ICU · Toxicology

Toxicology — The General Approach to the Poisoned Patient

Also known as Poisoning · Overdose · Toxidromes · Activated charcoal · Decontamination · Enhanced elimination · Antidotes

The structured approach to the poisoned patient in the ICU — the resuscitation and the ABCDE adapted to the toxin; the clinical assessment and the toxidromes (the sympathomimetic, the anticholinergic, the cholinergic, the opioid, the sedative-hypnotic, the serotonin, the neuroleptic malignant); the investigation (the drug levels, the ECG, the anion and the osmolar gaps); the decontamination (the activated charcoal, the whole-bowel irrigation, the haemoperfusion); the enhanced elimination (the urinary alkalinisation, the haemodialysis); the antidotes (the naloxone, the N-acetylcysteine, the flumazenil, the digoxin Fab, the atropine and the pralidoxime, the lipid emulsion, the fomepizole); and the supportive care.