Emergency medicine clinics of North America
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This article reviews the background, metabolism, clinical effects, and treatment of toxic alcohols, specifically ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropyl alcohol. This article also reviews the importance of an anion gap metabolic acidosis in relation to toxic alcohols and explores both the utility and the limitations of the osmol gap in patient management.
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Emerg. Med. Clin. North Am. · May 2022
ReviewFound Down: Approach to the Patient with an Unknown Poisoning.
Approximately 30% of poison exposures reported to centers each year are either referred to or initiated within a health care facility. Among these exposures, undifferentiated poisoned patients are among the most challenging cases faced in the emergency department. ⋯ This includes considering key additional history, a possible toxidrome, and data in the form of vital signs, physical examination, laboratory analysis, ECG, and imaging. After which a tailored approach to supportive care, decontamination, possible antidotes, and enhanced elimination techniques will improve outcomes.
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Emerg. Med. Clin. North Am. · May 2022
ReviewMetabolic Acidosis: Differentiating the Causes in the Poisoned Patient.
Numerous drugs and toxins can cause metabolic acidosis. The treating clinician should be aware of the many compounds that can produce metabolic acidosis following an accidental exposure, an overdose, or with therapeutic use. Awareness and comprehension of those substances associated with metabolic acidosis will facilitate the diagnosis and treatment of poisoned patients.
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Pediatric poisonings comprise the majority of the toxic exposures reported to U. S. poison centers. ⋯ These toxins include such substances as specific prescription medications, over-the-counter medications, essential oils, and common household items. With such a vast array of potential toxic exposures that can affect children, it is imperative that health care practitioners who work with children understand the general management of the poisoned pediatric patient.