TOX oriented ACLS: An evidence-based approach

Joint Meeting on 5^th World Holistic Nursing Conference & 2^nd Annual Congress on Emergency Medicine and Acute Care

June 10-11, 2019 Helsinki, Finland

Shamim Ahmad Bhat and Rashid Shireen

King Saud Medical City Riyadh, Saudi Arabia
Al Kabeer Center, India

Scientific Tracks Abstracts: J Nurs Care

Abstract :

Statement of the Problem: Toxicology is one of the subspecialty which has grown leaps and bounds in the recent years worldwide. Intoxication constitutes a global burden and most of the emergency physicians are worldwide facing difficult cases of intoxication more over arrival of an intoxicated unresponsive patient makes it more difficult for the treating physicians to approach their management. Researchers have reported diverse different approaches for managing such cases and international bodies are framing day in and day out the updated guidelines for such cases. The purposes of this literature review are to identify the recent TOX oriented ACLS guidelines and compare them with the recent evidence.

Method: After looking through the recent 2015 ACLS guidelines in relation to TOX afflicted patients presenting with cardiac arrest or instability in terms of neuro and hemodynamics, a through literature review was done for the most commonly poisoning patients and the guidelines were compared to the recent standard evidence available related to various poisoning cases. Following this the level of evidence and recommendations made were also evaluated. This all was done to have an evidence-based approach for the commonest poisoning induced instability and cardiac arrests and incorporate it for the board residency residents of emergency medicine. In addition, it was anticipated to form a general consensus for treating such cases in future and clear off some of the myths related to treatment involved for such cases.

Findings: The comparison of the recent guidelines from ACLS and the evidence in its support proved most of the treatment has weak evidence as to the disbelief of most of the treating physician. Some of the antidotes used in current practice are at the edge of being disrepute and are no more recommended to be standard of care e.g. Flumazenil in BZD poisoning.

Conclusion: This literature review made it clearer that it is needed to review the standard guidelines every now and then in terms of the supporting evidence against or in favor of it particularly if it is a subspecialty like TOX.

Biography :

Shamim Ahmad Bhat is working as a Consultant Emergency Medicine in Dept. of Emergency Medicine King Saud Medical City Riyadh. He is a board certified from India and currently holding the chair of Academic and research co coordinator in the same department. He is also holding the chair of deputy program director for Saudi diploma in emergency medicine. He is the director of the TRR (KSMC and ALFRED University) training in King Saud Medical City. He is a part of the panel of evaluators and examiners for Saudi board of Emergency Medicine, approved by Saudi commission for health specialties.