Resumen de Management of poisoning
Allister Vale, Sally Bradberry
Management of poisoning involves the assessment and treatment of airway compromise, ventilation impairment and haemodynamic instability. Thereafter, temperature disturbances should be treated, convulsions controlled, fluid, acid–base and electrolyte abnormalities corrected, and complications such as methaemoglobinaemia, rhabdomyolysis and serotonin syndrome diagnosed and managed optimally. There is no evidence that methods to reduce absorption improve clinical outcome. Multiple-dose activated charcoal to enhance drug elimination should be considered if a patient has ingested a life-threatening amount of carbamazepine, dapsone, phenobarbital, quinine or theophylline. Urine alkalinization should be employed in patients with moderately severe salicylate poisoning. Haemodialysis/haemodialfiltration should be considered in cases of severe intoxication with ethanol, ethylene glycol, isopropanol, lithium, methanol or salicylate. Newer treatments including intravenous lipid, and insulin and glucose, may have a role in acute poisoning. A psychiatric and/or social assessment should be undertaken.
