RT Book, Section A1 Hoffman, Robert J. A2 Farcy, David A. A2 Chiu, William C. A2 Flaxman, Alex A2 Marshall, John P. SR Print(0) ID 55814823 T1 Chapter 41. The Critically Ill Poisoned Patient T2 Critical Care Emergency Medicine YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-162824-2 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=55814823 RD 2024/10/07 AB The 2001 publication by the American Heart Association, TOX-ACLS Toxicologic-Oriented Advanced Life Support,1 marked wide recognition that critical illness resulting from poisoning may require very different management from similar illness occurring in the nonpoisoned patient. That publication made specific suggestions for management of dysrhythmias and other toxicity caused by cocaine, calcium channel blockers and β-blockers, opioids, tricyclic antidepressants, and drug-induced cardiovascular shock. In 2010, the updated American Heart Association ACLS guidelines contained specific evaluation and recommendations regarding poisoning with these same aforementioned toxins, as well as cyanide, digoxin, and antidotal therapy with flumazenil and lipid emulsion.2 The relevance of those publications is recognition that proper management of many clinical problems caused by toxins differs or deviates from management of the same clinical problem occurring in the nonpoisoned patient.