Toxidromes; Roadside to Resus

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 15 September 2020

⏱️ 59 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Drug ingestion both accidental and intentional accounts for a significant proportion of attendances at UK Emergency Departments and 999 calls.

In 2016 there were >2,500 registered deaths in England and Wales related to drug misuse, which had increased by nearly 60% in a decade.

So without a doubt we are all going to come across critically unwell patients with drug ingestions. But inappropriate drug use is not confined to illicit substances, with many prescription drugs being misused to ill effect and also overdosed in an attempt to end patients lives.

In this podcast we’re going to run through the assessment of patients presenting with a possible drug ingestion, cover the potential toxidromes you may encounter and talk about the management of these presentations. Specifically we take a look at serotonin syndrome, sedative toxidrome and both cholinergic and anti-cholinergic syndrome.

In next months Roadside to Resus we'll take a look at specific medications of overdose; paracetamol, beta blockers, calcium channel blockers and the intricacies of their management along with other key parts of critical care including the management of cardiac arrest due to toxicity.

Make sure to take a look at the references and resources below.

Enjoy!

Simon, Rob & James

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.5	Five, four, three, two, one, fire.
0:12.1	So hi, and welcome back to the Recess Room podcast.
0:15.4	I'm Simon Lang.
0:16.7	I'm Rob Penwick.
0:17.8	And I'm James Yates.
0:19.1	And we're back after our summer break, and we're going to go in with a big one.
0:23.0	It's Roadside to Recess on Toxidromes.
0:26.3	Oh yes.
0:27.0	Now, I'm looking forward to this one because this is definitely a presentation that has got to be familiar to a lot of us working in emergency care,
0:34.1	whether that's pre-hospital or in hospital. So, yeah, I think this is a great,
0:38.6	relevant topic to rouse us back after our summer rest. Absolutely. I couldn't agree more.
0:43.6	And it's one of those great topics that actually is completely applicable to everyone because
0:47.9	it isn't about tests. It's about good clinical assessment and it's about taking a good history
0:52.9	and all of those factors that we
0:54.5	love about doing emergency in pre-hospital care. And we've got a different host with us this time.
0:59.7	We've got the neontologist in the house. That's not me. I suppose I better stick my hand up.
1:07.2	I don't know. It's probably going a bit far. I definitely don't want to go above my station.
1:10.6	But I am trying to learn about little people at the minute. And there may well be some
1:16.6	reflection of that role in future episodes. Looking forward to it. I'm looking forward to
1:22.2	toxodromes in neonates, which is coming next one. Yeah. I mean, it sounded very much before we switch record on, like we were going to have a
1:31.8	broody episode with James Yates getting all clucky, but hopefully that won't come out in this
	...

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