First Things First (assess and treat for the following)

• ABCs, obtain vital signs, establish IV access, cardiac monitor
• Diagnosis is based on patient’s history of ingestion with presence of symptoms (tachycardia, nausea/vomiting, tremor, etc.).
• Obtain theophylline level – it is essential to determine some treatment courses.
• Orogastric lavage should be considered for an acute ingestion < 1-2 hours prior to presentation.