Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 23 , ISSUE S4 ( December, 2019 ) > List of Articles


Initial Management of Poisoned Patient

Jagadish Chandran

Keywords : Accidental poisoning, Charcoal hemoperfusion, Resuscitation

Citation Information : Chandran J. Initial Management of Poisoned Patient. Indian J Crit Care Med 2019; 23 (S4).

DOI: 10.5005/jp-journals-10071-23307

License: CC BY-NC 4.0

Published Online: 01-04-2015

Copyright Statement:  Copyright © 2019; The Author(s).


  1. Rosner F. Moses Maimonides’ treatise on poisons. JAMA 1968;205: 98–100. DOI: 10.1001/jama.1968.03140390038010.
  2. Common poisoning syndromes (toxidromes). In: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA; 2014 (Accessed on 11 November 2019).
  3. Tomaszewski C, Runge J, Gibbs M, Colucciello S, Price M. Evaluation of a rapid bedside toxicology screen in patients with drug toxicity. J Emerg Med 2005;28(4):389–394. DOI: 10.1016/j.jemermed. 2004.11.021.
  4. Adnet F, Borron SW, Finot MA, Lapandry C, Baud FJ. Intubation difficulty in poisoned patients: association with initial Glasgow Coma Scale score. Acad Emerg Med 1998;5(2):123–127. DOI: 10.1111/j.1553-2712.1998.tb02596.x.
  5. O'Connor MFHJ, Schmidt GA, Wod LDH. Acute hypoxemic respiratory failure. In: Hall JBSG, Wood LDH, ed. Principles of critical care, 2nd ed., New York: McGraw-Hill; 1998.
  6. Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med 2015;65(4):349–355. DOI: 10.1016/j.annemergmed.2014.09.025.
  7. Weingart SD. Preoxygenation, reoxygenation, and delayed sequence intubation in the emergency department. J Emerg Med 2011;40(6):661–667. DOI: 10.1016/j.jemermed.2010.02.014.
  8. Salord F, Gaussorgues P, Marti-Flich J, Sirodot M, Allimant C, Lyonnet D, et al. Nosocomial maxillary sinusitis during mechanical ventilation: a prospective comparison of orotracheal versus the nasotracheal route for intubation. Intensive Care Med 1990;16(6):390–393. DOI: 10.1007/BF01735177.
  9. O'connor MFKM, Hall JB. Airway management. In: Hall JBSG, Wood LDH, ed. Principles of critical care, 2nd ed., New York: Mc-Graw Hill; 1998.
  10. Holzapfel L, Chevret S, Madinier G, Ohen F, Demingeon G, Coupry A, et al. Influence of long-term oro- or nasotracheal intubation on nosocomial maxillary sinusitis and pneumonia: results of a prospective, randomized, clinical trial. Crit Care Med 1993;21(8): 1132–1138. DOI: 10.1097/00003246-199308000-00010.
  11. Wood LDHSG, Hall JB. Principles of critical care of respiratory failure. In: Murray JF, Nadal JA, ed. Textbook of respiratory medicine, 3rd ed., Philadelphia: WB Saunders; 2000.
  12. Serpa Neto A, Cardoso SO, Manetta JA, Pereira VG, Esposito DC, Pasqualucci Mde O, et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA 2012;308(16):1651–1659. DOI: 10.1001/jama.2012.13730.
  13. Fuller BM, Mohr NM, Drewry AM, Carpenter CR. Lower tidal volume at initiation of mechanical ventilation may reduce progression to acute respiratory distress syndrome: a systematic review. Crit Care 2013;17(1):R11. DOI: 10.1186/cc11936.
  14. Brent J. Critical care toxicology: diagnosis and management of the critically poisoned patient. New York, NY: Springer Berlin Heidelberg; 2017.
  15. Mowry JB, Spyker DA, Brooks DE, McMillan N, Schauben JL. 2014 annual report of the American Association of Poison Control Centers’ national poison data system (NPDS): 32nd annual report. Clin Toxicol (Phila) 2015;53(10):962–1147. DOI: 10.3109/15563650.2015.1102927.
  16. Murphy C. Hypertensive emergencies. Emerg Med Clin North Am 1995;13(4):973–1007.
  17. Grossman E, Messerli FH. High blood pressure. A side effect of drugs, poisons, and food. Arch Intern Med 1995;155(5):450–460. DOI: 10.1001/archinte.1995.00430050022003.
  18. Griffin JP. Methaemoglobinaemia. Adverse Drug React Toxicol Rev 1997;16(1):45–63.
  19. Hardy KR, Thom SR. Pathophysiology and treatment of carbon monoxide poisoning. J Toxicol Clin Toxicol 1994;32(6):613–629. DOI: 10.3109/15563659409017973.
  20. Cyanide toxicity. Agency for toxic substances and disease registry. Am Fam Physician 1993;48(1):107–114.
  21. Cohen RD, Woods HF. Clinical and biochemical aspects of lactic acidosis. J Clin Pathol 1976;30(1):92.
  22. Jones AE, Tayal VS, Sullivan DM, Kline JA. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med 2004;32(8):1703–1708. DOI: 10.1097/01.CCM.0000133017.34137.82.
  23. Seif D, Perera P, Mailhot T, Riley D, Mandavia D. Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol. Crit Care Res Pract 2012;2012:503254. DOI: 10.1155/2012/503254.
  24. Hannemann L, Reinhart K, Grenzer O, Meier-Hellmann A, Bredle DL. Comparison of dopamine to dobutamine and norepinephrine for oxygen delivery and uptake in septic shock. Crit Care Med 1995;23(12):1962–1970. DOI: 10.1097/00003246-199512000-00004.
  25. Doyon S, Roberts JR. The use of glucagon in a case of calcium channel blocker overdose. Ann Emerg Med 1993;22(7):1229–1233. DOI: 10.1016/S0196-0644(05)80997-7.
  26. Salzberg MR, Gallagher EJ. Propranolol overdose. Ann Emerg Med 1980;9(1):26–27. DOI: 10.1016/S0196-0644(80)80436-7.
  27. Kline JA, Leonova E, Raymond RM. Beneficial myocardial metabolic effects of insulin during verapamil toxicity in the anesthetized canine. Crit Care Med 1995;23(7):1251–1263. DOI: 10.1097/00003246-199507000-00016.
  28. Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS. High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning. Clin Toxicol (Phila) 2011;49(4):277–283. DOI: 10.3109/15563650.2011.582471.
  29. Cave G, Harvey M, Willers J, Uncles D, Meek T, Picard J, et al. LIPAEMIC report: results of clinical use of intravenous lipid emulsion in drug toxicity reported to an online lipid registry. J Med Toxicol 2014;10(2):133–142. DOI: 10.1007/s13181-013-0375-y.
  30. de Lange DW, Sikma MA, Meulenbelt J. Extracorporeal membrane oxygenation in the treatment of poisoned patients. Clin Toxicol (Phila) 2013;51(5):385–393. DOI: 10.3109/15563650.2013.800876.
  31. Masson R, Colas V, Parienti JJ, Lehoux P, Massetti M, Charbonneau P, et al. A comparison of survival with and without extracorporeal life support treatment for severe poisoning due to drug intoxication. Resuscitation 2012;83(11):1413–1417. DOI: 10.1016/j.resuscitation.2012.03.028.
  32. Benson BE, Hoppu K, Troutman WG, Bedry R, Erdman A, Hojer J, et al. Position paper update: gastric lavage for gastrointestinal decontamination. Clin Toxicol (Phila) 2013;51(3):140–146. DOI: 10.3109/15563650.2013.770154.
  33. Chyka PA, Seger D, Krenzelok EP, Vale JA, American Academy of Clinical Toxicology, European Association of Poisons Centres and Clinical Toxicologists. Position paper: single-dose activated charcoal. Clin Toxicol (Phila) 2005;43(2):61–87. DOI: 10.1081/CLT- 51867.
  34. Stapczynski JS, Tintinalli JE. Tintinalli's emergency medicine: a comprehensive study guide, 8th ed., New York: McGraw-Hill Education; 2016.
  35. Chyka PA, Holley JE, Mandrell TD, Sugathan P. Correlation of drug pharmacokinetics and effectiveness of multiple-dose activated charcoal therapy. Ann Emerg Med 1995;25(3):356–362. DOI: 10.1016/S0196-0644(95)70295-4.
  36. Proudfoot AT, Krenzelok EP, Vale JA. Position paper on urine alkalinization. J Toxicol Clin Toxicol 2004;42(1):1–26. DOI: 10.1081/CLT-120028740.
  37. Fertel BS, Nelson LS, Goldfarb DS. Extracorporeal removal techniques for the poisoned patient: a review for the intensivist. J Intensive Care Med 2010;25(3):139–148. DOI: 10.1177/0885066609359592.
  38. Ghannoum M, Roberts DM, Hoffman RS, Ouellet G, Roy L, Decker BS, et al. A stepwise approach for the management of poisoning with extracorporeal treatments. Semin Dial 2014;27(4):362–370. DOI: 10.1111/sdi.12228.
  40. Liolios A, Oropello JM, Benjamin E. Gastrointestinal complications in the intensive care unit. Clin Chest Med 1999;20(2):329–345. DOI: 10.1016/S0272-5231(05)70145-3.
  41. Legere BM, Dweik RA, Arroliga AC. Venous thromboembolism in the intensive care unit. Clin Chest Med 1999;20(2):367–384. DOI: 10.1016/S0272-5231(05)70147-7.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.