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Emergency Medical Services for Children
NEW HAMPSHIRE
Poisoning / Overdose Syndromes
Poison Control (phone): 800-222-1222
Poison Control Online
NH Patient Care Protocols
Poisoning/Overdose 2.19P
Nerve Agent/Organophosphate Poisoning 2.14P
Possible Adverse Reaction Quick List (Merck Manual):
Acetaminophen: initially no signs/symptoms or nausea/vomiting. If not detected and treated, may cause irreversible liver failure.
Antipsychotics (e.g. haloperidol) and anti-emetics (e.g. prochlorperazine or metoclopramide): Akathisia (feelings of anxiety, agitation, and jitteriness) and dystonic reactions (neurological movement disorder leading to sustained muscle contractions cause twisting and repetitive movements or abnormal postures).
Anticholinergic (e.g. diphenhydramine, tricyclic antidepressants, bupropion): tachycardia, fever, dilated pupils, mental status changes. Blind as a bat (blurred vision). Dry as a bone (dry mouth). Red as a beet (flushing). Mad as a hatter (confusion). Hot as a hare (hyperthermia).
Aspirin/Salicylate: abdominal pain, vomiting, tachypnea, fever, altered mental status, tinnitus, hyperthermia, respiratory alkalosis, and metabolic acidosis. Late signs include renal dysfunction, liver failure, and or cerebral edema among.
Carbon monoxide (CO): headache, nausea, weakness, angina, dyspnea, loss of consciousness, seizures, and coma.
Cardiac Medications: dysrhythmias, altered mental status, hypotension, hypoglycemia.
Depressants: bradycardia, hypotension, decreased temperature, decreased respirations, non-specific pupils.
Opiate (e.g. heroin, fentanyl, morphine, oxycodone): Respiratory depression or arrest, pinpoint pupils, decreased mental states. Prolonged overdoses may result in compartment syndrome and/or hypothermia.
Organophosphates (e.g. fertilizer): bradycardia, increased secretions, nausea, vomiting, diarrhea, pinpoint pupils.
Solvents: nausea, coughing, vomiting, mental status change and arrhythmias. Patient with significant solvent exposure, must be handled gently to reduce the incident of arrhythmia and/ or subsequent cardiac arrest.
SSRIs (Serotonin Syndrome): Hyperthermia, agitation, ocular clonus (slow, continuous, horizontal eye movemens), tremor, dilated pupils, akathisia (see above), deep tendon hyperreflexia (common), muscle clonus (common), muscle rigidity, bilateral Babinski signs, dry mucus membranes, flushed skin and diaphoresis, ncreased bowel sounds.
Sympathomimetic/Stimulants: tachycardia, hypertension, seizures, agitation, increased temperature, dilated pupils, anxiety, paranoia, diaphoresis. Examples are bath salts, cocaine, methamphetamine, ecstasy, ADHD drugs, thyroid meds (rarely), salbutamol.
Tricyclics: seizures, dysrhythmias, hypotension, decreased mental status or coma.