Overview of treatment for poisonings

Resuscitation is always the first priority in the management of a poisoning. Other interventions differ depending on the drug or toxin involved, and whether specific antidotes are available—see individual monographs for detailed advice. Prehospital care may involve removal of the patient from a hazardous environment, removal of a venomous animal, first aid, resuscitation and decontamination.

Depending on the urgency of management, many of the following interventions for poisoning are undertaken simultaneously:

• resuscitation
  • advanced life support for cardiorespiratory arrest due to poisoning
  • support of airway and breathing in poisoning
  • support of circulation in poisoning
  • cooling for drug-associated hyperthermia
• decontamination
  • gastrointestinal decontamination with activated charcoal
  • whole bowel irrigation
• enhanced elimination
  • multiple-dose activated charcoal
  • extracorporeal elimination
• administration of antidotes, if available
  • many antidotes can be toxic themselves; if considering the use of an antidote, seek advice from a clinical toxicologist
  • indications for antidotes and dosing regimens can be found in the individual drug and toxin monographs.

Other interventions may be indicated depending on the drug or toxin involved; these include:

• sedation for agitation
• seizure control
• treatment for aspiration pneumonitis
• treatment for rhabdomyolysis.

Supportive care of patients with poisoning includes maintaining adequate hydration with intravenous fluid therapy (replacement of fluid losses and maintenance fluids), close observation of sedated patients, general nursing care and pressure care.