Suicide, Poisoning & Mental Health [Case #2]

“A 28 year old woman is brought into Resus having taken some tablets. She has been seen in the department with multiple overdoses in the past and is known to have depression. She was recently started on amitriptyline and the paramedics have brought in several empty packets.”

Questions

Answer one question before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. The first part of teaching will be spent discussing this case:

1. What are the clinical features of tricyclic antidepressant (TCA) overdose?

2. What are the ECG features of TCA overdose?

3. What are your management priorities?

4. What are the indications for sodium bicarb?

5. How much sodium bicarb would you give?

6. Unfortunately the patient arrests in front of you, how is the standard ALS algorithm altered in this case?