POISONING
Abstract
Over the past few years there has been an
increase in the number of patients presenting to
medical casualties with history of poisoning. In
most of the cases the agent is not known and the
history is vague. At times the patient may not even
admit to having taken anything. The patients are
usually accompanied by hordes of relatives who
by their impatient attitude compel the attending
doctor to initiate acute medical treatment on the
basis of scarce information given .in such cases,
it is a test of the doctor’s clinical acumen to
give the patient emergency care that will prove
life- saving in a situation where immediate
investigations may not be readily available at
hand. A methodical approach by the doctor,
counseling of the attendants, and explanation
of the ongoing process can alleviate many
problems.
Clinical examination of the patient can
reveal much valuable information about the agent
used for poisoning. Blood pressure, temperature,
pulse, respiratory pattern, skin, cardiovascular
status, odour of breath and neurologic function
should all be assessed. A fast or irregular pulse
points towards ingestion of anti muscarinics,
tricyclic’s or quinine, respiratory depression goes
in favour of opiate or barbiturate intoxication,
constricted pupils are a hallmark of opiates and
organophosphorus poisoning, with dilated
pupils favour amphetamine and cocaine
poisoning.
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