Poisoning
Abstract
The problem of poisoning in the emergency department is considerable Acute poisonings may be either accidental or intentional Among children age 5 and under essentially all poisonings are accidental whereas suicide attempts are encountered mostly in adolescents After the institution of basic life support measures a good historical evaluation and a careful physical and laboratory examination are essential for the management of the poisoned child It must be remembered that toxicology screens are not always reliable The general principles for managing the poisoned child are as follows: I Termination or minimization of toxic exposure 1 Simple dilution 2 Gastric decontamination A Surgical B Non surgical a Emesis b Gastric lavage 3 Activated charcoal 4 Catharsis 5 Intestinal lavage II Systemic antidotes III Alternating the metabolism of the toxic substance IV Enhancing the elimination of the toxic substance 1 Gastrointestinal dialysis 2 Enhanced renal elimination 3 Extracorporal drug removal 4 Exchange transfusion 5 Plasmapheresis 6 Broncihal lavage V Symptomatic treatment A poisoned child s outcome may be strongly influenced by the emergency medical service response The role of the Poison Control Centers is also very important in the diagnosis and treatment of intoxications
Keywords
Zehirlenmeler
Abstract
SummaryThe problem of poisoning in the emergency department is considerable Acute poisonings may be either accidental or intentional Among children age 5 and under essentially all poisonings are accidental whereas suicide attempts are encountered mostly in adolescents After the institution of basic life support measures a good historical evaluation and a careful physical and laboratory examination are essential for the management of the poisoned child It must be remembered that toxicology screens are not always reliable The general principles for managing the poisoned child are as follows: I Termination or minimization of toxic exposure 1 Simple dilution 2 Gastric decontamination A Surgical B Non surgical a Emesis b Gastric lavage 3 Activated charcoal 4 Catharsis 5 Intestinal lavage II Systemic antidotes III Alternating the metabolism of the toxic substance IV Enhancing the elimination of the toxic substance 1 Gastrointestinal dialysis 2 Enhanced renal elimination 3 Extracorporal drug removal 4 Exchange transfusion 5 Plasmapheresis 6 Broncihal lavage V Symptomatic treatment A poisoned child s outcome may be strongly influenced by the emergency medical service response The role of the Poison Control Centers is also very important in the diagnosis and treatment of intoxications
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