Circulation

Following chlorophenoxy herbicide poisoning, if hypotension due to fluid loss is problematic, treat initially with intravenous fluid resuscitation. If hypotension persists, start inotropic support.

Inotropic therapy is guided by the patient’s haemodynamics. Bedside echocardiography is useful to determine the relative contributions of negative inotropy and vasodilation to hypotension, and hence guides treatment choice—discuss with a clinical toxicologist.

Correct hyperkalaemia urgently if present (see Treating hyperkalaemia).