The 15-year-old patient attempted suicide by ingesting an entire bottle of her father’s metoprolol. She is found unresponsive by emergency medical services and is intubated due to an inability to manage her own airway. Upon arrival to the emergency department, her blood pressure is 49/32 mmHg, heart rate is 24 bpm, and the pulse oximeter reads 82%. An 18-gauge peripheral IV is placed in the left antecubital vein and a 22-gauge IV is placed in the right antecubital vein. Which interventions are included in care? Select all that apply.

Question

The 15-year-old patient attempted suicide by ingesting an entire bottle of her father&rsquo;s metoprolol. She is found unresponsive by emergency medical services and is intubated due to an inability to manage her own airway. Upon arrival to the emergency department, her blood pressure is 49/32 mmHg, heart rate is 24 bpm, and the pulse oximeter reads 82%. An 18-gauge peripheral IV is placed in the left antecubital vein and a 22-gauge IV is placed in the right antecubital vein. Which interventions are included in care? Select all that apply.

Accepted Answer

4 mg ondansetron IV push  , 5 mg glucagon slow IV push, 1000 mL normal saline bolus , Epinephrine infusion 1 mcg/minute. The antidote for beta blocker poisoning is intravenous glucagon. Glucagon can cause vomiting, which must be prevented with ondansetron. Fluid resuscitation with an isotonic fluid bolus such as normal saline is necessary for the hypotension. The epinephrine infusion provides vasopressor support for blood pressure and heart rate. Because only peripheral IV access is available, the patient should receive calcium gluconate, not calcium chloride. Calcium chloride should only be administered via central line.

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