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Critical Care Reviews |

Adult Toxicology in Critical Care*: Part I: General Approach to the Intoxicated Patient

Babak Mokhlesi, MD; Jerrold B. Leiken, MD; Patrick Murray, MD; Thomas C. Corbridge, MD, FCCP
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*From the Division of Pulmonary and Critical Care Medicine (Dr. Mokhlesi), Cook County Hospital/Rush Medical College, Chicago; Evanston Northwestern Healthcare-OMEGA (Dr. Leiken), Chicago; Section of Nephrology (Dr. Murray), University of Chicago, Chicago; and Medical Intensive Care Unit (Dr. Corbridge), Northwestern University Medical School, Chicago, IL.

Correspondence to: Babak Mokhlesi, MD, Division of Pulmonary and Critical Care Medicine, Cook County Hospital/Rush Medical College, 1900 West Polk St, Chicago, IL 60612; e-mail: Babak_Mokhlesi@rush.edu



Chest. 2003;123(2):577-592. doi:10.1378/chest.123.2.577
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Intensivists are confronted with poisoned patients on a routine basis, with clinical scenarios ranging from known drug overdose or toxic exposure, illicit drug use, suicide attempt, or accidental exposure. In addition, drug toxicity can also manifest in hospitalized patients from inappropriate dosing and drug interactions. In this review article, we describe the epidemiology of poisoning in the United States, review physical examination findings and laboratory data that may aid the intensivist in recognizing a toxidrome (symptom complex of specific poisoning) or specific poisoning, and describe a rational and systematic approach to the poisoned patient. It is important to recognize that there is a paucity of evidence-based information on the management of poisoned patient. However, the most current recommendations by the American Academy of Clinical Toxicology and European Association of Poisons Centers and Clinical Toxicologists will be reviewed. Specific poisonings will be reviewed in the second section of these review articles.

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