First 30 seconds
- 1ABCDE, IV access, continuous ECG
- 2Intubate if GCS ≤8 or refractory seizure
- 3Activated charcoal 50 g if <1 h and airway protected
- 412-lead ECG
Overdose of TCA causing Na-channel blockade, anticholinergic effects, α-blockade, seizures.
A
Airway
- • Patent? Talking? Stridor?
- • Suction, jaw-thrust, adjuncts, definitive airway if needed
B
Breathing
- • RR, SpO₂, auscultate, percuss
- • O₂ to target sats, NIV / intubate as required
C
Circulation
- • HR, BP, cap refill, JVP
- • 2× large-bore IV, bloods, monitor, ECG
D
Disability
- • AVPU/GCS, pupils, glucose, temp
E
Exposure
- • Full exposure, skin, rash, bleeding, lines, infection source
