Managing acute poisonings and drug overdoses in the ICU: Strategies for initial stabilization, toxin removal, supportive care

Janice L. Zimmerman

Research output: Contribution to journalArticle

Abstract

When confronted with a poisoned patient, first assess the airway, breathing, and circulation. Intubate the patient and institute mechanical ventilation if respiratory depression, obtundation, or copious respiratory secretions are present. Use isotonic fluids initially to correct any hypotension. Once the patient's condition is stable, a medical history, physical examination, ECG, and selected tests (such as arterial blood gas studies, toxicology tests on blood and urine, and measures of serum osmolality and electrolyte levels) may help identify the toxin. Administer the antidote, if one is available, or consider gastric lavage, activated charcoal, or whole bowel irrigation to prevent toxin absorption. Multiple doses of charcoal, hemoperfusion, urine alkalinization, or hemodialysis may enhance toxin elimination in selected patients.

Original languageEnglish (US)
Pages (from-to)368-375
Number of pages8
JournalJournal of Critical Illness
Volume12
Issue number6
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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