Norepinephrine is useful for patients with substantial vasodilation, such as those intoxicated with:.Epinephrine is generally a good choice, as it may help improve bradycardia and hypotension.In severe intoxications, volume overload often becomes a major problem – so avoid over-resuscitation.However, most patients aren't hypovolemic. Administer fluid if there is evidence of hypovolemia.Try to determine whether the primary problem is vasodilation versus pump failure.If the patient received a dose of charcoal, passage of charcoal per rectum may also be a sign of adequate evacuation. Continue until effluent is clear (just as one would for a colonoscopy prep).If emesis occurs, reduce the rate by 50%. An isotonic solution of polyethylene glycol (i.e., “GoLytely”) may be infused via an orogastric tube, beginning at a rate of 1.5-2 liters/hour.This may be conceptualized as an accelerated preparation for a colonoscopy. ![]()
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