Skip to Main Content

++

INTRODUCTION

++

The poisoned or envenomated patient represents a unique challenge to the EMS medicine practitioner. In many cases the offending medication, toxin, plant, or animal is unknown to the rescuer. Even when the offending agent is known, treatment can vary significantly based on severity of symptoms. Management of a patient with tricyclic antidepressant ingestion, for example, can range from benzodiazepines to bicarbonate to intravenous intralipid emulsion therapy. Proper education and training, coupled with robust, updated protocols, is needed to care for this group of patients effectively.

++

OBJECTIVES

++

  • Describe important toxidromes for the evaluation of prehospital patients.

  • Describe the initial prehospital evaluation and management of overdose on prescription medications.

  • List common toxic ingestions and their antidotes (Table 46-1), including whether or not charcoal is indicated.

  • Describe the initial prehospital evaluation and management of exposure to pesticides.

  • Describe the initial prehospital evaluation and management of exposure to dangerous inhalants.

  • Describe the initial prehospital evaluation and management of carbon monoxide poisoning.

  • Describe the initial prehospital evaluation and management of insect envenomations.

  • Describe the initial prehospital evaluation and management of reptile envenomations.

  • Describe the initial prehospital evaluation and management of marine envenomations.

++
Table Graphic Jump Location
TABLE 46-1

Common Toxic Ingestions and Their Antidotes

++

TOXIDROMES

++

Prehospital patients who are exposed to toxins or a drug overdose frequently display a set of signs and symptoms known as a toxidrome. Table 46-2 describes the physiologic effects of several toxidromes. These effects are important clues to the exposure and can often guide management.

++
Table Graphic Jump Location
TABLE 46-2

Toxidrome Drug Groups and Their Physiologic Characteristics

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.