from
children’s environment. Familiarize self with
poisonous plants in your area.
Use childproof safety caps on containers of
medications and other potentially dangerous
substances.
56. Keep products in their original containers.
Use poison symbols to identify dangerous
substances.
Dispose of outdated medications and
household products.
57. Nursing diagnosis
• Risk for injury/ suffocation related to contact with
chemical or poisonous agents.
• Risk of choking related to increased danger of
accidental suffocation
• Post-traumatic reaction related to painful and
prolonged reaction to attempted self harm
58. Recent Advances in the Management
of Poisoning Cases
• Deaths due to poisoning are on the rise over the years,
despite advanced knowledge regarding their
pharmacokinetics and pathology, and newer and better
techniques being developed for the management of
poisoning cases. Though the general principles of
treatment of a poisoned patient remain the same,
traditional methods like gastric lavage, for example,
have taken a back seat. There has been gaining
popularity of newer methods like use of activated
charcoal and a variety of newer antidotes.
59. Some Newer Antidotes
• Hydroxycobalamin: cyanide poisoning
• Digoxin specific antibodies (Fab
antibodies):
indicated in life threatening
arrhythmia/hyperkalemia caused by
intoxication with cardiac glycosides.
60. • Octreotide: A synthetic polypeptide that
antagonizes pancreatic insulin release, it is
indicated in overdose of insulin or oral
hypoglycemic agents, mainly sulphonylurea.
• Succimer (2,3dimercaptosuccinicacid): it is a
chelating agent used for the treatment of lead,
mercury and arsenic poisoning. It is the water
soluble analogue of dimercaprol and can be taken
orally.