Critical Thinking Example: Poisonous Substances on a Medical Ward Unit

Poisoning can either be accidental or deliberate and can occur through injection, topical absorption, inhalation or oral ingestion. Physical assessment commences as soon as a patient is brought to the emergency room (ER) (Williams, R. & Erickson, T. 2015, 103).Notably, all these resuscitation procedures following poisoning are within the framework of the departments protocol and should not be violated. The initial process is reviewing the patients breathing, airway, and circulation (Eddleston, M., Buckley, N. Eyer, P. & Dawson, A. 2008, 598). The medical professional also checks the level of consciousness of the patient to get some information if possible (Erickson, T., Thompson, T. & Lu, J. 2007, 257). The patients respiratory system should also be checked since certain poisons either reduce or increase the respiratory process. The patient should have a clear airway, which implies the removal of debris such as dentures, vomits and mucus (Vale, A. & Bradberry, S. 2016, 84).

The secretions can be sucked away, and the health personnel can conduct tracheotomy if required (Eddleston, M. et al. 2008, 601). As part of the assessment, it is necessary to provide adequate ventilation and suppress convulsion. Underventilation may result in hypoxemia, while overventilation may cause hypertension and alkalosis (Williams, R. et al. 2015, 106). The convulsions should be controlled by way of adequate ventilation in the ER. Notably, the healthcare personnel must avoid barbiturates, which is similar to intense anesthesia. Barbiturates are the initial sedatic hypnotic agents that were mostly prescribed before benzodiazepines, a hypnosedative drug that is less toxic (Daly, F., Little, M. & Murray, L. 2006, 397). The blood volume circulation and the restoration of cardiac output and venous re-tune. This practice is called electrolyte and fluid therapy.

The healthcare provider must administer a liter of isotonic saline along with a liter and isotonic glucose each day (Vale et al. 2016, 87). The balance of fluid and the volume of urine have to be recorded to avert renal failure or manage it if evident. The gastric lavage in the stomach should be emptied especially if the patient is conscious (Eddleston, M. et al. 2008, 599). Although inducing vomiting is acceptable sometimes using ipecac syrup, it should not be the case when the patient is unconscious or drowsy (Erickson, T. et al. 2007, 273). Also, vomiting should not be induced if the patient has ingested corrosive mineral acid or caustic alkali.

References

Daly, F.F.S., Little, M. and Murray, L., 2006. A risk assessment based approach to the management of acute poisoning. Emergency medicine journal, 23(5), pp.396-399.

Eddleston, M., Buckley, N.A., Eyer, P. and Dawson, A.H., 2008. Management of acute organophosphorus pesticide poisoning. The Lancet, 371(9612), pp.597-607.

Erickson, T.B., Thompson, T.M. and Lu, J.J., 2007. The approach to the patient with an unknown overdose. Emergency medicine clinics of North America, 25(2), pp.249-281.

Vale, A. and Bradberry, S., 2016. Assessment and diagnosis of the poisoned patient. Medicine, 44(2), pp.82-86.

Williams, R.H. and Erickson, T., 2015. Evaluating toxic alcohol poisoning in the emergency setting. Laboratory Medicine, 29(2), pp.102-108.