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Case Report: Survival After Deliberate Strychnine Self-Poisoning, With Toxicokinetic Data, David Michael Wood, Emma Webster, Daniel Martinez, Paul Ivor Dargan, Alison L. Jones
Case Report: Survival After Deliberate Strychnine Self-Poisoning, With Toxicokinetic Data, David Michael Wood, Emma Webster, Daniel Martinez, Paul Ivor Dargan, Alison L. Jones
Faculty of Science, Medicine and Health - Papers: part A
Introduction Strychnine poisoning is uncommon, and in most severe cases, the patient dies before reaching hospital. The management of strychnine poisoning is well documented, although there are few data on the kinetics of elimination of strychnine after overdose. Case report A 42-year-old man presented shortly after ingestion of an unknown quantity of strychnine powder. After a respiratory arrest, with intensive supportive management requiring admission to an intensive care unit, he survived. Eight serum samples were taken over the first 5 days and analysed subsequently for strychnine concentrations. Results The initial concentration at 1.5 hours after ingestion was 4.73 mg/l, falling …
Acetaminophen Poisoning: An Update For The Intensivist, Paul I. Dargan, Alison L. Jones
Acetaminophen Poisoning: An Update For The Intensivist, Paul I. Dargan, Alison L. Jones
Faculty of Science, Medicine and Health - Papers: part A
Acetaminophen overdose is common and can result from deliberate/nonstaggered or accidental/staggered ingestion. Patients presenting within 24 h of an acetaminophen overdose can safely be managed on medical wards. Early management of nonstaggered overdose is guided by the plasma acetaminophen concentration, whereas management of accidental/staggered ingestion is guided by ingested dose. Ingested dose and time from ingestion to presentation are important prognostic factors in accidental/staggered ingestion. Acetaminophen-induced acute liver failure (ALF) requires meticulous supportive care in an intensive care unit (ICU), with early identification and transfer of patients who are likely to require liver transplantation to a specialist liver centre. The …