title: Of pills, plants, and paraquat: the relevance of poison centers in emergency medicine.
abstract: The organization and work of a poisons center are demonstrated on the basis of GIZ-Nord Poisons Center Annual Report for 2011. In a short summary the basic principles of clinical toxicology are elucidated: the indications for gastric lavage and the application of activated charcoal. Moreover the means of enhanced elimination are presented: hemodialysis, hemoperfusion, multi-dose activated charcoal and molecular absorbent recirculating system (MARS). Gastric lavage is indicated within one hour after ingestion of a life-threatening dose of a poison. In intoxications with CNS penetrating substances gastric lavage should be performed only after endotracheal intubation due to the risk of aspiration. The basic management of the intoxicated patient by emergency medicine personnel out of hospital and on the way into the hospital is presented. The "Bremen List", a compilation of five antidotes (atropine, 4-DMAP, tolonium chloride, naloxone, activated charcoal) for the out of hospital treatment by emergency doctors is introduced.
authors.affiliation: GIZ-Nord Poisons Centre, University Medical Centre Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany. aschaper@giz-nord.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Schaper
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
authors.forename: Michael
authors.initials: M
authors.lastname: Deters
authors.forename: Guido
authors.initials: G
authors.lastname: Kaiser
mesh_terms: D000931:Antidotes / Q000627:therapeutic use*; D004635:Emergency Medicine / Q000458:organization & administration*; D005751:Gastric Lavage / Q000379:methods*; D006801:Humans; D011039:Poison Control Centers / Q000458:organization & administration*; D011041:Poisoning / Q000628:therapy*; D016060:Sorption Detoxification / Q000379:methods*
chemical_list: D000931:Antidotes