Union Hospital Emergency Department
 Basic
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Information
Name and amount of substance
Time of exposure
First aid measures initiated prior to arrival in ED
Current symptoms
Situation prior to the event: traumatic, medical
or psychological factors
 Inhalation
 Ingestion
 Dermal
 Ocular
 Parenteral
 Accidental
 Intentional:
suicide attempt or abuse
 Chemical
exposure
 Pesticide application
 Stained Glass Worker (lead)
 Pain stripper (Methylene Chloride and Carbon
Monoxide
 Maintain
ABC’s
 Provide Gastrointestinal Decontamination to
prevent absorption
Use 36-40 FR orogastric hose 500-3000 ml fluid
 Consider intubation if the patient requires
airway protection secondary to respiratory
depression
 Patient should be on left side position to
minimize risk of aspiration
 Do not use orogastric tube if patient has intact
gag reflex
 Continue to lavage until the contents return to
clear
 Contraindications: ingestion of caustics, coingestion of sharp objects, non-toxic ingestions
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 Dose
depends on patient’s weight and is 50100 G per kg
 Administer orally or via lavage tube
 Multiple dose charcoal may be helpful in
specific overdoses
 Contraindications: corrosive ingestion,
decreased or absent bowel sounds, toxins not
bound by charcoal (metal, iron)
 Ensure
provider protective gear is used
 Remove all contaminated clothing
 Immediately flush area with saline/water
and soap, particularly for caustic exposures,
includes the hair and under the nails
 Cathartic
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administration
Mix and administer with charcoal orally or via
lavage tube (magnesium citrate)
Contraindication: caution in absent bowel
sounds, especially in peds or elderly
Avoid patients with pre existing renal impairment
or heart failure
 The
use of sodium bicarbonate is
contraindicated in
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Pulmonary edema
Renal failure
 Oxygen
for carbon monoxide (CO)
 Naloxone for opiates
 Atropine/Pralidoxime for organophosphates
 Cyanide antidote kit for cyanide
 Flumazenil for benzodiazepines
 Chelation therapy for heavy metal poisoning
 Poison
Control
 Gastric Lavage
 Urine Drug Screen/Rapid Drug Screen
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Opiates, TCA, Benzodiazepines, Marijuana,
Cocaine, Amphetamines, Methamphetamines,
Barbiturates