Local anaesthetic toxicity (e.g.lidocaine, bupivacaine). L&D - Kept in ED, Pharmacy EDC and any wards / departments using benzodiazepines.īHT - Kept in Accident & Emergency and any wards / departments using benzodiazepines Use with caution in patients with benzodiazepine poisoning, particularly in mixed drug overdoses contraindicated in mixed TCA/benzodiazepine overdose. Reversal of iatrogenic over-sedation with benzodiazepines. L&D - Kept in ED antidote cupboard and Pharmacy EDC.ĭigoxin specific antibody fragments 40mg (Digifab ®)īHT - contact Pharmacy (Oncall Pharmacist via switchboard out of hours) L&D - Kept in EDC (Pharmacy emergency drug cupboard)īHT - Kept in Primrose or via Pharmacy (Oncall Pharmacist via switchboard out of hours) iron, lithium, also for bodypackers and for slow release preparations.īHT - Kept on Howard ward, Reginald Hart ward and RIverbank wardĬalcium folinate 300mg/30mL (Leucovorin ®) Whole bowel irrigation for agents not bound by activated charcoal eg.
NOTE: Do not confuse with Movicol preparations. Reduction of absorption of toxic substances by the GI tract that are adsorbed by charcoal.īHT - Kept in Accident & Emergency, AAU and Whitbread ward
Toxicity with organophosphates and carbamatesīHT - Kept in Accident & Emergency (Fridge) L&D - Kept in Pharmacy EDC and in theatres.īHT - Kept in Delivery Suite Theatre, Modular Theatre and Upper Theatre RecoveryīHT - Contact Pharmacy (Oncall Pharmacist via switchboard out of hours) Other drug-related hyperpyrexia (consult TOXBASE) (Not lead poisoning).īHT - Contact Pharmacy (Oncall via switchboward out of hours) L&D - Kept in ED antidote cupboard and ITU.īHT - Kept in Accident & Emergency, Upper Theatre and Delivery Suite Theatreįor copper poisoning and Wilson disease. Methylthioninium chloride 0.5% (Proveblue ®) NICE TA 697 Andexanet alfa for reversing anticoagulation from apixaban or rivaroxaban To be used in accordance with the following NICE TA(s): (200 mg powder for solution for infusion) Specialist information and advice on the treatment of poisoning is available on the Toxbase website (link below but log-in required) or from the UK National Poisons Information Service day and night on the following number: 03.
CYANIDE ANTIDOTE KIT COST FULL
Therapeutic abortion may be indicated in the presence of fetal demise following obstetric evaluation and stabilization of the mother.Bedfordshire and Luton Joint Formulary Formularyīedfordshire and Luton Joint Formulary Bedfordshire Hospitals NHS Foundation Trust Bedfordshire, Luton and Milton Keynes ICBįormulary Chapter 18: Emergency Treatment of Poisoning - Full Chapter Administer hydroxocobalamin or sodium thiosulphate and sodium nitrite if the diagnosis is strongly suspected. Management of cyanide toxicity involves air way control, ventilation and 100% oxygen, crystalloids and vasopressor, as needed for hypertension, Sodium bicarbonate is titrated according to arterial blood gas (ABG) and serum bicarbonate level decontaminate the patient with removal of clothing /skin flushing and/or activated charcoal (1g/kg), as appropriate in alert patients or after endotracheal intubation in an unconscious patient through a nasogastric tube after gastric lavage. Clinical features include: initial bradycardia and hypertension, then transient tachypnea, cherry red skin, sooth in the mouth, normal or dilated pupils, diaphoresis, altered mental status, mydriasis, ataxia, generalized convulsions and coma. Cyanide toxicity occurs when cyanide attaches itself to ubiquitous metalloenzymes, rendering cytochrome oxidase inactive, thereby uncoupling mitochondrial oxidase phosphorylation and inhibiting cellular respiration, even in the presence of adequate oxygen stores, consequently affecting tissues (brain and heart) with the highest oxygen requirement. Historically, cyanide has been used as a chemical warfare agent, and it could potentially be an agent for a terrorist attack. Although, a rare form of poisoning, smoke inhalation, suicidal ingestion, industrial exposure, treatment with sodium nitroprusside, long term consumption of cyanide containing foods like apricot, poorly processed cassava, and apple seeds are possible sources of cyanide poisoning. Cyanide toxicity occurs when a living organism is exposed to a compound that produces cyanide ion (CN-) when dissolved in water.
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