Red Flower Publications

Critical Care Nursing in Emergency Toxicology

Editor(s)/Author:

Vivekanshu Verma, MBBS, DFM

Status: Available

Publication Year: 2019-11-01

Toxicology is a notoriously difficult subject to master considering the volume of information that needs to be memorized. Critical Care Nursing in Emergency Toxicology is the need of the hour. The authors have made easier to remember all this, with the help of quirky mnemonics, toxic poems, easy recalls & point wise discussion. It has authentic knowledge from the latest concepts in managing poisoning. Simple words are used with least medical jargon, easy to understand and recall for the health care providers. Highlights of this Book includes: Toxidromal approach in examination & diagnosis, Crime Scene Investigation (CSi) by Toxic Detective Nurse in poisoning, Accreditation norms for drug management in ER, Dosing & Dilution in toxicology, Mega-doses of antidotes available in pharmacy, Chain of custody for samples to forensic lab, Physical restraints & chemical restraints in violent intoxicated patients, Involuntary admission in psychiatric drug addict patients, Precautions in nursing suicidal attempters after poisoning, Narcotic drugs in double lock under NDPS act, Nursing Drug addicts & Alcohol Withdrawal patients, Nursing Precautions in Opioid dependent Cancer patients, Do Not Resuscitate (DNR) in toxicology, Organ transplantation in toxicology. Toxic Poems by Toxic Detective: Poems & Paintings for Prevention of Poisoning in Paediatrics. An unconventional literary approach to learn and teach Drug Overdoses, Venomous bites & stings related Poisonings in Rhymes includes Drinking Driving, Enough is Enough, What to Eat, What to Drink, and What to Leave for Poison, Kiss of life, Saving lives from autopsy knives, Snakebite, Snake poem, Long snake- Little wound- Larger damages- Lives Lost, Viper bites, Scorpion Stings, Pesticides, Coral Snakes Rhyme, Atropa Belladona, Colouring pages for venomous snakes, ants, bee, wasp, scorpions, poisonous plants- opium, Dhatura. The environment in Emergency & Intensive care is very stressful & challenging, not only for the budding nurses & resident doctors, who don’t have the experience & expertise to manage the fatal poisoning exposures, but also for toxicology nurses & emergency doctors, due to unpredictable outcome & high risk of mortality & morbidity, managing at odd hours in midnight duties, while overcoming their sleep & exhaustion, for which this book will be the to be read & consulted, at a stressful location (ICU, Emergency. Crime Scene Etc.,) as a Stress-Buster to Stressed & Burned-out Nurses & Doctors; as well as a Myth-Buster (to administer antidote or not, to do gastric lavage or not), and this book will be this year’s Block-Buster (Indian ICU Nursing Book on Emergency Toxicology).

Dedicate the First Edition to v
Foreword to First Edition    vii
Foreword to First Edition    ix
Foreword to First Edition    xi
About the Book xiii
Preface    xv
Acknowledgement xvii
List of Contrubutors xix
Senses Developed for Toxic-Detectives Nurses 1
Colour Coding for Patient Risk Identification 5
1-2-3-4-5-6 Mnemonics 7
Toxidromic Approach 11
Recalling Rights of Medications 13
Accreditation Norms in Toxicology 15
Antidotes At A Glance 17
Activated Charcoal 18
Anaphylaxis Management in Toxicology 26
Basics of Managing Drug Overdose 28
Brain Death in Posioning: Diagnostic Dilemma 33
Classifying Poisoning Based on Their Effect/Outcome   34
Crime Scene Investigation 36
Controlled Substances Storage Guidelines 39
Cognizable Offences in Toxicology 41
Crime Scene in Toxicology            49
Decoding IPC in Toxicology           53
Drug Errors and Incident Reporting          59
Dialysis in Intoxication: Queries Answered 62
Differential Diagnosis of Coma in Suspected Poisoning   65
“Do not use” List of The Joint Commission Guidelines in Toxicology          66
Dose & Dilution of Antidotes in Intoxication 69
Drug Schedules in Drugs & Cosmetics Act 72
Toxic Drug Names Made Easy 78
Fit to Fly in Sedated & Intoxicated            87
Gaps & Graphs in Poisoning        89
Glucose as an Antidote 92
Hazmat Protocol                94
Heparin & Its Antidote Protamine 96
How to Write Mediolegal Report in Poisoning Case          105
Iatrogenic Misconducts & Addicitons 108
Lipid Therapy 114
Liquor Liability in Alcohols 117
Managing Errors in Toxicology: Incident Reporting 119 Marine Envenomation (Sea-Bather Sickness): Toxi-Mnemonics 121
Medical Device Rules & Heavy Metal Toxicity with Implants         127
Advance Medical Directives        138
Methanol Outbreak Management Made Ridiculously Simple 140
Murder or Accident in Toxicology Section 80 IPC                148
Mnemonics in Toxicology             151
Mushroom Poisoning     153
N-AcetylCysteine (NAC)- Antidote 158
Naloxone–Antidote in Opioid Toxicity 160
Narcotics – Opioid Policy for Nursing   163
Non-Toxic-Labs decoding by Toxic Detective Nurse          166
Organ Transplantation in Toxicology 169
Para- Medicolegal & Toxicological Importance 177
Paradox* for Toxic Detective Nurse 182
Pesticides Poisoning Management Made Ridiculously Simple      185
Managing Injured – Intoxicated 189
Postmortem Examination in Toxicology 193
Preparation Errors in Toxicology 196
Iatrogenic Drug Errors 198
Prevention of Medication Errors in Toxicology 204
Rail Road Poisoning: Stupefying Agents 206
Rat Poisons         208
Thallium Toxicity               213
Reconciliation Errors in Toxicology 220
Samples Preserved for Toxicological Analysis 221
Medical Etiquettes in Toxicology 223
Indian Society of Life Support Courses 225
Scorpion Sting Poisoning (िबचछुडंक) 231
Snakebite 238
Dosing & Dilution in Polyvalent Anti-Snake-Venom          242
Snake Identification Made Easy 244
Snakebite Management Protocol 247
Stress-Related Errors In Toxicology 258
Adverse Drug Reaction 259
Antidote in Alcoholics    263
Toxic-Plants for Toxic-Detective Nurses 266
Good-vs-Bad Chemicals in our Homes 271
Toxic Cosmetics Makeup by Toxic - Detective 275
Toxscreens from Urine Samples 284
Toxic- Dance Decoding by Toxic Detective Nurse*            286
Triaging Critically Toxic Patients in ER 289
Driver’s Fitness & Traffic Rules 293
Violent Crimes Associated with Intoxication 295
WHO Recommended Qualitative Colour Tests in Toxicology         301
Appendix            304
Toxic Poems by Toxic Detective 304
Bibliography & Suggested Reading 380
Our More Medical Books on Topic of *Toxicology* Management Authored 381

Dr Vivekanshu Verma, MBBS, DFM is a unique combination of a Clinical Toxicologist, Author, Editor, Poet, Clinical Forensic physician, Medical Examiner, Instructor, Skill Trainer& Medicolegal Expert. He is Honorary Toxicology Expert, Central Bureau of Investigation. He is currently posted as Associate Consultant& Fellow in Department of Emergency& Trauma Care, MEDANTA the Medicity, Gurugram.He has been honoured recently by “Award of excellence in field of Forensic Medicine and Toxicology” by Indian Association of Forensic Medicine, 2019. He ranked 9th in Pre-Medical Test (1997), Ranked 1st in PG foundation programme at SMS Medical college, Jaipur (2009), Ranked 1st in Rajasthan University of Health Sciences in Diploma in Forensic Medicine (2011). He is Associate faculty in Department of Forensic Medicine & Toxicology, Saveetha Medical College, Chennai&Interstate Medical Examiner in Masters in Emergency Medicine exit examination by George Washington University. He is appointed asIndian Society of Toxicology (IST) Vice President- North Zone, for (2018-19). He is appointed as Coordinator of Indian Society of Toxicology Life Support Course (ISTOLS). He has Experience of presenting and contributing to featured series on Emergency in Broadcast Media:Featured as Consultant Toxicologist in National Geographic serial ‘Emergency Room’ Documentary recorded in Medanta: Performed Lifesaving skills in 3 episodes of international TV serial telecasted in 2013- 2014.He is anAuthor & Editor in internationally published Medical Books on Medical Toxicology. Capt. Sandhya Shankar Pandey, RN, RM; BSc Nsg (Hons), MBA (Healthcare Management), MBA (Human Resource Management); PG Dip. (Clinical Leadership – National University of Singapore). She is currently Director Nursing, Medanta -The Medicity, Gurugram. She has Twenty four years contribution to Military Nursing, Industrial and Corporate Nursing and Healthcare Quality Assurance. She is NABH Assessor; NABH Nursing Excellence Faculty and Assessor; AHA Instructor. She received General Kariappa’s Medal for Best All-round Nursing Officer at AFMC; Jun 1998.She is honoured in 2016 with Max India Chairman’s Award in recognition of consistent outstanding performance across employees of Max India Group of Companies. She is recently honoured with"Woman Leadership Award" at the "National Healthcare Leadership Congress and Awards" by Zee Business, 2019. She has authored Hospital Housekeeping Guidelines for Indian Hospitals; facilitated, Published and released by Ministry of Health and Family Welfare. Dr Atul Bansal,MBBS, MRCEM, FRCEM, is currently working as Consultant, Emergency Medicine, Frimley Health NHS Foundation Trust, Wexham Park Hospital, Sough SL2 4HL, United Kingdom.