小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 心动过速
- 高血压
- 低血压
- 瞳孔缩小
- 瞳孔散大
- 心动过缓
- 精神状态改变
- 幻觉
- 惊厥
其他诊断因素
- 恶心
- 呕吐
- 腹痛
- 腹泻
- 呼吸困难
- 皮肤潮红
- 皮炎
- 皮肤/黏膜刺激
- 可见出血：鼻衄、黑粪症、血尿症、呕血、咯血
- 头痛
- 胸痛
- 肌肉疼痛/肿胀
- 皮肤苍白
- 容易出现瘀伤
- 瘀点
- 黄疸
- 扑翼样震颤
- 腹水
- 肝掌
- 蜘蛛痣
- 发汗
- 皮肤干燥
- 发热
- 尿潴留
- 便秘
- 过度换气
- 肌束震颤
- 神经肌肉无力
- 感觉改变
危险因素
- 采食野生植物
- 将野生植物发酵成茶
- 孩子被发现或被怀疑摄入了植物
诊断性检查
首要检查
- 心电图 (ECG)
- 全血细胞计数 (FBC）
- 血清电解质
- 血清肌酐
- 血清乳酸
- 血清尿素/肌酐
- 肝功能检查
- INR
- 动脉血气 (ABG)
- 胸部 X 线检查
需考虑的检查
- 肌钙蛋白水平
- 血清地高辛水平
- 对毒扁豆碱的反应
治疗流程
所有患者
撰稿人
作者
Susan Smolinske, PharmD, DABAT, FAACT
Director
New Mexico Poison and Drug Information Center
Professor
Pharmacy Practice and Administrative Sciences
University of New Mexico
Albuquerque
NM
利益声明
SS is a member of the ToxED advisory board and consults with webPOISONCONTROL.
Cynthia K. Aaron, MD
Medical Director
Program Director Medical Toxicology
Regional Poison Center at Children's Hospital of Michigan
Professor of Emergency Medicine and Pediatrics
Wayne State University School of Medicine
Detroit
MI
利益声明
CKA owns personal stock in Merck. CKA was on the State of Michigan Public Health Advisory Council for 3 years.
鸣谢
Dr Susan Smolinske and Dr Cynthia K. Aaron would like to gratefully acknowledge Dr Gerald F. O'Malley and Dr Rika N. O'Malley, previous contributors to this topic. GFOM and RNOM declare that they have no competing interests.
利益声明
GFOM and RNOM declare that they have no competing interests.
同行评议者
Jessamine Soderstrom, MD, MBBS, FACEM
Clinical Toxicologist
Emergency Consultant
Emergency Department
Royal Perth Hospital
Perth
Australia
利益声明
JS declares that she has no competing interests.
Scott Phillips, MD
Clinical Faculty
Department of Toxicology
Rocky Mountain Poison & Drug Center
Denver
CO
利益声明
SP declares that he has no competing interests.
Judith Alsop, PharmD, DABAT
Poison Center Director
California Poison Control System, Sacramento Division
University of California Davis Medical Center
Sacramento
Associate Clinical Professor of Pharmacy
University of California San Francisco School of Pharmacy
San Francisco
Clinical Professor of Medicine
Volunteer Clinical Faculty
University of California Davis School of Medicine
Sacramento
CA
利益声明
JA declares that she has no competing interests.
鉴别诊断
- 病毒性胃肠炎
- 细菌性胃肠炎
- 急性心肌梗死
更多 鉴别诊断
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明