Acute Poisoning - Samuel Schvartsman

Acute Poisoning: A Comprehensive Guide to Diagnosis and Treatment

Introduction

Acute poisoning is a serious medical emergency that can lead to significant morbidity and mortality. This comprehensive guide provides a detailed overview of the diagnosis and treatment of acute poisoning, with a focus on the latest evidence-based practices.

Epidemiology

Acute poisoning is a global health problem, with an estimated 10 million cases occurring annually. The incidence of acute poisoning varies widely between countries, with the highest rates occurring in low- and middle-income countries. The most common causes of acute poisoning include:

Pharmaceuticals: Prescription drugs, over-the-counter medications, and illicit drugs are the most common causes of acute poisoning.
Household products: Cleaning products, personal care products, and pesticides are also common causes of acute poisoning.
Industrial chemicals: Exposure to industrial chemicals can occur in the workplace or through accidental ingestion.
Environmental toxins: Environmental toxins, such as lead, mercury, and arsenic, can cause acute poisoning through ingestion, inhalation, or skin contact.

Clinical Presentation

The clinical presentation of acute poisoning can vary widely depending on the type of poison ingested. Some of the most common symptoms include:

Gastrointestinal symptoms: Nausea, vomiting, abdominal pain, and diarrhea are common symptoms of acute poisoning.
Neurological symptoms: Headache, dizziness, confusion, seizures, and coma can all occur in acute poisoning.
Cardiovascular symptoms: Tachycardia, hypotension, and arrhythmias can occur in acute poisoning.
Respiratory symptoms: Respiratory depression, shortness of breath, and wheezing can all occur in acute poisoning.

Diagnosis

The diagnosis of acute poisoning is based on the patient's history, physical examination, and laboratory findings. The history should include information about the type of poison ingested, the time of ingestion, and the patient's symptoms. The physical examination should focus on identifying signs of toxicity, such as altered mental status, respiratory depression, and cardiovascular instability. Laboratory findings can help to confirm the diagnosis of acute poisoning and to identify the specific toxin involved.

Treatment

The treatment of acute poisoning is based on the type of poison ingested and the patient's clinical condition. Some of the most common treatments include:

Decontamination: Decontamination involves removing the poison from the body. This can be done through gastric lavage, activated charcoal, or whole bowel irrigation.
Antidotes: Antidotes are specific medications that can reverse the effects of certain poisons.
Supportive care: Supportive care includes measures to maintain the patient's vital signs, such as oxygen therapy, intravenous fluids, and vasopressors.

Prognosis

The prognosis of acute poisoning depends on the type of poison ingested, the dose, and the timeliness of treatment. With early diagnosis and treatment, most cases of acute poisoning can be successfully treated. However, some cases can lead to serious complications or even death.

Prevention

The best way to prevent acute poisoning is to avoid exposure to poisons. This can be done by:

Keeping medications and household products out of reach of children.
Reading and following the directions on all product labels.
Storing chemicals in a safe place.
Avoiding contact with environmental toxins.