Conference Notes 2-21-2012
TAKING YOUR PRESENTATION TO THE NEXT LEVEL WORK SHOP
CARLSON TOXICOLOGY 3 STUDY GUIDE
Decon rat poison does not need active monitoring or treatment if a toddler has a single ingestion. For an intentional ingestion for suicidal ideation these patients require close monitoring of INR and possibly vitamin K over several days.
Methyl chloride ingestion cause carbon monoxide poisoning
If iron ingestion has no symptoms for 6 hours it will not be a toxic ingestion.
Macrolides can prolong the QT interval resulting in torasades.
Excessive vitamin C intake can cause kidney stones.
Methemoglobinemia is commonly due to benzocaine, or pyridium. Pulse ox will be around 85%. Pt will be cyanotic. Treat with methylene blue.
Button batteries >15mm are at increased risk of impaction in the GI tract. Button battery in the nose or esophagus needs to be removed immediately.
ORAL BOARDS COGHLIN AND KUTKA
Case 1. Bronchiolitis requiring intubation. Had to trouble shoot hypoxia following intubation due to oxygen tubing becoming unplugged.
Case 2. Guillain Barre Syndrome. Check vital capacity. Give IVIG. ICU admit with neuro on board
Case 3. CRAO. Occular massage, breathe in paper bag, give timoptic an acetazolamide. Consult Ophtho
RADIATION EXPOSURE MEDICINE MCDERMOTT
Alpha particles: 2 protons/2 neutrons. Can be blocked by paper/wall/skin. Inhaled particles are bad. Uranium, plutonium are sources.
Beta particles: Electrons. blocked by plastic sheet. Tritium, Strontium are sources
Gama Rays: Can create ionization. Higher energy than xray. Easily travels thru matter. Blocked by lead or thick concrete. Can hit bone marrow, gi tract, brain.
Neutrons: Uncharged particles. Can cause another material to be radioactive.
Irradiation=exposure with no material transfer. Contamination=material transfer.
Basic unit of radioactivity is the Curie. 1 Gray=1 sievert.
Important isotopes to know: Iradium, Cesium, Cobalt (industrial 3). Hydrogen, Uranium, Plutonium, Americum (military 5 hard to get and enrich).
Geiger Counter measures radiation present from contamination of an area or patient.
Personal protection is fairly effective with just coveralls, gloves, and face shields.
Decontamination of patients is best in a closed space in an isolated area of ED.