Whole bowel irrigation with polyethylene glycol may be effective to prevent GI tract absorption of arsenic. Definitive chelation therapy and hemodialysis should not be delayed. Hematology and nephrology consultations will be necessary 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 prior to discharge if the ingestion was intentional.
The use of chelation therapy is imperative in all patients who are symptomatic. The use of chelators in patients exposed to arsine is controversial. Chelating agents - Bind heavy metals and hasten their excretion. By binding in plasma, they render such metals nontoxic. Administered IM q4h, mixed in a peanut oil base.