Management principles for the overdosed patient

Abstract

Priorities in the treatment of the poisoned patient are maintenance of airway, breathing, and circulation. While the patient is being stabilized, a history of drug ingestion should be obtained. Because the history is so often unreliable, physical examination directed to a search for toxic syndromes assumes more importance. Discriminate use of the laboratory may be helpful in confirming a clinical diagnosis. Priorities after initial stablization and during physical examination and laboratory confirmation are preventing toxicity by removing the toxin from the gastrointestinal tract, decreasing its absorption, and increasing its elimination. For a limited number of substances, antidotes may be beneficial. Because of the wide variety of clinical situations and toxins involved, the resources and expertise available through your regional Poison Centre should be used.