clinical presentation
- SLUDGE:
- salivation
- lacrimation
- urination
- diarrhoea
- g??
- emesis (vomiting)
- bronchorrhea, bronchospasm
- miosis = small pupils!
- fasciculation
toxins
- organophosphate
- inhibition of acetylcholinesterase: rivastigmine, physostigmine
- edrophonium
- sarin nerve gas...
management
- Resuscitation
- A - control the airway
- B - maintain normoxia
- C - establish access, resuscitate with fluids/vasopressors
- D - Seizure control, correction of hypoglycaemia
- E - Correction of hypothermia and electrolyte abnormalities
- Rescue antidotes:
- atropine - 0.02mg/kg bolus, then double the dose with every subsequent dose
- for organophosphates: pralidoxime
- Risk assessment
- Supportive care and monitoring
- Investigations
- screening (ECG, paracetamol)
- Specific (eg. drug levels, CK)
- Decontamination: remove remove remove
sources/links