A Single Pill

  • 4y/o boy

    p/w ? tablet ingestion

    PMH: fit & well, no previous health / DHHS contacts

    Hx
    Mother found child playing with her tablets
    All tablets poured on to the floor
    Possible ingestion
    Now seems not himself

    Mothers Medication:
    Paracetamol, Metformin, Gliclazide, Verapamil SR, Oxycodone, Aspirin

  • o/e looks unwell
    A: maintaining
    B: no WOB, normal RR
    C: bradycardia, hypotension, cool, cCRT 3
    D: eyes to voice, temp 36 BSL 10

  • CCB toxicity

  • ECG
    Bloods: including screening paracetamol level & VBG (note iCa)

  • Fluid resus: 10-20ml/kg
    Adrenaline: bolus + infusion
    HIET
    Noradrenaline
    Calcium gluconate
    Elective early intubation (initial stabilization then RSI)
    aCharcoal NGT

  • Calcium Channel Blocker Overdose

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