vyseerx
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you(physician) happen to see a child at your EMERGENCY ROOM ,who was brought with the history of having consumed tablets of an unknown medicine, half an hour ago.on examination, patient was pale, apprehensive, febrile,and dehydrated. he has voimted a couple of times in the house after ingestion of tablets.what do you do FIRST(MOST APPROPRIATE INITIAL STEP IN THE MANAGEMENT?)
A.CALL POSIONCONTROLL NUMBER
B.IPEAC EMESIS
C.GASTRIC LAVAGE
D.ORAL REHYDRATION
E.N-ACETYL CYSTEINE
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vyseerx
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| alice8
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C.GASTRIC LAVAGE :?:
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| meg
Forum Guru
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The child is in shock (except for febrile- which I dont understand... unless it was atropine tabs!). I think getting his circulation back to normal is vital. If the child is conscious, give Oral rehydration, else i.v. fluids(which is not here in the list :roll: )
So answer could be D
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| meg
Forum Guru
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Posts: 806
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if aspirin was the tablet, then gastric lavage might be right.
Also, if any anticholinergic drug was taken, like imipramine, then it is good to give gastric lavage even if an hour or more has passed since taking the drug, because anticholinergics decrease intestinal motility and delay absorption, so they will be found still sitting in the lumen!
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| vyseerx
Forum Guru
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most important thing to do , IF THE PATIENT IS BROUGHT TO ER with in ONE HOUR is emesis.use IPEAC.IPEAC IS and the treatment of choice if patient is alert. (ref.conrad fishcer,kaplan).if patient is not alert, confused, moribund,and having altered mental status , then GASTRIC LAVAGE should be the treatment of choice. patient is just dehydrated, not in shock.ORS is not treatment for shock anyway.incase of poisoning ,it is important to get the poison out FIRST!!meg should do somereading on emergency medicine !!
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| meg
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yes vyseerx, you are right , I have to do some reading in EM... just started studying for step 2 a week back, not yet reached EM :cry:
but hasnt this patient already vomitted twice?
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