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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, 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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