Please enable JavaScript.
Coggle requires JavaScript to display documents.
Fe poisoning (Clinical presentation (Diarrhoea (grey, black, bloody),…
Fe poisoning
Clinical
presentation
Diarrhoea (grey, black, bloody)
Abdo pain
N+V (grey, black, bloody)
Haematemesis
Confusion/coma
Diagnosis
Investigations
Bedside: obs (may have shock), ECG, BM (hypo)
Bloods: ABG (metabolic acidosis) FBC, Fe studies, glucose
Imaging: AXR (count radiopaque tablets)
Examination
Abdo: haematemesis (black/bloody), tender abdo
PR: black/bloody stool
History
PC/HPC: dark/bloody stools/vomit, dose, timing
PMH: Fe deficiency, psychiatric disorder
DH: Fe tablets, other meds, allergies
SH: alcohol, illicit drugs, smoking
Pathophysiology
Often accidental by kids
(thinking they are sweets)
Toxicity >60mg elemental Fe,
lethal >150-300mg elemental Fe
(check prep for elemental levels)
Management
Initial ABCDE
Definitive
Medical
Gastric lavage
Indication: <1h ingestion
Whole bowel irrigation
Fe chelator
Indication: serious (coma/shock)
Eg. desferrioxamine
MOA: Fe chelator
SEs: hypotension, rash, anaphylaxis,
ARDS, pulmonary oedema, orange/red urine
Conservative
Monitoring (obs, cardiac, bloods)
TOXBASE
Definition
Ingestion of Fe to
toxic levels for the body
Complications
Late deterioration (1-2d)
Jaundice, shock, hepatic encephalopathy,
renal failure, metabolic acidosis