Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
Stabilization
If airway compromise or refractory agitation, intubation with post-intubation sedation
If intubating, avoid succinylcholine if concern for rhabdomyolysis or hyperkalaemia
Post-intubation sedation with benzodiazepine or propofol based on hemodynamics
If hyperthermia, aggressive external cooling
If core temperature ≥ 40 C, treat as heat stroke physiology
If shivering limits cooling, sedation escalation
If seizures, benzodiazepine first line
If refractory, levetiracetam or phenobarbital per status epilepticus pathway
If hypotension, isotonic crystalloid bolus
If persistent hypotension, norepinephrine infusion
Toxidrome recognition
Anticholinergic toxidrome pattern
Delirium with agitation or hallucinations
Mydriasis with poor accommodation
Dry hot flushed skin with anhidrosis
Tachycardia
Ileus with decreased bowel sounds
Urinary retention
Monitoring and environment
Monitoring set
Continuous cardiac monitoring
Frequent temperature checks including core temperature if hyperthermia suspected
Capnography if sedated or intubated
Point-of-care glucose early in altered mental status
Key decision points
Antidote candidacy
Physostigmine only for severe anticholinergic delirium with suspected pure antimuscarinic toxicity
If QRS widening or concern for sodium channel blockade coingestion, avoid physostigmine
If seizure risk high or mixed toxidrome, prioritize supportive care and sedation
Decontamination threshold
If large recent ingestion and airway protected, activated charcoal consideration
If ileus present, delayed absorption risk with recurrent toxicity
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.