Essentials 1 Paracetamol poisoning is one of the most common toxicological presentations to Australasian emergency departments. 2 The decision to treat patients with antidotal therapy following acute single ingestions should be made using the paracetamol treatment nomogram. 3 Acetylcysteine (NAC)…
Essentials 1 Chronic lithium toxicity is associated with significant morbidity and mortality, especially where diagnosis and treatment are delayed. a The diagnosis of lithium intoxication needs to be considered in any patient on lithium, and a serum lithium undertaken. b…
Essentials 1 Tricyclic antidepressant (TCA) overdose is associated with severe cardiovascular toxicity, seizures, coma and death. 2 Sodium bicarbonate is the specific treatment of TCA cardiotoxicity. 3 Selective serotonin reuptake inhibitors (SSRIs) produce mild clinical effects in overdose; however very…
Essentials 1 Antipsychotics can cause numerous adverse effects at therapeutic doses, which may limit compliance. 2 Extrapyramidal effects are less pronounced with second-generation antipsychotics. 3 Clozapine is associated with agranulocytosis and myocarditis with therapeutic use and requires strict surveillance. 4…
Essentials 1 Calcium channel blockers, β-blockers, digoxin and sodium channel blocker poisonings are associated with potentially life-threatening toxicity. 2 The key to the management of calcium channel blocker and β-blocker toxicity rests with aggressive supportive care of the circulation including…
Essentials 1 Self-poisoning is a manifestation of an underlying psychiatric, drug and alcohol, or social disorder. 2 A wide range of clinical manifestations of toxicity may be observed following drug overdose. 3 An accurate risk assessment predicts the likely clinical…
Essentials 1 The high-altitude syndromes—acute mountain sickness (AMS), high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE)—are all clinical diagnoses, where management may need to be undertaken without access to diagnostic testing. 2 AMS and HACE represent stages along a…
Essentials 1 Death from electric shock is due to ventricular fibrillation, the lethal arrhythmia occurring at the time of the exposure. Routine admission for ECG monitoring is unnecessary. 2 Most deaths are caused by low-voltage (<1000 V) exposures. 3 The…
Essentials 1 The incidence of non-fatal drownings requiring medical assessment to fatal drownings is around 2 to 20 times greater than fatal drowning. 2 The highest rates of drowning occur in children from 1 to 4 years of age and…
Essentials 1 Radiation accidents are rare but require well-planned protocols for successful management. The principal challenge will be managing large numbers of people who have concerns about their exposure to radiation, or contamination with radioactive material as a result of…