Fisdap Unit Exam: Medical Emergencies
SLUDGEM - salivation, sweating
lacrimation
urination
defecation, drooling, diarrhea
gastric upset and cramps
emesis
muscle twitching/miosis (pinpoint pupils)
Opiates and opioids - morphine, codeine, and heroin, methadone, oxycodone
hypoventilation, respiratory arrest, pinpoint pupils, sedation, coma, hypotension
sympathomimetics - epinephrine, albuterol, cocaine, methamphetamine
hypertension, tachycardia, dilated pupils, agitation, seizures, hyperthermia
sedative hypnotics - diazepam, secobarbital, flunitrazepam, midazolam
slurred speech, sedation, coma, hypoventilation, hypotension
,anticholinergics - atropine, diphenhydramine, chloropheniramine, doxylamine, datura
stramonium (jimsonweed)
tachycardia, hyperthermia, hypertension, dilated pupils, dry skin and mucous membranes, sedation,
agitation, seizures, coma, delirium, decreased bowel sounds
cholinergics - organophosphates, pilocarpine, nerve gas
airway compromise
SLUDGEM
miosis - excessively constricted pupil, often bilateral after exposure to nerve agents.
Inhaled poisons - can cause hypoxia (CO), airway obstruction and pulmonary edema (chlorine
gas), burning eyes, sore throat, cough, chest pain, hoarseness, wheezing, respiratory distress, dizziness,
confusion, headache, stridor, seizures, altered mental status,
treat by removing the patient from exposure and applying oxygen
some inhaled agents cause progressive lung damage and damage may not be evident for several hours.
It may take 2-3 days or more of ICU to restore normal lung function.
prompt transport, O2 via non rebreathing and possible positive pressure ventilation if necessary. pulse
oximetry readings may be inaccurate with inhaled poisons. suction if necessary.
Absorbed and surface contact poisons - corrosive substances will damage the skin, mucous
membranes, eyes, cause chemical burns, rashes, or lesions,.
,acids/alkalis, petroleum (hydrocarbon) products are destructive to the skin and external tissue.
distinguish between contact burns and contact absorption
history of exposure, liquid or powder on patient skin, burns, itching, irritation, redness of skin, odors of
substance.
avoid contaminating yourself and others
remove substance from the patient as fast as possible
remove all contaminated cothes
brush off dry powdery substances, flood/flush with water 15-20 minutes. use soap.
irrigate eyes quickly: make sure the fluid runs from the bridge of the nose outward, initiate on scene and
continue during transport; keep the patient eyes open.
ingested poisons - 80% of all poisoning is by mouth. usually accidental in children and purposeful
in adults.
GI problems, cardiac problems, neurological problems.
injected poisons - intravenous drug abuse and envenomation by insects, arachnids, and reptiles.
usually absorbed quickly into the body, can cause intense local tissue destruction. Often life threatening.
weakness, dizziness, fever, chills, unresponsiveness, excitability
monitor airway, provide high flow O2, be alert for nausea and vomiting.
, remove rings, watches, bracelets from areas around the injection site if swelling occurs
if poison route or type is unknown, reassess as if unstable
Toxin emergency medical care - perform external decontamination
remove tablets/pill fragments from the patient's mouth, wash/brush dry poison from the skin.
assess and maintain ABCS
activated charcoal - binds specific toxins and prevents absorption, toxins leave the body in stool.
not indicated/ineffective with alkali, cyanide, ethanol, iron, lithium, methanol, mineral acids, or organic
solvent poisons.
if patient has decreased LOC or cannot protect their airway (no gag reflex), do not give activated
charcoal.
premixed suspension bottles usually contain up to 50g of activated charcoal.
usual dose for adult or child is 1g per kg of body weight.
Average in adults in 30-100g, average in children is 15-30g for children younger than age 13.
always obtain approval from medical control.
most effective if used within 1 hour of ingestion.
