Emergencies

Cardiac SupportPoisons & Antidotes

Cardiac Anatomy

CODE Blue Emergencies

• System to communicated a life threatening situation

• Patient’s heart and/or breathing has stopped

• Etiology– Sudden death, sudden arrhythmia, myocardial

failure

Emergency Procedures

• Goal to stabilize patient• Basic Life Support

– To prevent circulatory & respiratory arrest• Advanced Cardiac Life Support

– Ventilation, give IV fluids, administer drugs, provide cardiac monitoring, defibrillation, arrhythmic control, postresuscitation care

Agents for Cardiac Emergencies

• Cardiac Stimulants– Amiodarone– Digoxin– Diltiazem– Dobutamine– Epinephrine– Lidocaine– Procainamide– Verapamil

• Blue Alert Cart • Stocked with drugs• Expiration dates

POISONINGS

Poisonings• Children account for

2/3rds of accidental poisonings

• Involves under 6 yrs old and household chemicals

• Once taken:– Eliminate it from patient’s

GIT– Diminish the effects of

the dose absorbed

Common Poisoning Agents

• FeSo4• TCA’s• Calcium Channel

Blockers• Opiates• ASA• Etoh

Supportive Care

• Gastric Lavage• Step 1

– Specific antidote• Step 2

– Forced diuresis• Step 3

– Dialysis and exchange transfusion

• Syrup of Ipecac– Special issues

• Apomorphine• Activated Charcoal

Selected Antidotes• Atropine

– Cholinergics

• Cyanide antidote kit• Mucomyst

– APAP

• Methylene blue– Nitrates

• Narcan (naloxone)– Narcotics

• Vitamin K– Warfarin

• EDTA– Lead

• BAL– Heavy metals

• Deferoxamine– Iron

• Cuprimine (penicillamine)– Copper, zinc, mercury, lead

Anti-venoms Support Drugs• Benztropine• Diphenhydramine• Lidocaine• Phenytoin• Physostigmine• Propranolol

• Where have you seen these before? For what conditions?

Summary Slide

• CODE Blue Emergencies• Agents for Cardiac Emergencies• Common Poisoning Agents• Supportive Care • Selected Antidotes