Consider discharge for patients with mild symptoms after 6hr obs if their symptoms resolve
Long-acting agents, plant seeds and large ingestions should have extended observation up to 24-48 hours even if asymptomatic due to decreased gastrointestinal motility
Admit if physostigmine was given (half-life of physo is often shorter than the ingested drug)
Patients may be cleared if symptoms do not recur within 6 hours of the last antidote dose
Anticholinergic toxicity
Sympathomimetic toxicity
Antipsychotic toxicity
Red, dry skin and absent bowel sounds favors anticholinergic toxicity
Tricyclic antidepressant toxicity
Encephalitis
Benzodiazepine toxicity
Head trauma