Blood and urine arsenic levels are elevated acutely, but these findings are not necessarily helpful in treatment decisions. Electrocardiogram Peaked T waves from hyperkalemia may be seen. Nonspecific ST segment and T wave abnormalities have been reported. QT interval prolongation is possible from arsenic toxicity. No routine imaging studies are indicated.
Chest radiography is indicated to detect ARDS in patients with pulmonary symptoms.
Provide high-flow oxygen. Exchange transfusion is the treatment of choice for patients with severe hemolysis. Initiate diuresis to avoid heme-pigment nephropathy. Both IV mannitol and urinary alkalinization have anecdotal value. Alert the blood bank regarding the possibility of exchange transfusion.