EM Cases · Tricyclic antidepressant poisoning
TCA resus — QRS, bicarb, avoid the wrong drugs
OSCE resus station on wide-QRS tricyclic toxicity, alkalinisation, seizures and prohibited therapies.
On this page
Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
Wide-QRS amitriptyline overdose with hypotension and seizure risk.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
Format. Resus station 11 minutes.
References7ShowHide
- [1]Hoegberg LCG, Gosselin S, Buckley NA, et al. Recommendations from the Clinical Toxicology Recommendations Collaborative on the administration of activated charcoal in acute oral overdose. Clin Toxicol (Phila), 2026.PMID 41906697
- [2]Pai K, Buckley NA, Isoardi KZ, et al. Optimising alkalinisation and its effect on QRS narrowing in tricyclic antidepressant poisoning. Br J Clin Pharmacol, 2022.PMID 34312917
- [3]Hwang Y, Sohn JT. Effect of lipid emulsion on neuropsychiatric drug-induced toxicity: A narrative review. Medicine (Baltimore), 2024.PMID 38489675
- [4]Bradberry SM, Thanacoody HK, Watt BE, et al. Management of the cardiovascular complications of tricyclic antidepressant poisoning : role of sodium bicarbonate. Toxicological reviews, 2005.PMID 16390221
- [5]Woolf AD, Erdman AR, Nelson LS, et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management. Clinical toxicology (Philadelphia, Pa.), 2007.PMID 17453872
- [6]Gosselin S, Hoegberg LC, Hoffman RS, et al. Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning(). Clinical toxicology (Philadelphia, Pa.), 2016.PMID 27608281
- [7]Liebelt EL, Francis PD, Woolf AD ECG lead aVR versus QRS interval in predicting seizures and arrhythmias in acute tricyclic antidepressant toxicity. Annals of emergency medicine, 1995.PMID 7618783