Hypoglycemics Plant Poisoning Treatment & Management

  • Author: Jennifer Coles Schecter, MD; Chief Editor: Asim Tarabar, MD   more...
 
Updated: Jan 12, 2011
 

Prehospital Care

  • Hypoglycemia and airway compromise should be identified.
  • Intravenous access and administration of dextrose, benzodiazepines (if needed to control seizures), and dextrose-containing intravenous fluid, as necessary, should be provided.
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Emergency Department Care

  • ED management of ackee poisoning is mainly supportive.
  • Obtain a rapid fingerstick glucose and initiate glucose replacement with D50W boluses (D25W boluses in young children and D10W in neonates) and continuous infusions of 10% dextrose, as needed.
  • Airway assessment and endotracheal intubation, if necessary, should be performed.
  • Activated charcoal may be administered once the airway is secured.
  • Electrolyte status should be assessed.
  • Antiemetics such as metoclopramide, odansetron, or granisetron may be administered for profuse vomiting.
  • Seizure precautions should be followed; treat seizures with benzodiazepines and dextrose.
  • Theoretically, L-carnitine could be beneficial similar to its effect in valproic acid toxicity.
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Consultations

  • Consultation with a poison center and toxicologist may be helpful.
  • Contact public health authorities for suspected outbreaks.
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Contributor Information and Disclosures
Author

Jennifer Coles Schecter, MD  Staff Physician, Department of Emergency Medicine, Lahey Clinic, Burlington, MA

Disclosure: Nothing to disclose.

Coauthor(s)

Sage W Wiener, MD  Assistant Professor, Department of Emergency Medicine, State University of New York Downstate, Director of Medical Toxicology, Department of Emergency Medicine, Kings County Hospital Center

Sage W Wiener, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Emergency Medicine, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

B Zane Horowitz, MD, FACMT  Professor, Department of Emergency Medicine, Oregon Health and Sciences University; Medical Director, Oregon Poison Center; Medical Director, Alaska Poison Control System

B Zane Horowitz, MD, FACMT is a member of the following medical societies: American Academy of Clinical Toxicology and American College of Medical Toxicology

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Michael Hodgman, MD  Assistant Clinical Professor of Medicine, Department of Emergency Medicine, Bassett Healthcare

Michael Hodgman, MD is a member of the following medical societies: American College of Medical Toxicology, American College of Physicians, Medical Society of the State of New York, and Wilderness Medical Society

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

References

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