Resuscitation, poisoning

A principle of the therapy for acute poisonings with anticholinesterase compounds (OPC, carbamates) lies in the complex performance of specific antidotic therapy including methods for poison excretion and intensive resuscitation measures. 

As such attacks continued, uric acid s standing with the profession as a whole was steadily lowered. By 1915, physicians could joke that, "There was as much to be said for uric acid as there is for intestinal toxemia [the invalid theory of ptomaine poisoning] it cured for a time its thousands, but the theory built about it caught cold and died." (67) Already the year before, an American journal had concluded its brusque review of Kenneth Haig s Health Through Diet with the prediction that "the uric acid fad has had its day, and...the present volume will not resuscitate it." (68)... 

Specific antidotes are available for only a few toxic agents (Table 7.2). Even these are not always effective, particularly if the poisoning is severe. The best treatment begins with supportive care. This includes resuscitation (if necessary) and maintenance of respiratory and cardiovascular functions. Imbalances in fluid and electrolytes may have to be corrected. An approach to the treatment of victims of poisoning is presented in Table 7.3. 

Cyanide poisoning Victims may be successfully resuscitated by proper circulatory and respiratory support while waiting for the antidote to be administered. Every... 

Or in other more bizarre ways. A 23-year-old medical student saw his dog (a puppy) suddenly collapse. He started external cardiac massage and a mouth-to-nose ventilation effort. Moments later the dog died, and the student felt nauseated, vomited and lost consciousness. On the victim s arrival at hospital, an alert medical officer detected a bitter almonds odour on his breath and administered the accepted treatment for cyanide poisoning after which he recovered. It turned out that the dog had accidentally swallowed cyanide, and the poison eliminated through the limgs had been inhaled by the master during the mouth-to-nose resuscitation. Journal of the American Medical Association 1983 249 353. 

Standard cardiorespiratory resuscitation and antiarrhythmia treatment are used for acute solvent poisoning. Toxicity from carbon tetrachloride and chloroform involves the generation of phosgene (a 1914-18 war gas) which is inactivated by cysteine, and by glutathione which is formed from cysteine treatment with N-acetylcysteine, as for poisoning with paracetamol, is therefore recommended. 

In Morocco, intoxication with PPD is a major health problem. A reported series of 171 cases of PPD poisoning admitted to the medical resuscitation service in Ibn Roshd hospital between January 1994 and October 1997. In this series, there were 5 men and 166 women, with a mean age around 26 years. Twenty four percent of the patients developed severe ARF and 55 deaths (38.7%) were observed in this study [26]. In 90% of the cases PPD was ingested in the context of a suicidal attempt. The amount ingested varied between 3 and 15 grams. 

The affected person should be removed from exposure to adiponitrile immediately. Contaminated clothes should be removed and the patient sponged to avoid any absorption through skin. Immediate cardiopulmonary resuscitation should be administered. If the victim breathes with difficulty, oxygen should be given. In case of ocular contact, the eyes should be flushed with copious amounts of water for at least 20 min. In cases of ingestion, vomiting should be induced. Mouth-to-mouth resuscitation should be avoided in order to prevent self-poisoning. 

Consumption of small amounts of antifreeze can be deadly. Poisonous constituents are typically ethylene glycol and methanol. There is no home treatment aside from standard first-aid and cardiopulmonary resuscitation (CPR) for signs of shock or cardiac arrest. Gastric treatment and dialysis may be immediately necessary for survival depending on the dose, and long-term kidney and brain damage are possible. 

Murphy MJ, Culliford EJ, Parsons V. 1979. A case of poisoning with mercuric chloride. Resuscitation 7 35-44. 

K8. Killick, E. M., and Marchant, J. V., Resuscitation of doge from severe acute carbon monoxide poisoning. J. Physiol. (London) 147, 274-298 (1959). 

At the same time, doctors and nurses from the Self Defense Force Central Hospital also suspected sarin poisoning and brought various documents and supplies to St. Luke s International Hospital. By the time most of the patients with cardiopulmonary or respiratory arrest had been resuscitated, results of laboratory tests revealed decreased plasma cholinesterase. Based on the various medical data, clinical and test findings, sarin poisoning was diagnosed with relative ease. 

In Morocco, intoxication with PPD is a major health problem. A reported series of 171 cases of PPD poisoning admitted to the medical resuscitation service in Ibn Roshd hospital between January 1994 and October... 

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