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Poisoning & Drug Overdose
Who needs the ICU?

Considerations for Intensive Care Unit Admission

What are the characteristics of the drug?
Is the drug a known killer?
Can the patient deteriorate rapidly from its toxic effects?
Can it cause delayed effects?
Does the drug have cardiac effects that will require cardiac monitoring?
What is the dose? Is it potentially lethal?
Does the therapy have potential adverse effects?
Do we know enough about this drug to make a confident decision?
What about the patient?
Does the patient have any signs of serious end-organ toxicity?
Are laboratory data suggestive of serious toxicity?
Are drug concentrations rising?
Does the patient have any ECG changes suggestive of poisoning? (QRS > 100msec; prolonged QTc)
Does the patient have preexisting medical conditions?
Is the patient suicidal?
Can the patient care unit handle this patient?
Does the admitting physician and nursing staff appreciate the potential seriousness of a toxicologic emergency?
Is the staffing adequate to monitor the patient?
Are time-consuming nursing activities required that cannot realistically be met on the patient care unit?
Can a safe environment be provided for a suicidal or agitated patient?