Urgent Investigation of the Patient with Poisoning
Tests requested should take into account poison(s) taken, physiological status and comorbidities Blood glucose, sodium, potassium, urea and creatinine Paracetamol level if paracetamol poisoning is known or possible Full blood count Urinalysis (myoglobinuria due to rhabdomyolysis gives a positive stick test for blood) Arterial blood gases and pH Chest X-ray ECG if there is hypotension, coexistent heart disease or suspected ingestion of cardiotoxic drugs (e.g. anti-arrhythmics, tricyclics) If the substance ingested is not known, save serum (10 mL) and urine (50 mL) at 4°C in case later analysis is needed |
* The normal range of plasma osmolality is 280300mOsmol/kg. If the measured plasma osmolality (by freezing-point depression method) exceeds calculated osmolality (from the formula [2(Na+K)+urea+glucose]) by 10mOsmol/kg or more, consider poisoning with ethanol, ethylene glycol, isopropyl alcohol or methanol.