CALCIUM CHANNEL or BETA BLOCKER TOXICITY (e.g. Verapamil, Metoprolol) Assess for bradycardia, hypotension and shock; apply and assess 12-lead EKG: Activated Charcoal Calcium Chloride as indicated for Calcium Channel Blocker overdose. Glucagon as indicated for Beta Blocker Toxicity. TRICYCLIC ANTIDEPRESSANTS (e.g. Elavil, Amitriptyline, Etrafon, Pamelor, Nortriptyline) Oxygen as indicated. If SBP <90, seizure, and/or QRS widening > 0.10 seconds is present: Sodium Bicarbonate ANTIPSYCHOTICS WITH EXTRAPYRAMIDAL REACTION (e.g. Haldol, Haloperidol) Assess for fixed, deviated gaze to one side of body, painful spasm of trunk or extremity muscles and/or difficulty speaking: Diphenhydramine CYANIDE Assess for nausea, headache, anxiety, agitation, weakness, muscular trembling, seizures, apnea, soot around mouth or airway: Remove contaminated clothing. Do NOT transport with patient. For suspected overdose: Transport patient to receiving hospital for treatment. Sodium Thiosulfate is not routinely stocked on the ambulances, but is available in If available, administer pharmaceutical disaster caches called, “CHEMPACK.” Sodium Thiosulfate 12.5 grams (50 ml of 25% solution) IV. ORGANOPHOSPHATES (e.g. Malathion) Assess for “SLUDGE”: (Salivation, Lacrimation, Urination, Diaphoresis/Diarrhea, Gastric hypermotility, Emesis/Eye (small pupils, blurry vision). Severe exposures may result in decreased
CALCIUM CHANNEL or BETA BLOCKER TOXICITY (e.g. Verapamil, Metoprolol) Assess for bradycardia, hypotension and shock; apply and assess 12-lead EKG: Activated Charcoal Calcium Chloride as indicated for Calcium Channel Blocker overdose. Glucagon as indicated for Beta Blocker Toxicity. TRICYCLIC ANTIDEPRESSANTS (e.g. Elavil, Amitriptyline, Etrafon, Pamelor, Nortriptyline) Oxygen as indicated. If SBP <90, seizure, and/or QRS widening > 0.10 seconds is present: Sodium Bicarbonate ANTIPSYCHOTICS WITH EXTRAPYRAMIDAL REACTION (e.g. Haldol, Haloperidol) Assess for fixed, deviated gaze to one side of body, painful spasm of trunk or extremity muscles and/or difficulty speaking: Diphenhydramine CYANIDE Assess for nausea, headache, anxiety, agitation, weakness, muscular trembling, seizures, apnea, soot around mouth or airway: Remove contaminated clothing. Do NOT transport with patient. For suspected overdose: Transport patient to receiving hospital for treatment. Sodium Thiosulfate is not routinely stocked on the ambulances, but is available in pharmaceutical disaster caches called, “CHEMPACK.” If available, administer Sodium Thiosulfate 12.5 grams (50 ml of 25% solution) IV. ORGANOPHOSPHATES (e.g. Malathion) Assess for “SLUDGE”: (Salivation, Lacrimation, Urination, Diaphoresis/Diarrhea, Gastric hypermotility, Emesis/Eye (small pupils, blurry vision). Severe exposures may result in decreased
2725-2.10_Poison_and_Overdose_2015_03_01.docx