Emergency & clinical flowcharts
Neurological – Cardiovascular – Gastrointestinal
| Signs and symptoms1 |
Emergency medical treatment (symptomatic) |
Poisoning and differential diagnosis |
Specific treatment |
|
Neurological: acroparaesthesias, myalgia, muscle weakness, paralysis, including paralysis of the respiratory musculature → respiratory failure |
Endotracheal intubation, artificial respiration |
Ciguatera2 | Mannitol (no convincing evidence!) |
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| Tetrodotoxin poisoning2 |
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Cardiovascular: bradycardia, arrhythmia, arterial hypotension |
Atropine, anti-arrhythmics, vasopressors |
Paralytic shellfish poisoning (PSP) | ||||
| Neurotoxic shellfish poisoning | ||||||
|
Gastrointestinal: vomiting, diarrhoea → dehydration |
Rehydration |
(ASP)2,3 |
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| DD: type E botulism (see Diagnosis & Treatment: General practitioner / health post) |
Trivalent ABE antitoxin |
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| DD: poisoning by contaminated foodstuffs (see Diagnosis & Treatment: General practitioner / health post) |
Refer to toxicology manuals |
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Allergic
| Signs and symptoms1 |
Emergency medical treatment (symptomatic) |
Poisoning and differential diagnosis |
Specific treatment |
|
Skin: Urticaria, redness, pruritus, angio-oedema |
Treatment of immediate-type allergic reactions, including anaphylactic shock |
H1 and H2 receptor antagonists |
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Respiratory: Dyspnoea, rhonchi |
DD: allergy to fish, shellfish or crab (see Diagnosis & Treatment: General practitioner / health post) |
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Cardiovascular: arrhythmias, syncope |
DD: allergies to other foodstuffs and food additives (see Diagnosis & Treatment: General practitioner / health post) |
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Gastrointestinal: → dehydration |
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Gastrointestinal
| Signs and symptoms1 |
Emergency medical treatment (symptomatic) |
Poisoning and differential diagnosis |
Specific treatment |
|
Vomiting, abdominal pain, diarrhoea → dehydration |
Rehydration |
Diarrhoetic shellfish poisoning (DSP) |
. |
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|
DD: infectious gastroenteritis (see Diagnosis & Treatment: General practitioner / health post) |
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| |
other forms of poisoning caused by poisonous animals (see Biomedical database entries) |
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| 1 |
See also the Clinical flowchart as a guide to the dynamics of poisoning. |
| 2 | Cardiovascular signs and symptoms have been described in ciguatera, tetrodotoxin poisoning and ASP. |
| 3 | Symptoms of ASP: confusion, lethargy, seizures, coma, short-term memory loss. Paraesthesias, paresis and myalgia have not been observed. |