Drug Overdose Poisoning: Difference between revisions
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** If Torsades de Pointes administer [[Electrolytes|MAGNESIUM SULFATE]] 2 gm, IV bolus (if no renal disease). | ** If Torsades de Pointes administer [[Electrolytes|MAGNESIUM SULFATE]] 2 gm, IV bolus (if no renal disease). | ||
* For Antipsychotics and Acute Dystonic Reaction, | * For Antipsychotics and Acute Dystonic Reaction, | ||
** Administer [[ | ** Administer [[Diphenhydramine|DIPHENHYDRAMINE]] (BENADRYL) 25 mg IV bolus. | ||
** If there is an inadequate response, repeat in 10 minutes. | ** If there is an inadequate response, repeat in 10 minutes. | ||
* For Calcium Channel blockers, | * For Calcium Channel blockers, |
Revision as of 12:33, 24 April 2020
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 PROMETHAZINE OR ZOFRAN 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
- Administer ATROPINE 0.5 mg IV, may repeat x 2 if no response.
- If no response, CALCIUM CHLORIDE 1 gm IV, If no response, repeat x 1
- If no response, GLUCAGON 3 mg IV or IN, If no response, repeat x 1
- If no response, begin TRANSCUTANEOUS PACING (TCP). (9.30)
- 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.
- Hemodynamically significant bradycardia or HB , including 3° HB and high grade 2° HB
- For patients with cardiovascular toxicity, as manifested by one or more of the following:
- 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
- Administer ATROPINE 0.5 mg IV, may repeat x 2 if no response.
- If no response, GLUCAGON 2 mg IV or IN, If no response, repeat x 1
- If no response begin Transcutaneous Pacing (TCP) (9.30)
- If hypotension
- 200 – 300 cc NS bolus, repeat as needed.
- Administer GLUCAGON 2 mg IV or IN, may repeat x 1.
- Hemodynamically significant bradycardia or HB, including 3° HB and high grade 2° HB
- For patients with cardiovascular toxicity, as manifested by one or more of the following: