Drug Overdose Poisoning

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Section 5 -MEDICAL

5.05 DRUG OVERDOSE / POISONING

INITIAL MEDICAL CARE (2.01) - Provide OXYGEN or assist ventilations as appropriate for patient condition.

  • DRAW BLOOD TUBES (9.03), if available.
  • Obtain and record blood sugar level and refer to HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS (5.10), as indicated.
  • If altered sensorium, refer to ALTERED MENTAL STATUS PRACTICE PARAMETER (5.03).
  • IF CORROSIVE INGESTION, administer an Antiemetic medication as appropriate.
  • For tricyclic and tetracyclic antidepressant overdose:
    • If wide complexes (QRS >0.10 sec), hypotension and any other arrhythmias, Administer SODIUM BICARBONATE, 1 meq/kg IVP. Repeat in 5 or 10 minutes.
    • If Torsades de Pointes administer MAGNESIUM SULFATE 2 gm, IV bolus (if no renal disease).
  • For Antipsychotics and Acute Dystonic Reaction,
    • Administer DIPHENHYDRAMINE (BENADRYL) 25 mg IV bolus.
    • If there is an inadequate response, repeat in 10 minutes.
  • For Calcium Channel blockers,
    • For patients with cardiovascular toxicity, as manifested by one or more of the following:
      • Hemodynamically significant bradycardia or HB , including 3° HB and high grade 2° HB
      • If hypotension give 200 – 300 cc NS bolus, repeat as needed.
        • Administer CALCIUM CHLORIDE 1 gm IV, may repeat x 1. Avoid if patient is on digoxin/lanoxin.
        • Administer GLUCAGON 2 mg IV or IN, may repeat x 1.
  • For Beta blockers:
    • For patients with cardiovascular toxicity, as manifested by one or more of the following:
      • Hemodynamically significant bradycardia or HB, including 3° HB and high grade 2° HB
      • If hypotension
        • 200 – 300 cc NS bolus, repeat as needed.
        • Administer GLUCAGON 2 mg IV or IN, may repeat x 1.

Physician's Order: POISON CONTROL INFORMATION and subsequent treatment.