Whole bowel irrigation with polyethylene glycol may be effective to prevent GI tract absorption of arsenic. Do not delay with definitive chelation therapy and hemodialysis. Consult hematology and nephrology in cases of arsine exposure. Neurology and physiatry consultations are appropriate in cases of arsenic exposures. Consultation with a medical toxicologist conversant with the use of chelation therapy may be very useful.
Psychiatric consultation is necessary before discharge if the arsenic ingestion was intentional.
Chelating agents - Bind heavy metals and to hasten excretion. By binding in plasma, they render heavy metals nontoxic. Administered IM q4h, mixed in a peanut oil base. Excreted in urine and bile. May be administered to patients with renal failure.