Poisoning is one of the most common causes of ICU admission. The vast majority of these patients do fine, with minimal supportive therapy and observation. However, occasional patients will progress to organ failures and potentially death. This chapter explores how to approach these patients, with an eye towards identification and prompt treatment of the critically ill.
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The IBCC chapter is located 👉 here.
- The podcast & comments are below.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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What are your thoughts on gastric lavage? As far as I know the literature out there isn’t of very good quality, but the consensus seems to be that it is not recommended. Also the potential for doing harm is substantial. It is still widely used, however, in emergency departments in Norway.
The approach to hyperthermia mentions intubation after paralysis with a depolarising agent. Shouldn’t that be a nondepolarising agent due to risk of hyperkalemia with rhabdomyolysis?
What does the robot head emoji indicate in the clonus column of the chart?
Hey Josh, re: treating acute agitation with dexmedetomidine, i always start with a load and can get them settled down fairly quick. Just starting infusion takes way too long. Can give 1mcg/kg over 3-5 minutes. I’ll repeat 2-3x if needed. While you’ll get some bradycardia, generally hemodynamics are maintained.