ISCCM TEXTBOOK OF TOXICOLOGY TREATING THE CRITICALLY ILL POISONED PATIENT

This book is an important initiative to address the issues related to severe poisonings encountered in South East Asia, especially focused on problems in the Indian subcontinent.The book has been divided into 4 sections with the first section focusing on approach to a poisoned patient, clinical and laboratory diagnosis, and resuscitation in the emergency room as well as intensive care units. There is an important aspect discussed here that focuses on dealing with the comprehensive psychiatric assessment of the victim.The second section focuses on the individual toxins and covers the pathophysiology, clinical presentation, and management in a more detailed fashion. The emphasis here is on the specific management issues related to commonly encountered local toxins like pesticides, herbicides, commonly encountered household toxins, envenomation, plant poisons, heavy metal, and Complementary and Alternate Medicine (CAM) toxicities. There is an important aspect discussed here dealing with the comprehensive psychiatric assessment of the victim. The threats of chemical and biological terrorism are also covered here, which is the need of the hour.The third section deals with supportive care of poisoned patients, with special reference to the intensive care unit. This section addresses the nuances of cardiovascular support, ventilatory support, renal replacement therapy, plasma exchange, and endoscopic management.The last section deals with individual antidotes. The issues regarding the dose and duration of individual antidotes have been adequately addressed here. This book on the treatment of critically ill poisoned patient is an attempt to ¬ll the gap in a common and frequently encountered problem in critical care units in India. The spectrum of toxicological problems is unique to geographical regions and hence this book assumes much relevance given that there is limited content available on the common toxicological problems in India in a single publication. The chapters are written by intensivists for intensivists in training as well as those who have been practicing critical care. The book focuses on the approach to and management of the common toxicological problems in India. The ¬first section provides an overview of the comprehensive evaluation of a poisoned patient and forms the platform for the subsequent sections. The second section is on specifi¬c poisons and deals with the common as well as the not-so-common toxicological conditions in India with a focus on critical care aspects. The third section deals with supportive therapy in poisoning with the application of the principles of organ support in toxicology. The ¬final section is an evidence-based approach on the use of antidotes in poisoning.

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