CME : Your SA Journal of CPD - Volume 21, Issue 8, 2003
Volume 21, Issue 8, 2003
Source: CME : Your SA Journal of CPD 21, pp 438 –444 (2003)More Less
When dealing with a suspected toxic exposure or poisoning, one of the major priorities should be to attempt to identify agents with a high inherent toxicity as soon as possible. <br>Early identification will allow timeous antidotal or special decontamination procedures so that severe tissue damage or complications can be avoided. <br>Patients who have ingested poisons with a high inherent tissue-damaging potential often present with severe and persistent gastrointestinal symptoms and signs. <br>The suspected toxic substance or the material ingested is crucial for rapid and positive identification of a poison.
Antidotes, supportive agents and other essentials in the management of acute toxic exposures and poisonings : main articleSource: CME : Your SA Journal of CPD 21, pp 452 –464 (2003)More Less
Although it is not possible to be fully prepared for all poisoningrelated eventualities, it is possible to take proactive steps to deal with the commonly encountered poisonings and overdoses responsible for more than 90% of incidents. <br>In addition to the medicines, equipment and accessories necessary to support vital functions, arrangements should be made to have readily available specific antidotes and agents required to counter the effects and to prevent systemic absorption of toxins.
Source: CME : Your SA Journal of CPD 21, pp 466 –470 (2003)More Less
Acid-base and potassium abnormalities are common in poisoning. <br>Poisoning should be excluded in cases of unexplained metabolic acidosis. <br>Major adverse consequences of severe acidaemia include decreased cardiac output, decreased arterial blood pressure, reduction in the threshold for cardiac dysrhythmias, and a decrease in hepatic and renal blood flow. <br>The anion gap is increased in cases of ketoacidosis, lactic acidosis, and other forms of acidosis in which organic anions are increased, as in methanol and ethylene glycol poisoning.
Source: CME : Your SA Journal of CPD 21, pp 471 –474 (2003)More Less
Paralytic shellfish poisoning (PSP) is caused by ingestion of mussels that have concentrated the poison, saxitoxin, produced by the 'red tide' dinoflagellate <I>Alexandrium catenella</I>. In severe cases, progressive muscular paralysis, with pronounced respiratory difficulty, develops. Since respiratory depression can develop surreptitiously, extreme vigilance should be exercised to monitor and support patients, especially during the first 12 hours. <br>Scombroid poisoning is caused by the consumption of 'spoiled' fish which has undergone autolytic changes as a result of improper storage conditions. It resembles a histamine- like or acute allergic reaction. The treatment of the condition is symptomatic and supportive. The majority of patients respond well to antihistamines. <br>Venomous marine animals may inflict injury by means of bites, stings or simply by direct contact. Secondary infection is a common complication. Coelenterata are responsible for most marine envenomations. These include bluebottles (the Portuguese man-of-war or <I>Physalia</I>).