A 44-year-old woman presents to a Perth ED, triage category 1, after amitriptyline overdose. GCS 9, BP 86/52. ECG shows QRS 150 ms and terminal R

Question

A 44-year-old woman presents to a Perth ED, triage category 1, after amitriptyline overdose. GCS 9, BP 86/52. ECG shows QRS 150 ms and terminal R wave in aVR. She has a brief generalised seizure. What is the most appropriate management?

Accepted Answer

IV sodium bicarbonate

Answer

Subcutaneous insulin

Answer

Oral activated charcoal after 12 hours

Answer

IV calcium gluconate as sole therapy

Answer

IV flumazenil

Tricyclic antidepressant poisoning — ACEM Fellowship MCQ

A 44-year-old woman presents to a Perth ED, triage category 1, after amitriptyline overdose. GCS 9, BP 86/52. ECG shows QRS 150 ms and terminal R wave in aVR. She has a brief generalised seizure. What is the most appropriate management?