pt admitted to ER with bleeding gums, bloody emesis, bruises all over. She admitted of having ingested rat poison. what's the immediate treatment?
Immediate treatment is with FFPs.
contains what is known as 'Superwarfarins' commonly seen in rodenticides aka rat poison... the method of killing in rat is blockage of Vit K cycle====> no production Vit K dependent coagulation factors 2, 7, 9, 10====> extensive bleeding and death!
Same thing happens in humans as well
"she admitted to have consumed rat poison"--- an unlikely vignette coz most questions are 'most common' kinda question--- therefore the commonest exposure type is accidental and commonest exposure group will be children under 6!
and yeah... FFP seems to be the best answer
i didn't make this test, and it was like that in the test, isn't it possible someone to try kill herself with a rat poison? especially a woman, who changes her mind in the halfway?
blood transfusion (for blood loss) + FFP (for coagulation factor replacement) + IV Vit K ( to compensate for all the lost VitK)----> First line therapy
yeah you are right---can be possible-- hovering over to behavioral science for a sec-- Men are suicide completers and women are attempters!
i had a patient a young lady who had 28 suicide attempts, and would go to bathroom, lock herself up, pull out her tracheostomy and call for help when she was starting to choke.
FFP + VIT K IV + BT but always ABC first
NPO
airway
IVF
ekg
TYPE AND CROSS MATCH /CBC/CMP/UA/BT/CLOTTING PROFILE/cxr/ua
AND ADMIT ICU