الفهرس 
Early Measures that are Done to Poisoned PatientsOnly 14 pages are availabe for public view
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Abstract
The history of poisoning is as old as the human history itself. Since the earliest times, human had been updating and refining their knowledge of toxins.
In excessive amounts, substances that are usually innocuous, such as oxygen and water, can cause poisoning. Conversely, in small doses, substances commonly regarded as poisons, such as arsenic and cyanide, can be consumed without ill effect.
Exposures to drugs and chemicals are among the most common reasons for emergency department visits and ICU admission in developed countries.
Toxic overdose can present with various clinical symptoms, including abdominal pain, vomiting, tremor, alterd mental status, seizures, cardiac dysrhythmias and respiratory depression. These may be the only clues to when the cause of toxicity is unknown at the time of initial assessment and management.
The prognosis and clinical course of recovery of a patient poisoned by a specific agent depends largely on the quality of care delivered within the first few hours in the emergency setting. Fortunately, in most instances, the drug or toxin can be quickly identified by a careful history, a direct physical examination, and commonly available laboratory tests. Attempts to identify the poison should never delay life-saving supportive care.
An integral part of the practice of critical care is treating patient who either intentionally or inadvertently ingest or is exposed to a potentially toxic substance so An intensive care unit is usually recommended to be the most appropriate location for management of poisoned patient requiring hospital admission because of the availability of repaid diagnostic procedures, intense observation monitoring and complex treatment modalities.
Routine poison management involves the following: stabilization, toxidrome recognition, Decontamination, anti dot administration, enhanced elimination of toxin. Stabilization involve airway, ventilation, and circulation support. In patient with altered mental status, oxygen, naloxone, glucose, and thiamine should be administrated.
Symptom complex that related to specific classifications of toxins are referred to as toxidrome.
Decontamination can be done by the following: Emesis by means of syrup ipecac which may be rarely used for in-hospital gastric decontamination.
Whole bowel irrigation also useful in decontamination in case of iron, lead, and lithium poisoning.
Activated charcoal is a useful adsorbent for gastric decontamination.
Enhancement of elimination may involve multiple dose of activated charcoal, haemodialysis and haemoperfusion.
Morbidity and morality due to acute poisoning is a worldwide phenomenon and has enormous medical, legal and social significance.
Emergency physicians should take a more active role in the emergency management of poisoning, not only in the A&E department, but also in the prehospital setting, where early decontamination and antidote treatment can be initiated if necessary. With the early use of appropriate gut decontamination methods, proper use of antidotes, and better supportive care, the risk of morality from poisoning will greatly decrease and most patients will return to society with minimal disability.
Most critically ill poisoned patients have acutely reversible conditions that will clearly benefit from intensive care intervention. Toxicological emergencies have confusing presentations, do not have a well recognized clinical course or predictable complications, neverless may be fatal.
Finally, the prognosis and clinical course of recovery of a patient poisoned by a specific agent depends largely on the quality of care delivered to the patients within the first few hours in the emergency setting and intensive care unit later.