![]() Perform carboxyhemoglobin (CO) device assessment, if available.Monitor pulse oximetry and ETCO 2 for respiratory decompensation.Attach cardiac monitor and examine rhythm strip for arrhythmias (consider 12-lead EKG).Assess ABCD and, if indicated, expose patient for assessment, and then re-cover to assure retention of body heat.Consider body substance isolation (BSI) or appropriate PPE.Consider using environmental Carbon Monoxide (CO) detector on “first in” bag if possible Serotonin Syndrome (presentation with at least three of the following).Normal or depressed vital signs (pulse, respirations, blood pressure).Bronchospasm/ Bronchorrhea/ Bradycardia (the killer Bs).Cholinergic (DUMBELS) DUMBELS is a mnemonic used to describe the signs and symptoms of acetylcholinesterase inhibitor agent poisoning – all patient age groups are included where the signs and symptoms exhibited are consistent with the toxidrome of DUMBELS.“Tachy” like a pink flamingo (tachycardia and hypertension). ![]() Mad as a hatter (Altered mental status).These toxidrome constellations may be masked or obscured in poly pharmacy events Toxidromes (constellations of signs and symptoms that add in the identification of certain classes of medications and their toxic manifestations).Known exposure to toxic or irritating gas.Chemical burns around or inside the mouth.Signs and symptoms may include, but are not limited to, the following: Presentation may vary depending on the concentration and duration of exposure.Treat signs and symptoms in effort to stabilize patient. ![]()
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