A 44-year-old man arrives after ingesting amitriptyline. Triage acuity is ESI 1; BP 78/42 mm Hg, HR 136/min. He is obtunded, and ECG shows QRS 170

Question

A 44-year-old man arrives after ingesting amitriptyline. Triage acuity is ESI 1; BP 78/42 mm Hg, HR 136/min. He is obtunded, and ECG shows QRS 170 ms. He has received airway support and IV access is established. Which of the following is the most important immediate intervention?

Accepted Answer

Give IV sodium bicarbonate boluses

Answer

Administer propranolol

Answer

Start hemodialysis as primary therapy

Answer

Give calcium gluconate as the antidote

Answer

Give physostigmine

Tricyclic antidepressant overdose treatment — ABEM Board MCQ

A 44-year-old man arrives after ingesting amitriptyline. Triage acuity is ESI 1; BP 78/42 mm Hg, HR 136/min. He is obtunded, and ECG shows QRS 170 ms. He has received airway support and IV access is established. Which of the following is the most important immediate intervention?