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Surgical issues in the poisoned patient
Ashok L Jain1, Gregory J Robertson, Maria I Rudis
1Department of Emergency Medicine, LAC + USC Medical Center, Keck School of Medicine, 1200 N. State Street, Los Angeles, CA 90033, USA. ajain@usc.edu
Emergency Medicine Clinics of North America
|January 8, 2004
Summary
Emergency physicians (EPs) must recognize when surgical intervention is needed for toxicologic emergencies. Familiarity with surgical decontamination methods and vigilance for delayed organ failure requiring transplantation are crucial for optimal patient outcomes.
Area of Science:
- Toxicology
- Emergency Medicine
- Surgical Critical Care
Background:
- Toxicologic emergencies can necessitate surgical intervention beyond standard medical management.
- Many such poisonings and exposures are infrequent, posing a challenge for emergency physicians (EPs).
Purpose of the Study:
- To highlight the critical role of surgical intervention in managing specific toxicologic emergencies.
- To emphasize the need for EPs to be knowledgeable about surgical decontamination techniques and potential complications.
Main Methods:
- Review of indications for operative care in toxicologic emergencies.
- Discussion of surgical decontamination modalities, including cardiopulmonary bypass.
- Emphasis on recognizing delayed presentations and organ failure.
Main Results:
- Surgical intervention is a vital component of care for select toxicologic emergencies.
- Knowledge of surgical decontamination and transplantation referral is essential for EPs.
- Vigilance for delayed organ failure is critical.
Conclusions:
- Emergency physicians must be prepared for rare but critical toxicologic emergencies requiring surgical management.
- Expertise in surgical decontamination and timely transplantation consultation are paramount.
- Proactive management can improve outcomes in severe poisoning cases.