See treatment and investigations.
Clinical features
- • Anticholinergic (mydriasis, dry, warm, delirium)
- • QRS widening, arrhythmia
- • Hypotension, seizures, coma
Investigations
- • ECG (QRS >100 ms = toxicity; >160 = high seizure/arrhythmia risk)
- • ABG
Management
- • Sodium bicarbonate 1-2 mmol/kg IV bolus if QRS >100 ms or arrhythmia; target pH 7.5-7.55
- • Benzo for seizure
- • IV fluids + noradrenaline for hypotension
- • Intubate if GCS <8
- • AVOID Class Ia/Ic antiarrhythmics
- • Lipid emulsion in refractory arrest
Related in WardRound
Educational — verify locally.
