| ID | 221 |
|---|---|
| Name | BARBITURATE POISONING |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | Management: 1. Immediate hospitalization and airway clearence (by tracheostomy or endotracheal intubation if needed) 2. If the patient is conscious vomiting should be induced by either tickling the pharynx or by giving the patient saline water to drink. 3. If the patient is in an unconscious state and if the drug has been taken within the previous 4 hours then give gastric washing by activated charcoal 50 gm in 400 ml dist, water. 4. Oxygen inhalation. (5) litre/m. 5. Infuse 5% dextrose in aqua 2000 c.c. and dextrose in normal saline 1000 c.c. in i. v. drip in 24 hours. 6. Inj. Frusemide. 40-80 mg. i. v. stat and repeat it if necessary after 6-8 hours or 40-80 mg. in i.v. drip and repeat it if necessary. 7. Inj. Sodi-bi-carb (7.5%) 500 c.c in i. v. drip in 24 hours. 8. Inj. Ampicillin 250 mg. i.m. hourly to prevent secondary infection. 9. If no inprovement by above treatment then Inj.-Bemegrtde (1 amp.= l0mg) -1 amp. i.v. stat and repeat it in 10 minute interval if necessary & available. 10. If respiratory failure, then give artificial respira-tion. 11. If urinary incontinence then apply condom catheter. 12. Change die posture every half-hourly. 13. Maintain intake-output chart |
| Introduction | Back ground: Suicidal in middle class or upper class people. Minimum lethal dose (MLD): 1-2gm. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: Clinical feature depends upon the amount of barbiturate consumed. In mild poisoning drowsiness, mild headache, slurred speech and drunken gait present, stupor, slow and shallow respiration, circulatory collapse, cyanosis, cold and clammy skin, dilated fixed pupils, absence of reflexes. Some cases may develop pulmonary odema. In early hours of coma, there may be phase of rigidity of limbs, hyper active reflexes, ankle clonus, extensor planter response and decerebrate posturing. |
| Preventions | |
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