Pediatric emergency medicine trisk 3052 3052

Iron Isoniazid (INH) Local anesthetics Methanol/ethylene glycol Methemoglobinemic agents Opioids Phenothiazines (dystonic reaction) Sulfonylureas Tricyclic antidepressants Warfarin (and “superwarfarin” rat poisons) Animals PO every 12 hrs for 14 days (Mercury, Lead ) Deferoxamine: 5–15 mg/kg/hrs IV; use higher dosage for severe symptoms (see text) and decrease as patient recovers Pyridoxine 5–10%, g per gram of INH ingested (70 mg/kg up to g if dose unknown) IV slowly over 30–60 Intravenous lipid emulsion 20%, 1.5 mL/kg bolus followed by infusion of 0.25 mL/kg/min Fomepizole: Load 15 mg/kg; maintenance 10 mg/kg q12h doses, then 15 mg/kg q12h (dose should be adjusted during dialysis) Ethanol loading dose: 600 mg/kg infused over hr (use only if fomepizole unavailable) Ethanol maintenance: 110 mg/kg/hr infusion; adjust as needed with target level 100 mg/dL Folate 1–2 mg/kg IV every 4–6 hrs (methanol) Thiamine 0.25–0.5 mg/kg and pyridoxine 1–2 mg/kg every hrs (ethylene glycol) Methylene blue 1%, 1–2 mg/kg (0.1–0.2 mL/kg) IV slowly over 5–10 if cyanosis is severe or methemoglobin level >40% Naloxone 0.04–2 mg IV, IM, sublingual or by ETT; may repeat up to total 8–10 mg in adolescent/adult (see text) Diphenhydramine, 1–2 mg/kg IM or IV; or benztropine, 1–2 mg IM or IV (adolescents) Octreotide 1–2 μg/kg/dose subcutaneous (SC) or IV every 6–12 hrs Sodium bicarbonate, 1–2 mEq/kg IV Vitamin Kt 10 mg (adult); 1–5 mg (pediatric) IV, IM, SC, PO Antivenin b for envenomation (see Chapter 10 Shock )