Description
Organophosphorus, acid, and alcohol poisonings present distinct challenges in medical management. Organophosphorus poisoning, often due to insecticides, requires prompt administration of atropine and pralidoxime to counteract cholinergic toxicity. Acid poisoning necessitates timely neutralization and meticulous airway management to prevent complications like aspiration pneumonia. Alcohol poisoning, marked by central nervous system depression, demands supportive care, including airway protection and fluid resuscitation, while addressing potential co-ingestions. Individualized treatment plans, close monitoring, and collaboration across medical specialties are crucial for optimizing outcomes in cases of these diverse poisonings.
Résumé
- Poisoning is defined as anything in excess that harms the body, including food, water, alcohol, or medications. The initial approach to managing poisoning involves identifying the substance, its quantity, and how it was ingested. The primary steps are airway, breathing, circulation, disability, and exposure (ABCDE).
- Stabilization begins with ensuring a clear airway, administering oxygen, and managing circulation with fluids or inotropes. Collecting evidence about the substance, its form, and the time of consumption is crucial. A focused examination can help identify toxidromes, and lab tests like cholinesterase levels, urine tests, and ECGs may be necessary.
- Decontamination involves removing contaminated clothing and washing the skin thoroughly with soap and water. Gastric lavage is considered for life-threatening poisonings and pesticide ingestion within six hours. Activated charcoal, an absorbent, is administered to prevent further absorption of the poison.
- Contraindications for gastric lavage include acid or alcohol ingestion due to the risk of esophageal damage. In comatose patients, securing the airway through intubation is crucial before gastric lavage. Activated charcoal is generally contraindicated in corrosive poisonings and kerosene ingestion.
- Elimination methods include forced alkaline diuresis, which increases urine excretion of weak acids. Hemodialysis is used for water-soluble poisons with low molecular weight, while charcoal hemoperfusion is effective for substances like caroxine and theophylline, although it carries risks like thrombocytopenia and hypotension.
- Organophosphorus poisoning management involves gastric aspiration, activated charcoal, and atropine administration. Atropine targets are systolic blood pressure over 90 mmHg and a heart rate of 90 bpm. Pralidoxime (PAM) is used if atropine is ineffective.
- Corrosive poisoning management prioritizes irrigation of eyes and skin with copious amounts of water. Gastric lavage and charcoal are contraindicated. Pantoprazole infusion is administered continuously, and endoscopy may be required for further evaluation.
- Organophosphorus (OP) poisoning induces cholinergic crisis characterized by muscarinic and nicotinic receptor stimulation, causing symptoms like diarrhea, miosis, bradycardia, muscle weakness, and respiratory failure. Treatment includes atropine to counteract muscarinic effects and pralidoxime to reactivate cholinesterase.
Exemple de certificat
À propos des intervenants
Dr Vijaypal Reddy Maddireddy
Anciens élèves - Collège médical gouvernemental d'Anantapur
Divulgation financière
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