The acute management of poisoning

Poisoning is commonly encountered in acute medical practice and can involve toxicity arising from exposure to any one of a large number of different drugs or chemicals. Clinical toxidromes can help to define particular toxicological mechanisms so that appropriate treatments can be considered. The electrocardiogram and arterial blood gas are particularly important assessing poisoned patients, and laboratory drug confirmation plays a role in some situations. Oral activated charcoal is capable of reducing the gastrointestinal absorption of a number of drugs and chemicals. A wide range of specific antidotes are available, including acetylcysteine. Generalized strategies that minimize toxicity include haemodialysis and intravenous lipid administration for selected poisonings. Poisons units provide access to specialist expertise and poisoning management advice.