💊 The Suicide Pill in the ICU: Aluminium Phosphide Poisoning 💊

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1. A 24-year-old male presents with severe ethylene glycol poisoning, pH 7.1, and plasma levels of 70 mg/dL. He is hemodynamically stable. Which extracorporeal modality is the most appropriate first-line therapy for toxin removal?
2. In a patient with aluminum phosphide poisoning and refractory cardiogenic shock, VA-ECMO is initiated. Which of the following clinical features is the strongest prognostic marker for survival?
3. A 40-year-old woman ingests a massive dose of carbamazepine. Her plasma level is markedly elevated, and she is obtunded but hemodynamically stable. Which extracorporeal modality is most effective for toxin removal?
4. A 32-year-old farmer presents 2 hours after ingestion of aluminum phosphide. He is hypotensive (SBP 70 mmHg), in shock despite high-dose norepinephrine, with severe metabolic acidosis (pH 6.9). ECMO initiation is discussed. According to the evidence, the survival benefit is greatest when ECMO is started:
5. Which of the following poison characteristics most strongly predicts poor clearance with extracorporeal dialysis techniques?
6. A 50-year-old male with paraquat ingestion presents within 3 hours of exposure. Which extracorporeal therapy, if initiated early, offers the best survival advantage?
7. In severe AlP poisoning where ECMO is unavailable, which of the following interventions has shown mortality benefit in trials and should be considered part of a multi-modal regimen?
8. A patient with massive metformin overdose presents with profound lactic acidosis (lactate >20 mmol/L, pH 6.9). Which extracorporeal modality is recommended by EXTRIP for toxin clearance?
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