Assessment of the patient's airway and breathing to make sure that the trachea, the passage to the lungs, is not blocked. If needed, a tube may be inserted through the mouth or nose and into the trachea to help the patient breathe. This procedure is called endotracheal (in the trachea) intubation.
Assessment of the patient's vital signs, including heart rate, blood pressure, body temperature, respiratory rate, and other physical signs that might indicate the effects of the drug.
Blood and urine samples may be collected to test for the presence of the suspected overdose drug, and other drugs or alcohol that might be present.
Attempt to eliminate the whatever of the drug that has not yet been absorbed. Vomiting may be induced using ipecac syrup or other drugs that cause vomiting. Ipecac syrup should not be given to patients who overdosed with tricyclic antidepressants, theophylline, or any drug that causes a significant change in mental status.
Gastric lavage, also known as pumping the stomach, may be attempted. For this procedure, a large flexible tube is inserted through the nose or mouth, down the throat, and into the stomach. The contents of the stomach are then suctioned out through the tube. A solution of saline (salt water) or regular tap water is pushed down into the tube to rinse out the stomach. The saline solution or water is then suctioned out. This process is repeated several times until the suctioned fluid is clear.
Activated charcoal to absorb the drug is sometimes given through a stomach tube or by having the patient swallow it.
Medication to stimulate urination or defecation may be given to try to flush the excess drug out of the body faster.
Intravenous (IV) fluids may be given. An intravenous line, a needle inserted into a vein, may be put into the arm or back of the hand. Fluids, either sterile saline (salt water solution) or dextrose (sugar water solution), can be administered through this line. Increasing fluids can help to flush the drug out of the system and to reestablish balance of fluids and minerals in the body. The pH of the body may need to be corrected by administering electrolytes such as sodium, potassium, and bicarbonate through the IV line. If drugs need to be administered quickly, they can also be injected directly into the IV line.
Hemodialysis is a procedure in which blood is circulated out of the body, pumped through a dialysis machine, then reintroduced back into the body. This process can be used to filter some drugs out of the blood and can clean the blood. It may also be used temporarily or long term if the kidneys are damaged due to the overdose.
Antidotes that are available for some drug overdoses may be administered. An antidote is another drug that counteracts or blocks the overdose drug.
Psychiatric evaluation is performed if the drug overdose was taken deliberately. If the overdose is determined to be a deliberate act, further psychiatric care is provided while the patient is hospitalized.
Lori Beck, The Gale Group Inc., Gale, Detroit,