2025 Multiprofessional Critical Care Review: Adult Online-Toxicology and Drug Overdoses

Video Transcription

Video Summary

This presentation emphasizes the importance of a thorough history, targeted physical exam, and scene safety in toxicology cases. Key diagnostic tools include checking pupils, skin, mental status, bowel activity, EKG changes, and labs such as basic metabolic panel and specific drug levels (e.g., acetaminophen, aspirin). Early management involves resuscitation with IV fluids, potential decontamination (e.g., charcoal), and antidotes guided by poison control centers. Specific toxicities discussed include cholinergic toxicity treated with atropine and pralidoxine, salicylate poisoning presenting with respiratory alkalosis and metabolic acidosis, and toxic alcohol ingestion managed with fomepizole and dialysis. The speaker highlights the complexity of acid-base disturbances in overdose, using the CULT mnemonic for anion gap acidosis causes. Treatment adjuncts for overdoses include sodium bicarbonate for arrhythmias, norepinephrine for hypotension, and benzodiazepines or propofol for seizures. Early identification, supportive care, and consultation with poison control are critical for patient outcomes.

Keywords

toxicology assessment

poisoning management

cholinergic toxicity

acid-base disturbances

antidote therapy

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