Poisoning

History – patient relative Agent Dose Time of ingestion Examination Vital signs Neurological – tone, clonus, reactive pupils Abdomen – bowel sounds Skin changes Urinary retention Clinical syndromes Anticholinergic syndrome Delirium with mumbling speech, tachycardia, dry, flushed skin, Cholinergic syndrome Muscurinic effect – diarrhoea, urination, miosis, bronchospasm, emesis Nicotinic effect – mydriasis, tachycardia, weankess, hypertension, […]

History – patient relative
Agent
Dose
Time of ingestion

Examination

Vital signs
Neurological – tone, clonus, reactive pupils
Abdomen – bowel sounds
Skin changes
Urinary retention
Clinical syndromes

Anticholinergic syndrome

Delirium with mumbling speech, tachycardia, dry, flushed skin,

Cholinergic syndrome

Muscurinic effect – diarrhoea, urination, miosis, bronchospasm, emesis
Nicotinic effect – mydriasis, tachycardia, weankess, hypertension, fasciculation, sweating
CNS effect – drowsy, delirium, confusion, coma, seizure

Sympathomimetics Syndrome

Causes amphetamine, ecstacy

Delusions, paranoia, tachycardia, tachypnoiec, pyrexia, piloerection

Cold and clammy with low saturation

Catecholamine induced cardiomyopathy

Chest X-ray pulmonary oedema

Opioid, sedatives or ethanol intoxication

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