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Emerg Med Clin North Am ; 32(1): 79-102, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24275170

ABSTRACT

Adverse cardiovascular events comprise a large portion of the morbidity and mortality in drug overdose emergencies. Adverse cardiovascular events encountered by emergency physicians treating poisoned patients include myocardial injury, hemodynamic compromise with shock, tachydysrhythmias, and cardiac arrest. Early signs of toxin-induced cardiovascular failure include bradycardia, tachycardia, and specific ECG findings. Treatment of toxicologic tachycardia relies on rapid supportive care along with proper use of benzodiazepines for sedation. Treatment of toxicologic bradycardia consists of the use of isotonic fluids, atropine, calcium salts, and glucagon. High-dose insulin euglycemia should be used early in the course of suspected severe poisoning and intravenous lipid emulsion given to patients who suffer cardiac arrest.


Subject(s)
Adrenergic beta-Agonists/poisoning , Calcium Channel Agonists/poisoning , Cardiovascular Diseases/chemically induced , Drug Overdose/complications , Emergency Medical Services/methods , Poisoning/complications , Cardiovascular Diseases/therapy , Drug Overdose/therapy , Humans , Poisoning/therapy , United States
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