28 Toxicology

S. Eliza Halcomb, Evan Schwarz, and Michael E. Mullins OVERDOSES Overdose, General GENERAL PRINC IPLES ü According to the American Association of Poison Control Centers (AAPCC), there were over 2 million exposures and 1,146 fatalities related to toxins in 2010 (Clin Toxicol 49(10):910). Overdoses are common in the emergency department, and although they are rarely fatal, it is important to follow some general guidelines while caring for the poisoned patient. ü Patients who present to the hospital with an overdose can be challenging for the clinician. This section will begin with a review of the general approach to the poisoned patient, followed by a discussion of specific ingestions. ü When managing the poisoned patient, as with all patients, it is vital to make sure the patient has patent airway, intact breathing, and palpable pulses. Beyond the basics of general emergency management, it is important to remember physiologic principles when approaching the poisoned patient. Quite often, patients can be categorized into one of the five toxidromes based on simple clinical examination findings.