(1) Decontamination/supportive therapy: |
(a) activated charcoal: single dose of 50 g for adults; |
(b) polyethylene glycol whole bowel irrigation: 2L/hr in adults until rectal effluent is clear; |
(c) intravenous fluids; |
(d) atropine: 1 mg IV (can be repeated up to 3 mg total). |
(2) Antidotes: |
(a) calcium salts: |
(i) calcium chloride: 10–20 mL of a 10% solution administered over 10 min (can repeat dose if no effect); |
(ii) calcium gluconate: 30–60 mL of a 10% solution (dose can be repeated if no effect); |
(iii) continuous infusion with either salt: 0.5 meq of Ca/kg/hr; |
(b) glucagon: 5 mg IV bolus, can be repeated twice at 10 min intervals. |
(3) PDI (e.g., amrinone and milrinone). |
(4) Adrenergic agents (e.g., norepinephrine and dopamine, etc.). |
(5) HIE: |
(a) regular insulin bolus of 0.1 U/kg IV and then continuous infusion of 0.2–0.5 U/kg/hr; |
(b) dextrose 25 to 50 g bolus followed by a continuous infusion of 0.5 g glucose/kg/hr that can be titrated to appropriate blood glucose. |
(6) Invasive therapy: |
(a) transvenous pacing; |
(b) intraaortic balloon pump; |
(c) cardiopulmonary bypass; |
(d) extracorporeal membrane oxygenation. |