Module 14- approach to suspected poisoning

ocular decontamination steps
Click the card to flip 👆
1 / 32
Terms in this set (32)
ocular decontamination steps
irrigate the eye for 15 minutes
Fluoroscein assessment
corticosteroids only if no ulceration
lubricants/topical antibiotics
define contraindication
a reason something is not advisable or should not be done
contraindications of emetics
neurological disfunction
corrosive ingestion
predisposed to aspiration (eg megaoesophagus and laryngeal paralysis)
time post ingestion is more than 4 hours
prior vomiting
Apomorphine (dogs)
an emetic
administered IV, subcut, or conjunctiva
central effect
can cause sedation so reverse with naloxone if required
Xylazine/Dexmedetomidine/Medetomidine (cats)
an emetic
moderately effective
cardiac and respiratory depression
atipamezole to reverse
hydrogen peroxide as an emetic
1-2ml/kg (max 50mls dogs)
mild gastric irritation
more side effects seen in cats and less effective
do not repeat more than once
gastric lavage
an less effect technique than emesis
consider in neurological patients
requires GA and a stomach tube
risk of aspiration
Gastric lavage contraindications
ingestion of corrosives
over four hours post ingestion
anesthetic risk too high
activated charcoal
absorbent- binds toxins to stop further absorbing
variable effects on different toxins
give in food via syringe/stomach tube
repeat 4 hours, 2 hours between charcoal and oral meds
IV fluids is especially useful for what poisoning?
Lillies and raisens- supports renal elimination
iv lipid emulsion is useful for?toxins with short half-life ie: ivermectin, permethrin, LAs, ibuprofen, cannabis should only use for severe toxicosis when other treatments are unsuccessfulparacetamol poisoning pathogenesisliver overwhelmed> accumulation of toxic metabolites and oxidative damage heinz body anemia chocolate blood dry eyeparacetamol poisoning clinical signs <24 hourscyanosis facial and paw oedema vomiting anemia tachycardia, tachypneoa, lethargyparacetamol poisoning clinical signs >24 hoursliver failure icterus seizures/coma renal failure haematuria/haemaglobinuriaparacetamol poisoning treatmentrecommended if over >10mg/kg cats and >100mg/kg dogs emetics is 1-2 hours post ingestion absorbents supportive care antidotesN-acetylcysteine - glutathione precursor S-adenosylmethionine (S-AME) Ascorbic acid (vit C) Cimetidine (dogs) - inhibits conversion to toxic metabolite are all antidotes to what?paracetamol poisoninmetaldehyde (snail pellets) poisoning clin. signs"Shake and bake"- hyper aesthesia, tremors, seizures, hyperthermiamethaldehyde poisoning treatmentemetics if asymptomatic and observe activated charcoal if seizures: diazepam, gastric lavage methocarbamol IVFT and nursing careAnticoagulent rodenticides pathogenesisblocks vitamin k activation 1-5 days before clin. signs appearanticoagulent rodenticides clinical signslethargy body cavity haemorrhage epistaxis gi bleed joint pain anaemiaanticoagulent rodenticides treatment- asymptomaticemesis, activated charcoal check coags 24, 48h, 72h if PT prolonged, treat with vitamin k1 (continue for up to 6 weeks)anticoagulent rodenticides treatment- symptomaticimmediate support- oxygen +/- transfusion vitamin k1anticoagulent rodenticides diagnosisprolonged prothrombin time (PT) occurs first platelets- normal or decreased PIVKA- proteins induced by vitamin k antagonism anemiaethylene glycol poisoning clinical signs<12 hours: neurological signs gi signs acidosis 12-24 hours cardiac/respiratory system affected 24-72 hours renal- azotaemia, anuria, hyperkalaemiaethylene glycol diagnosishistory/clin signs metabolic acidosis hypercalcaemia azotaemia calcium oxalate crystals in urine glycosuria/proteinuria "medullary rim sign"Ethylene glycol treatmentemetics not likely to be useful diazepam for seizures correct acidosis IVFT Antidotes if <12 hours20% Ethanol IV or stomach tube 4-Methylpyrazole (fomepizole) Less side effects Limited availibility are antidotes for what?ethylene glycol poisoningTheobromide (chocolate) poisoningseizures arrhytmias gi symptoms panting shakingtheobromide treatmentemesis activated charcoal IVFT continual ECG and seizure monitoring supraventricular tachycardia- beta blocker ventricular tachycardia- lidocaine symptomatic treatment of seizures and gi signsxylitol poisoning pathogenesisstimulates insulin release- hypoglycaemia, hypokalaemia, and hypophosphataemia can cause liver failurexylitol poisoning treatmentemesis before 30 minutes supportive care liver protectants S-AMERaison/Grape poisoning treatmentemesis & charcoal supportive care IVFT 48-72 hours