Barium permanganate

A) Institute continuous cardiac monitoring and obtain an ECG (evaluate for evidence of hypokalemia including T wave flattening and prominent U waves).
B) Monitor vital signs, with particular attention to evidence of respiratory insufficiency. Perform serial neurologic exams to evaluate for muscle weakness.
C) Determine potassium levels frequently (every 1 to 2 hours until stabilized). Monitor serum phosphorus, magnesium CK and renal function in symptomatic patients.
D) Serum barium concentrations are not readily available or useful in guiding therapy.

A) Monitor vital signs, liver enzymes, and renal function in patients with significant exposure.
B) Monitor INR or PT, PTT, CBC and platelet counts in patients with severe toxicity.
C) Monitor arterial blood gases, pulse oximetry, and pulmonary function tests, and obtain a chest x-ray in any patient with respiratory symptoms.
D) Monitor methemoglobin levels in symptomatic or cyanotic patients.
E) Potassium permanganate is radiopaque and performing an abdominal radiograph has been proposed as a way to assess the adequacy of gastrointestinal decontamination. However, there is no evidence to support the reliability of this maneuver.