![]() Most children with an isolated Benzodiazepine ingestion can be safely discharged if asymptomatic at 4 hours.The initial dose is 0.01 mg/kg given IV over 15 seconds (maximum dose 0.2 mg).Always discuss with a Toxicologist – call to the Victorian Poisons Information centre on 13 11 26.If CNS depression is severe the use of Flumazenil may be considered.Flumazenil may be used in accidental or iatrogenic overdose.Flumazenil is contraindicated in intentional overdose (it can precipitate seizures in withdrawal or mixed overdoses).Enhancement of benzodiazepine elimination is not effective and is not recommended.Gastrointestinal decontamination with activated charcoal is contraindicated because of the increased risk of aspiration.If respiratory depression, a concomitant opioid overdose may be present and it is reasonable to administer appropriate doses of parenteral naloxone.Standard procedures and supportive care.Measurement of serum benzodiazepine concentration correlates poorly with clinical findings and will not aid management. In intentional overdoses, consider co-ingestion risk, therefore Other – withdrawal syndrome, paradoxical reactions (agitation, aggression, hallucinations and combativeness)Īlways check for Medicalert bracelet in any unconscious patient, or any other signs of underlying medical condition (fingerprick marks etc.) Investigations.Neurologic – confusion, dysarthria, nystagmus, lethargy, ataxia, areflexia, hypotonia, seizure. ![]() Calculate the maximum possible dose per kg of each drug.If possible, determine the exact name and tablet strength.Always assume maximum number of missing/unaccounted tablets have been ingested. ![]() Risk assessment Red flag features in Red History
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