The acute poisoning (intoxication)

For young subjects poisoning [url=http://www.medecinesami.com]intoxication[/url] is a major cause of hospitalization. The average age of suicide grows gradually and in parallel, poisoning, accidental or intentional, are constantly increasing in the elderly. Now, the classic opposition between accidental poisoning [url=http://www.medecinesami.com]intoxication[/url] and suicide is replaced by more complex notions but also more realistic, will not overdose death, suicide, side effects of drugs and recreational drugs, drug interaction, accidental poisoning.
Data Service emergency medical show, in a surprising way, and the number of serious poisoning do not decrease despite all the advances in pharmacology and the pharmaceutical industry for the placing on the market products more active and less toxic.
Poison Control Center of Paris and for the first time in toxicology reveals the most common of the 100 drugs in question. These data provide evidence that if the poisoning is due to a myriad of products and, in fact, many poisonings are in the field of rare diseases. The medical approach to the patient should remain clinically intoxicated with symptomatic treatment.
The terms and indications of gastrointestinal decontamination are now well defined and progress of the antidotes are still evolving and some antidotes are considered first-line drugs.
Due to the resurgence of active ingredients to cause poisoning and complex interactions, the role of information centers, poison control should be emphasized. With new antidotes and techniques of emergency as circulatory support, intensive care units specializing in the management of poisoning provide an additional opportunity favorable evolution.
The suspicion arises simply because the reasoning in emergency, the certainty of intoxication is not required. Based on some simple criteria reasoning toxicological emergency occurs, such as the time since ingestion, the type of product and dose.
He must have seen the patient before considering the toxicological reasoning. In an emergency toxicology normal clinical examination indicates that the patient is consistent in his statements and it moves all four limbs so that he is conscious. Cyanosis is absent and pulmonary auscultation were normal and the frequency and the voltage pulse, the temperature is normal, there is no point calling abdominal or marbling. The electrocardiogram (ECG) is normal if done immediately.
Adult patients conscious nature of the active ingredients ingested is often known. The reasoning must always be based on active ingredients ingested through dictionaries drug identification is easy. If a drug off the market or, conversely, new, and its composition is not identified, call the poison center to solve this problem. The problems of the addition or diversification of the toxic effects posed by the combination of active ingredients. The composition of cosmetic products, agricultural, industrial and household changes over time. Information on classes or chemicals in the / preparations in question are obtained by calling the poison control center.
In terms of maximum dose possible that the patient could ingest, the dose is defined for each active ingredient. The problem is to define the maximum risk that the patient short. For children, it is absolutely imperative to relate the dose to the patient's weight. This is also true in adults where the weight can range from 40 kg to 100 kg.
There is an important parameter to consider is the delay between ingestion and clinical examination of the patient. There is a risk of aggravation later if time is short. For some frequently encountered poisoning, you should know that there is a free interval between taking the poison and the onset of symptoms, it can reach several hours. A normal clinical examination does not predict outcome.
Defects surveillance and processing delays are caused by misunderstanding of the concept of free interval in emergency toxicology is that may be causing irreversible damage and even death. By cons, how to behave requires hospitalization, sometimes in an intensive care unit.
To suspect products, call the poison center to define the intensity of potential problems that pose the indication for hospitalization, admission to intensive care environment eg chloroquine poisoning, or surgery by ingestion of strong bases or acids. It can also identify the points of impact of toxic and clinical parameters or biological monitoring. For some toxic, such as anti-vitamin K and paracetamol, the picture of intoxication is organic because the initial clinical examination is normal.
A single dose of activated charcoal is administered in case of ingestion of a toxic product, with a toxic dose ingested within less than 1 hour.
Before the poisoning: digitalis, carbamazepine, salicylates, phenobarbital, quinine or quinidine, theophylline, and all sustained-release forms, the administration of repeated doses of activated charcoal is discussed.
Now, the indications for gastric lavage are very clearly defined and limited, especially when it comes to poisoning by non-adsorbed by activated carbon, were: alcohols (ethanol, methanol, ethylene glycol) and the common form lithium in the first hour after ingestion, regardless of the deadline for its sustained release forms, heavy metals and iron salts.
The cons-indications to digestive decontamination, either by activated charcoal or gastric lavage, in a non-intubated is the existence of a disorder of consciousness, and in a non-intubated is ingested foaming, caustics or hydrocarbons.