POISONED PATIENT AND OVERDOSE

Inclusion Criteria:  Patients with an acute overdose or intoxication.  Paramedics must report to BioTel before leaving the scene all patients with a suspected suicide attempt or suicidal ideation.  Treat patients with altered level of consciousness using the ALTERED LEVEL OF CONSCIOUSNESS Guidelines.

SPECIAL NOTE

EMS personnel should contact BioTel in order to coordinate care of the poisoned patient with the North Texas Poison Control Center and the receiving facility.
This BioTel contact also applies to the asymptomatic pediatric patient with known or suspected poisoning or overdose.

Basic Level

  1. Assess and support ABCs.
  2. Place the patient in a position of comfort.  Place the patient supine, if hypotensive, and treat according to the SHOCK Guidelines.
  3. If the patient requires restraint, follow the RESTRAINT OF PATIENT Policy.
  4. Administer oxygen, as needed, to maintain a SpO2 of at least 94%.
  5. Begin transport as soon as possible.
  6. If carbon monoxide exposure is suspected, refer to the CARBON MONOXIDE EXPOSURE Guidelines.

Advanced Level

  1. Continuously monitor ECG and ETCO2.
  2. If cyanide toxicity is suspected, refer to the CYANIDE TOXICITY Guidelines and to the CYANIDE ANTIDOTE ADMINISTRATION Policy.
  3. Consider establishing IV/IO access at a TKO rate or use a saline lock. 
    1. Administer 20 mL/kg boluses, as needed, to maintain adequate perfusion. 
    2. Do not exceed 1 liter of IV fluids unless authorized by BioTel. 
    3. If needed, refer to SHOCK Guidelines.
  1. For additional patient care considerations (e.g. specific drug intoxications) not covered under standing orders, consult BioTel.