Wednesday, November 28, 2007

Vol1:1







Toxicology

After being fired from his job, a 35-year-old man attempts suicide by drinking from a bottle labeled “Insecticide”. Three hours later, EMS brings him in to the ED and you notice he is extremely diaphoretic, drooling, and vomiting. He is awake but confused. His vital signs are BP 170/90 mm Hg, HR 100, RR 22, Temp 98.6 ºF, and oxygen saturation 95% on room air. Physical exam demonstrates pinpoint pupils and crackles on lung exam. What is the treatment to reverse this patient’s poisoning?
a. Naloxone
b. N-acetylcysteine
c. Atropine and Pralidoxime (2-PAM)
d. Flumazenil
e. Bicarbonate and Kayexalate

Please submit your answer in the "comment" section. The person with the most correct entries at the end of the month will receive a copy of the book PreTest Emergency Medicine.

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22 comments:

Anonymous said...

2PAM and atropine

Anonymous said...

c. Atropine and Pralidoxime (2-PAM)

WongML said...

Looks like organophosphate poisoning.

Pralidoxime and atropine (2-PAM) for treatment.

Anonymous said...

C

Unknown said...

Atropine and Pralidoxime

cotrimaxazol said...

c. Atropine and Pralidoxime (2-PAM)

Anonymous said...

C. Atropine and Pralidoxime (2-PAM)

While hypertension and tachycardia aren't the classic presentation for organophosphate toxicity, they are possible as nicotinic effects.

Ken Fritz said...

c. Atropine and Pralidoxime (2-PAM)

2-5mg Atropine titrated to effect, 30 mg/kg 2-PAM.

ohnohideitsjosh said...

C. atropine and 2-PAM

coderiferous said...

C

Anonymous said...

c. atropine and pralidoxime

Anonymous said...

Cholinergic crisis: 2-PAM and atropine

Francis said...

2-pam

NPG said...

C. Atropine and pralidoxime

ditzydoctor said...

c. atropine and pralidoxime because insecticide is an organo-phosphate

Anonymous said...

C. 2-PAM, need to give atropine first.

HicksterAZ said...

c. 2-PAM, must give atropine first

Unknown said...

C. atropine and pralidoxime

Anonymous said...

C. Atropine and 2 pam this is an organophosphate poisoning with cholinergic toxicity

Andaleeb said...

C. Atropine and Pralidoxime.

Anonymous said...

c.
Jean

Brian and Jennifer said...

2pam and atropine baby!