View source for Drug Overdose Poisoning

== Section 5 -MEDICAL ==
=== 5.05 DRUG OVERDOSE / POISONING  ===

[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - Provide OXYGEN or assist ventilations as appropriate for patient condition.
* DRAW BLOOD TUBES (9.03), if available.
* Obtain and record blood sugar level and refer to [[Hypo or Hyperglycemia|HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS]] (5.10), as indicated.
* If altered sensorium, refer to [[Altered Mental Status (AMS)|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).
* IF CORROSIVE INGESTION, administer an [[Antiemetic]] medication as appropriate.
* For tricyclic and tetracyclic antidepressant overdose:
** If wide complexes (QRS >0.10 sec), hypotension and any other arrhythmias, Administer [[Electrolytes|SODIUM BICARBONATE]], 1 meq/kg IVP. Repeat in 5 or 10 minutes.
** If Torsades de Pointes administer [[Electrolytes|MAGNESIUM SULFATE]] 2 gm, IV bolus (if no renal disease).
* For Antipsychotics and Acute Dystonic Reaction,
** Administer [[Antihistamines|DIPHENHYDRAMINE]] (BENADRYL) 25 mg IV bolus. 
** If there is an inadequate response, repeat in 10 minutes.
* For Calcium Channel blockers,
**For patients with cardiovascular toxicity, as manifested by one or more of the following: 
***Hemodynamically significant bradycardia or HB , including 3° HB and high grade 2° HB
**** Administer [[Antiarrhythmics|ATROPINE]] 0.5 mg IV, may repeat x 2 if no response.
**** If no response, [[Electrolytes|CALCIUM CHLORIDE]] 1 gm IV, If no response, repeat x 1
**** If no response, [[Antidiabetics|GLUCAGON]] 3 mg IV or IN, If no response, repeat x 1
**** If no response, begin [[Transcutaneous Pacing Procedure|TRANSCUTANEOUS PACING]] (TCP). (9.30) 
***If hypotension give 200 – 300 cc NS bolus, repeat as needed.
**** Administer [[Electrolytes|CALCIUM CHLORIDE]] 1 gm IV, may repeat x 1.  Avoid if patient is on digoxin/lanoxin.
**** Administer [[Antidiabetics|GLUCAGON]] 2 mg IV or IN, may repeat x 1.
* For Beta blockers:
**For patients with cardiovascular toxicity, as manifested by one or more of the following: 
***Hemodynamically significant bradycardia or HB, including 3° HB and high grade 2° HB 
****Administer [[Antiarrhythmics|ATROPINE]] 0.5 mg IV, may repeat x 2 if no response.
****If no response, [[Antidiabetics|GLUCAGON]] 2 mg IV or IN, If no response, repeat x 1
****If no response begin [[Transcutaneous Pacing Procedure|Transcutaneous Pacing]] (TCP) (9.30)
***If hypotension
****200 – 300 cc NS bolus, repeat as needed. 
****Administer [[Antidiabetics|GLUCAGON]] 2 mg IV or IN, may repeat x 1. 

====Physician's Order: POISON CONTROL INFORMATION and subsequent treatment.====