SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Suspected poisoning
Other Resources UpToDate PubMed

Suspected poisoning

Contributors: Jason Hack MD, FACEP, FACMT, John T. Finnell MD, Gerald F. O'Malley DO
Other Resources UpToDate PubMed


Emergent Care / Stabilization:
Call Poison Control Centers at 800-222-1222.

First 1 minute: Assess the patient for vital sign abnormalities that are life-threatening and correct them with cardiovascular or respiratory support. Pay particular attention to airway, pulse rate, and blood pressure stability.

Diagnosis Overview:
Care of a patient with an actual or suspected overdose or exposure can be very complicated and nuanced. An organized approach that addresses major decision points will assist the bedside doctor to identify priorities and stabilize the patient in most circumstances.


Z03.6 – Encounter for observation for suspected toxic effect from ingested substance ruled out

75478009 – Poisoning

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

The differential for presentations thought to be drug, alcohol, or exposure related includes:
  • Abnormalities of glucose (eg, hypoglycemia can present in dramatic and subtle ways).
  • Abnormalities of thyroid hormone.
  • Abnormalities of electrolytes (eg, sodium and magnesium).
  • Abnormalities of ventilation (eg, hypercarbia and hypoxia).
  • Central infection (eg, meningitis, encephalitis).
  • Traumatically injured patients.
Pitfalls include not assessing glucose, incomplete physical examination, misidentifying the toxidrome, ignorance of antidotal therapy, missing the opportunity for decontamination, intervening unnecessarily, ignorance of late-onset drugs, and the exclusion of patients from the observation period.

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:06/19/2023
Last Updated:07/23/2023
Copyright © 2023 VisualDx®. All rights reserved.
Suspected poisoning
A medical illustration showing key findings of Suspected poisoning
Copyright © 2023 VisualDx®. All rights reserved.