Anticholinergics
Which LA County protocol generally covers anticholinergic poisoning?
TP 1241 — Overdose / Poisoning / Ingestion
Which LA County protocol covers carbon monoxide exposure?
TP 1238 — Carbon Monoxide Exposure.
Which LA County protocol applies to suspected caustic ingestion?
TP 1241 — Overdose / Poisoning / Ingestion; add TP 1240 when a hazardous-material exposure requires it
What LA County protocol covers dystonic reactions?
TP 1239 — Dystonic Reaction
What findings suggest an anticholinergic toxidrome?
Dry skin, dilated pupils, tachycardia, hyperthermia, urinary retention, and altered mental status. These are clinical recognition findings
What oxygen flow rate does LA County specify for suspected CO exposure?
High-flow oxygen at 15 L/min
What is the first priority when a caustic exposure threatens the airway?
Assess and manage the airway per MCG 1302.
What must occur before confirming the dystonic reaction provider impression?
Contact Base Hospital. TP 1239 explicitly requires Base contact to confirm the impression
What cardiac assessment does adult TP 1238 specify?
Cardiac monitoring as needed and a 12-lead ECG to assess for cardiac ischemia
What cardiac assessment does adult TP 1238 specify?
Cardiac monitoring as needed and a 12-lead ECG to assess for cardiac ischemia
What should not be done after caustic ingestion?
Do not induce vomiting or attempt chemical neutralization. This is general toxicology guidance, not a quoted LA County-specific order
What is the adult IV diphenhydramine dose for dystonic reaction?
50 mg (1 mL) slow IV push after Base contact.
A suspected anticholinergic poisoning patient has poor perfusion. What additional protocol applies?
TP 1207 — Shock/Hypotension, in conjunction with TP 1241
What is the adult fluid order for poor perfusion in TP 1238?
Normal saline 1 L IV rapid infusion; reassess every 250 mL for volume overload and stop if pulmonary edema develops
What protocol addresses decontamination after a hazardous corrosive exposure?
TP 1240 — HAZMAT, using departmental decontamination procedures
What is the adult alternative if venous access cannot be obtained?
Diphenhydramine 50 mg (1 mL) deep IM
Which two consultation resources are relevant to an unknown anticholinergic ingestion?
Base Hospital and Poison Control. TP 1241-P directs considering Poison Control with Base for unknown medications or toxins
Should a measured CO level determine whether a patient is transported?
No. TP 1238 says measured CO level should not determine the transport decision; document and report the result
A corrosive-exposure patient has a life-threatening condition. What does TP 1240 direct?
Treat under the appropriate complaint-based protocol alongside decontamination; remove outer clothing and use containment measures before transport.
A pediatric patient has an acute dystonic reaction. What is the LA County diphenhydramine order?
Under TP 1239-P, after Base contact: diphenhydramine 1 mg/kg slow IV push, or deep IM if IV access cannot be obtained; dose per MCG 1309