Monday, April 16, 2018

Benzodiazepine poisoning in children


Benzodiazepine poisoning
Dr Usama Amjad
There is usually a history of benzodiazepine drug intake by elderly at home and so the dose taken by child can be inquired by missing tablets in pack. Benzodiazepine poisoning is rare as iatrogenic preprocedural sedation.
Signs and symptoms
Dizziness,drowsiness,confusion,blurred vision,unrespnsiveness

ASOC,Respiratory depression,cyanosis,Hypotension,Ataxia
Hypotonia,Coma,Weakness,amnesia
Investigations
SERUM GLUCOSE level
Septic profile
Workup for CNC infection
ECG
Save urine and serum samples for forensic workup
PREGANANCY TEST (IN WOMEN OF CHILDBEARING AGE
MANAGEMENT
Admit the patient
counsel parents
get high risk consent
get MLC

Maintain Airway and breathing (clear the secretions , and may need to pass ETT to get adequate chest rise ), Assess and maintain circulation. The heart rate and blood pressure mostly improves as airway and breathing are secured.

Do stomach wash till clear stomach contents are there.
SPECIFIC ANTIDOTE IS FLUMAZENIL
DOSE 0.01mg IV given over 30 seconds , may repeat after 1 minute, to maximum cumulative dose of 1 mg.
May need to give repeat bolus doses.

It may precipitate seizures .

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