Types of beds

Other resources

Labs

Imaging

Recording in the stab room

Sign outs

Asthma

Chest Pain

Overdose

Renal Patients

Seizures

Vaginal Bleed

Wound Care

• History and Physical Exam
  
  1. Obtain ingestion history including amount and type of pills, time of ingestion, other drugs involved including alcohol, any access to over the counter medication.
      
  2. History of depression or prior suicide attempts.
      
  3. If the patient is not cooperative or gives a vague history, try calling their house or friends and you may be able to get better information. Often the paramedics can give you a good history of what they found at the residence.
      
  4. On physical exam pay special attention to vital signs and mental status. Pupils should be checked for size and reactivity. It is important to continue to reevaluate the patients mental status.
     
     
• Work-up
1. Read Dr. Ling’s packet on approach to an overdose which is in your orientation packet.
    
2. Involve poison center early and they can give you recommendations and valuable information about the drugs taken.
    
3. Charcoal should be given early. If the patient refuses they may need a NG tube. If you think they are too sleepy to protect their airway when they take the charcoal be sure to let staff or a senior know.
    
4. These people need to be on a hold and in restraints. The staff or senior can sign the hold.
    
5. Often we obtain a Tylenol and Salicylate level/ Panel 3 on these patients.
    
6. They need to be on a cardiac monitor and pulse ox.
    
7. Continue to reassess their vital signs and mental status.
   
   
• Disposition
  
1. If after observation the decision is made that they are stable then the patient should be transferred to CIC. Call crisis at 73161 then fill out the CIC transfer form.
    
2. Admitted for monitoring – most patients go to the MICU, discuss with staff or the senior resident.