Careful gastrointestinal decontamination: No emesis! No activated charcoal! Possibly gastric lavage with small nasogastric (NG) for large volumes, intentional ingestions, and highly toxic HCs, including (CHAMP) = camphor, haloge-nated HCs, aromatic HCs, HCs associated with metals, HCs associated with pesticides. No cathartics, especially no olive or mineral oil cathartics (oily cathartics will increase absorption of lipophilic HCs), no prophylactic antibiotics or corticosteroids.
Mechanical ventilation for ARDS: Barotrauma risk = start with low positive end expiratoy pressure (PEEP) ^ next consider, high frequency jet ventilation (HFJV) ^ for refractory hypoxia, consider extracorporeal membrane oxygenation (ECMO).
Cardiovascular: Consider avoiding inotropic support during PEEP, due to myocardial sen-sitization to sympathetic catecholamines and potential arrhythmogenesis.
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