"Whole bowel irrigation" from_date:2012

Whole-bowel irrigation in cases of poisoning: A retrospective multicentre study of feasibility, tolerability, and effectiveness. Whole-bowel irrigation (WBI) is a strategy of gastrointestinal decontamination, recommended by several European and American learned societies, which may be used in the management of the poisoned patients. The objectives of this study were to describe the feasibility

Whole bowel irrigation in dapsone intoxication with persistent methemoglobinemia: A case report. Dapsone intoxication can be a life-threatening condition due its enterohepatic recirculation pharmacokinetics, and therefore, persistent methemoglobinemia development. We describe a case of a 17-year-old girl who was admitted 4 h after ingesting 5 g of dapsone. She presented methemoglobinemia (39 , clearance was enhanced by whole bowel irrigation. After 7 days of hospitalization, she was discharged in good general condition.

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is the antidote of choice. Ethanol should only be held if fomepizole is not available. Ethylene glycol, diethylene glycol, methanol Idarucizumab Dabigatran related active, life-threatening bleeding (use according to local and national guidelines – discuss with local haematologists and NPIS) L-Carnitine Severe sodium valproate toxicity Macrogol '3350' (polyethylene glycol) Klean-Prep® Whole bowel irrigation

of the toxicity of low-level exposure to lead)Gastrointestinal decontamination after ingestion of a lead foreign body or other lead-containing material1Take measures to remove solid lead objects, such as a bullets, lead pellets, jewellery, fishing or curtain weights, that are known to be in the stomach. Strong (very low-certainty evidence)2Consider whole bowel irrigation (WBI) for removing solid lead objects

bowel irrigationC Whole bowel irrigation (WBI) should not be used routinely in the management of the poisoned patient (pg 71).Grade C, Level 2+C The concurrent administration of activated charcoal and WBI may decrease the effectiveness of the charcoal (pg 73).Grade C, Level 2-C WBI should be considered for potentially toxic ingestions of sustained-release or enteric-coated

* No antidote * No activated charcoal (does not bind) * Supportive care and enhanced elimination. * Early crystalloid to enhance renal elimination (initial 1L bolus then 150% of maintenance if fluid tolerant – no CHF, etc.) * Diuretics are contraindicated (can worsen dehydration and elimination of lithium) * Correct electrolyte abnormalities * WBI (whole bowel irrigation): not recommended by Rosen’s[7] What

* Aggressively treat temp (if evaporative cooling does not work, then go for intubation, deep sedation and paralysis) * Physostigmine controversial see belowDecontamination * Generally not needed * There is no role for gastric lavage, whole bowel irrigation, or hemodialysis. * Oral activated charcoalnot indicated UNLESS: * symptomatic patients w/ ingestion of a highly toxic quantity of antimuscarinic plant

: * Cardiac Monitoring * Whole bowel irrigation with pack count * Immediate OR if signs of hemodynamic instability, obstruction or ruptureCriteria for D/C: * Three packet free stools * Reliable packet count consistent with ingestion * Normal contrast study[13] What are the primary risks with MDMA and Methamphetamines? * Amphetamines are stimulants originally designed for use as decongestants and dietary

lavage * Consider whole bowel irrigation if large ingestion of: * Acid * Zinc Chloride * Mercury Wisecracks[1] Is all bleach the same? * Liquid household bleach typically contains dilute (3% to 5%) sodium hypochlorite (NaOCl) * Ingestion rarely causes consequential injury * Industrial-strength bleach, however, contains significantly higher concentrations of NaOCl, which are more likely

in terms of guiding specific therapy. * Syrup of ipecac is not indicated in the ED care of a poisoned patient. Gastric lavage is not part of routine care. When given in a timely fashion (1 hour post ingestion), activated charcoal may be indicated for potentially lethal agents in alert, cooperative patients. * Whole-bowel irrigation is rarely useful for management of poisoned patients but is potentially not recommend the routine use of activated charcoal following ingestion. We do, however, recommend its use in certain overdose scenarios.” – Rosen’s page 1819 – 9th Ed. For a comprehensive algorithm to guide your decisions surrounding administration of activated charcoal, see Figure 139.1 in Rosen’s 9th Edition[8] For Whole Bowel Irrigation, List the Indications and Describe the Method

of iron toxicitySo you suspect it on hx (shooting a screening abdominal plain film may be helpful)! * [false-negative radiographs may occur with chewable, liquid, and completely dissolved iron compounds. Repeated radiographs can also demonstrate the efficacy of gastrointestinal decontamination efforts.]Activated charcoal does NOT bind iron. Whole bowel irrigation is the method of choice

bowel irrigation. Thirteen (11%) were admitted, 3 to the ICU. No morbidity or mortality was reported. The majority of unintentional pediatric lithium ingestions examined were exploratory and resulted in no significant symptoms. Only a small minority had detectable serum lithium concentrations. All isolated lithium exposures were asymptomatic. Unintentional exposures appear to be benign, even available: 19 (28%) were detectable (>0.1 mEq/L) and 4 were supratherapeutic (>1.2 mEq/L).One hundred (85%) patients were coded as having no effects. Four (3%) patients had coded effects-1 mild, 2 moderate, and 1 major; all were polydrug ingestions and recovered fully with basic supportive care. The loss to follow-up rate was 12%.A small minority received treatment with intravenous fluids and/or whole

concentration of 116 µg/24 h. An abdominal radiograph showed opacifications throughout her bowel, and she received whole bowel irrigation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pica is a common behavior in certain populations. Practicing clinicians should be familiar with the complications of pica, including chronic arsenic toxicity and its associated array of nonspecific symptoms.

benefit from internal decontamination with gastric lavage or whole bowel irrigation, but both procedures are high-risk and should be performed under the direction of your local poison control centre. Patients who can swallow or have an endotracheal tube in place and have ingested a toxin amenable to adsorption may be treated with activated charcoal.5 4. Antidote: The treatment for most toxidromes

to be an exclusion here? I am assuming that seizures were excluded because those patients never need to be intubated, but they aren’t clear on that point. Finally, although completely unproven, they make no mention of the one reason I occasionally consider intubation toxicology patients: other interventions, such as charcoal or whole bowel irrigation. Even the general exclusion of any patients with an “immediate

Polyethylene glycol electrolyte lavage solution increases tablet dissolution of acetaminophen in an in vitro model mimicking acute poisoning. Polyethylene glycol electrolyte lavage solution (PEG-ELS) is similar to pharmaceutical solvent propylene glycol and used following acute poisonings for whole bowel irrigation (e.g., "body stuffing"). This raises concern of PEG-ELS increasing solubility