Contributor: JP Brewer, MD
- Obtaining collateral is often vital to determine the potential drugs accessible to the patient – this may include medications found in their medicine cabinet prescribed to them or a family member
- After this, use ancillary sources such as EMS, family/friends, and police to determine the patient’s last normal, PMH and medications
- To help separate toxidromes, pupillary exam and skin exam are helpful
- Important physical exam clues in toxicology include the pupils and the skin
- Adjunct laboratory evaluation may include liver function tests, acetaminophen level, salicylate levels, urine drug screens, particularly in unknown ingestions
- Your local toxicologist (if you are fortunate to have one) or the Poison Center can always provide assistance in treatment and workup – consider involving them early
Erickson TB, Thompson TM, Lu JJ. The approach to the patient with an unknown overdose. Emerg Med Clin North Am 2007; 25:249.