ABSTRACT
Types of lab tests Testing methods (and degree of sensitivity and speci-
city, + to +++) Blood/serum levels Routine serum toxicology
Visualizing toxins Toxin-induced skeletal changes Chest x-rays: Lungs Chest x-rays: Pleura, mediastinum, heart Abdominal x-rays Head computerized tomographic (CT) scan
Electrolyte and temperature disturbances Digitalis and tricyclic antidepressants (TCAs) Tachyarrhythmias and common causes Drug-induced tachycardias Drug-induced bradyarrhythmias
Epidemiology of nontoxic exposures Categorizing nontoxic exposures Common nontoxic household exposures
Clear the airway. Assess and protect cervical spine. Intubate comatose patients for ventilation, lavage, and activated charcoal (AC) administration. Order arterial blood gas analysis and carboxyhemoglobin (COHb) level. Initiate electrocardiographic, temperature, oxygenation (STCO2), and central and peripheral perfusion monitoring. Start IV, uid load-normal saline or lactated Ringer’s solution; draw complete blood count (CBC), glucose, electrolytes, BUN, creatinine, toxicology screen. Manage three seizure types: (1) benzodiazepine (BZ) responsive seizures — suspect ethanol withdrawal; (2) special antidote-required seizures — suspect pyridoxine or isoniazid (INH); (3) tonoclonic seizures and/or persistent seizure activity on the electroencephalogram (EEG) — suspect carbon monoxide (CO).
