Identifying the cause of intoxication case without a clear history using flowcharts
Identifying the cause of intoxication case without a clear history
DOI:
https://doi.org/10.59747/smjidisurabaya.v1i1.7Keywords:
medical care, intoxication, toxidrome, vital signAbstract
Background: Suspicion of intoxication and its causative agents are required in the clinical practice of intensive care units. Patients with loss of consciousness and no history of leading causation present obstacles in emergency room management. An understanding of toxidromes and epidemiological evidence can help clinicians. However, classic toxidromes are not always presented. Objectives: This case was presented to determine the flow of approaches to identify the cause of intoxication and to design early strategies for supportive care in intoxication case management. Case: A woman with loss of consciousness accompanied by seizures, deep and rapid breathing, and hypotension. Since the search for collateral information did not produce any meaningful findings, the toxin diagnosis was given based on vital signs, pupil size, and mental status. Methanol intoxication was suspected based on hypothermia, decreased consciousness, normal pupil size, and Kussmaul breathing. Forensic analysis showed her serum was positive for ethanol and methanol. Conclusion: When facing a case without the classic presentation of the toxidrome, the toxin diagnosis can be directed based on vital signs, pupil size, mental status, and muscle tone. Introduction to epidemiology is also important in tracking intoxication causation
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