“Dum spiro spero” may be a simple aphorism, but it sets a high bar for the treatment of the poisoned patient, as any deficit in the patient’s oxygenation can impair his or her recovery.
If there is no airway obstruction and the skin and mucous membrane color is good, then there is no reason to intervene. Usually, however, the patient should be placed in an appropriate position without external impediments to breathing and kept under observation. At the point when a respiratory deficit is evident, it is necessary to be sure of airway patency by removing any dentures. If the patient, on the other hand, is comatose, it is best to introduce an endotracheal cannula with an appropriately sized inflatable balloon. If it has secretions they should be aspirated.
Intensive care
A patient, if dyspnoic should be admitted to the hospital and undergo intensive care. The aim is not only to restore adequate oxygenation, but also able to provide for broncho-pulmonary complications that can quickly set in. In the comatose subject, the value of the inflatable balloon endotracheal tube has been emphasized; it is important to take care to prevent the tube from descending into the right main bronchus, giving rise to a pneumothorax in one side and lung collapse in the other. Inhaled air should be humidified and if there is hypothermia, warmed as well. Respiratory complications can be a threat to the ICU patient’s recovery, so efforts must be made to prevent them.
Source: Roy Goulding’s Vademecum of Poisoning Therapy.
