Clinical toxicology focuses on the effects of substances in patients caused by accidental poisonings or intentional overdoses of medications, drugs of abuse, household products, or various other chemicals.
- Intoxication: Toxicity associated with any chemical substance
- Poisoning: A clinical toxicity secondary to accidental exposure
- Overdose: An intentional exposure with the intent of causing self-injury or death
- Toxidromes: A group of signs, symptoms, and laboratory findings that suggest a specific ingestion
POISINDEX is a database that is updated quarterly and is a primary resource for poison control centers.
Obtaining a history of exposure
- Identify the substance(s) ingested, the route of exposure, the quantity ingested, the amount of time since ingestion, signs and symptoms of overdose, and any associated illness or injury. Corroborate history and other physical evidence (e.g., pill containers) from prehospital providers.
- Neurological examination evaluates any seizures, alterations in consciousness, confusion, ataxia, slurred speech, tremor, headache, or syncope.
- Cardiopulmonary examination evaluates any syncope, palpitations, cough, chest pain, shortness of breath, or burning or irritation of the upper airway.
- Gastrointestinal (GI) examination evaluates any abdominal pain, nausea, vomiting, diarrhea, or difficulty in swallowing.
- Past medical history should include
a. Medications, including nonprescription (over-the-counter [OTC]) substancesb. Use of herbal medicationsc. Alcohol or drug abused. Psychiatric historye. Allergiesf. Occupational or hobby exposuresg. Travelh. Prior ingestionsi. Social history with potential for domestic violence or neglectj. Last normal menstrual period or pregnancy