ICU Management of Rodenticide Poisoning

Initial Assessment and Stabilization

• The American Heart Association recommends providing immediate supportive care including airway management, hemodynamic support, and correction of critical vital sign and metabolic derangements as the first priority 1, 2
• Contact poison control center for expert treatment guidance if available, as recommended by the American College of Cardiology 1, 2

Management of Specific Complications

Neurological Complications

• The American Heart Association recommends administering benzodiazepines for seizures or agitation 3
• Monitor for signs of increased intracranial pressure in patients with coagulopathy, as suggested by the Society of Critical Care Medicine 4
• Consider EEG monitoring in patients with altered mental status to detect non-convulsive seizures, as recommended by the Society of Critical Care Medicine 4

Cardiovascular Complications

• The American College of Cardiology recommends administering vasopressors as needed for hypotension 3
• Monitor cardiac function and treat dysrhythmias according to standard protocols, as recommended by the American College of Cardiology 1, 2

Special Considerations

• The American Heart Association recommends against administering activated charcoal unless advised by poison control center or emergency medical personnel 5
• The American Heart Association recommends against inducing emesis with syrup of ipecac as it has no clinical advantage and may delay advanced medical care 5

Follow-up Care

• Consider consultation with a medical toxicologist for complex cases, as recommended by the American College of Medical Toxicology 3

Pitfalls to Avoid

• The American College of Cardiology recommends not delaying supportive care while waiting for identification of the specific rodenticide 1, 2