Other Tests

Imaging Studies

  • Chest Radiography
    • Chest radiography is performed when the respiratory symptoms of TCA toxicity are noted or in cases of suspected aspiration and may be used to rule out other causes of fever, tachycardia, and altered mental state. (medscape.com)


lateral

http://www.med-ed.virginia.edu/courses/rad/cxr/technique1chest.html

Electrocardiogram (ECG)

  • ECG is the device that records your heart beat electronically. It is also used to diagnose sinus tachycardia as its most common finding in TCA toxicity. In sinus tachycardia, a patient’s sinus rhythm is greater than 100 beats per minute (bpm). Tachycardia is a medical term for fast heart beats. The sinus that is pointing here is not our nose but rather is the sinus node of the heart. The sinus node is located at the right atrium of the heart.  (Read more: http://en.ecgpedia.org/wiki/Sinus_node_rhythms_and_arrhythmias)

adam_ecg

http://lungcancer.ucla.edu/adm_tests_electro.html

 

Other laboratory tests

According to Medscape, there were studies saying that the serum levels of TCA has nothing to do with the severity of one’s TCA toxicity. And this is a poor predictor of clinical outcome.

Because ingestion of multiple substance (other than the TCAs) is very common, routine screening for other potentially treatable toxins is recommended (like aspirin, acetaminophen).

Request for the serum toxic levels should be performed as a guide on the clinical picture. For example, in patients with acidosis, assess for aspirin, ethylene glycol, and methanol.

  • Assess the following:

    • Electrolytes, Blood Urea Nitrogen tests, and creatinine levels (some liver function tests)
    • Anion gap (the positives and negatives of ions; see the Anion Gap calculator)
    • Complete Blood Count (RBCs, WBCs and Platelet counts)
    • Alcohol level
    • Arterial blood gases for evaluation of acidosis (increased blood acidity) or hypoxia (low oxygen supply in the body)

 

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