Obtaining collateral is often vital to
determine the potential drugs accessible to the patient - this may
include
After
this, use ancillary sources such as EMS, family/friends, and police
to determine the patient’s last normal, PMH and
medications
To
help separatetoxidromes, pupillary exam and skin exam are
helpful
Important physical exam clues in toxicology
include the pupils and the skin
Adjunct laboratory evaluation may include liver
function tests, acetaminophen level, salicylate levels, urine drug
screens, particularly in unknown ingestions
Your
local toxicologist (if you are fortunate to have one) or the Poison
Center can always provide assistance in treatment and workup -
consider involving them early
References
Erickson TB,
Thompson TM, Lu JJ. The approach to the patient with an unknown
overdose. Emerg Med Clin North Am 2007; 25:249.
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