Arsenic Poisoning, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Acute toxicity:

    • Caused by intentional ingestion, malicious poisoning, or medication error

  • Minimal lethal ingested dose ∼2 mg/kg

  • Chronic toxicity:

    • Resulting from occupational exposures, w...

Diagnosis

Signs and Symptoms

  • CNS:

    • Altered mental status/encephalopathy

    • Neurodevelopmental deficits in children

    • Peripheral neuropathy

      • Acute: Sensory neuropathy

      • Subacute: Sensorimotor neuropathy

    • Peripheral dys...

Treatment

Pre-Hospital

  • If possible to do so safely, bring containers in suspected overdose/poisoning.

  • Decontaminate skin.

  • Support airway/breathing/circulation.

  • Cardiac monitoring

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

Symptomatic arsenic exposures should be admitted to an intensive care setting. 

Discharge Criteria

  • Asymptomatic patients with a spot urinary arsenic level <50 μ...

Pearls and Pitfalls

  • Arsenic poisoning results in a myriad of signs and symptoms

    • Suspect acute arsenic poisoning when patients present with gastrointestinal distress and neurologic findings.

    • Suspect chro...

Additional Reading

  • Agency for Toxic Substances and Disease Registry. Toxicologic Profile for Arsenic. US Department of Health and Human Services. August 2007.

  • Chen  Y, Parvez  F, Gamble  M, et al. Arse...

Codes

ICD9

985.1 Toxic effect of arsenic and its compounds 

ICD10

  • T57.0X1A Toxic effect of arsenic and its compounds, accidental (unintentional), initial encounter

  • T57.0X2A Toxic effect of arsenic and its...

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