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Vital signs

Diagnosing toxicity from vital signs

 

Bradycardia (PACED)

  • Propranolol (beta-blockers), poppies (opiates), propoxyphene, physostigmine
  • Anticholinesterase drugs, antiarrhythmics
  • Clonidine, calcium channel blockers
  • Ethanol or other alcohols
  • Digoxin, digitalis

Tachycardia (FAST)

  • Free base or other forms of cocaine, freon
  • Anticholinergics, antihistamines, antipsychotics, amphetamines, alcohol withdrawal
  • Sympathomimetics (cocaine, caffeine, amphetamines, PCP), solvent abuse, strychnine
  • Theophylline, TCAs, thyroid hormones

Hypothermia (COOLS)

  • Carbon monoxide
  • Opioids
  • Oral hypoglycemics, insulin
  • Liquor (alcohols)
  • Sedative-hypnotics

Hyperthermia (NASA)

  • Neuroleptic malignant syndrome, nicotine
  • Antihistamines, alcohol withdrawal
  • Salicylates, sympathomimetics, serotonin syndrome
  • Anticholinergics, antidepressants, antipsychotics

Hypotension (CRASH)

  • Clonidine, calcium channel blockers
  • Rodenticides (containing arsenic, cyanide)
  • Antidepressants, aminophylline, antihypertensives
  • Sedative-hypnotics
  • Heroin or other opiates

Hypertension (CT SCAN)

  • Cocaine
  • Thyroid supplements
  • Sympathomimetics Caffeine
  • Anticholinergics, amphetamines
  • Nicotine

Rapid respiration (PANT)

  • PCP, paraquat, pneumonitis (chemical), phosgene
  • ASA and other salicylates
  • Noncardiogenic pulmonary edema, nerve agents
  • Toxin-induced metabolic acidosis

Slow respiration (SLOW)

  • Sedative-hypnotics (barbiturates, benzodiazepines)
  • Liquor (alcohols)
  • Opioids
  • Weed (marijuana)

Coma (LETHARGIC)

  • Lead, lithium
  • Ethanol, ethylene glycol, ethchlorvynol
  • Tricyclic antidepressants, thallium, toluene
  • Heroin, hemlock, hepatic encephalopathy, heavy metals, hydrogen sulfide, hypoglycemics
  • Arsenic, antidepressants, anticonvulsants, antipsychotics, antihistamines
  • Rohypnol (sedative hypnotics), risperidone
  • G: GHB
  • Isoniazid, insulin
  • Carbon monoxide, cyanide, clonidine
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