Paeds Cases · acute-care-resuscitation-and-toxicology
Read the acidosis, choose the antidote — iron, salicylate and toxic alcohol poisoning
A bedside structured clinical encounter testing recognition of a child with a mixed overdose producing a high-anion-gap metabolic acidosis, the reading of the poison-specific signature, the choice of decontamination and weight-based antidote (desferrioxamine for iron, urinary alkalinisation for salicylate, fomepizole for the toxic alcohols), the avoidance of the three lethal traps, communication, early escalation to dialysis and retrieval, and safeguarding in parallel.
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This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses first-impression recognition of a high-anion-gap metabolic acidosis, the reading of the poison-specific signature, the choice of decontamination and weight-based antidote, communication, reassessment, early escalation to dialysis and retrieval, and safeguarding in parallel. [1] [6] [9]
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- [1]Chang TP, Rangan C Iron poisoning: a literature-based review of epidemiology, diagnosis, and management Pediatric Emergency Care, 2011.PMID 21975503
- [2]Manoguerra AS, Erdman AR, Booze LL, et al. Iron ingestion: an evidence-based consensus guideline for out-of-hospital management Clinical Toxicology, 2005.PMID 16255338
- [6]Snodgrass WR Salicylate toxicity Pediatric Clinics of North America, 1986.PMID 3960612
- [7]Juurlink DN, Gosselin S, Kielstein JT, et al. Extracorporeal treatment for salicylate poisoning: systematic review and recommendations from the EXTRIP workgroup Annals of Emergency Medicine, 2015.PMID 25986310
- [9]Brent J Fomepizole for ethylene glycol and methanol poisoning New England Journal of Medicine, 2009.PMID 19458366