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Chapter 18Poisoning
Types of Poisons• Ingested (swallowed)
Through the mouth • Inhaled (breathed)
Through the lungs• Absorbed (contact)
Through the skin• Injected
Through needlelike device
Ingested (Swallowed) Poisons• Occurs when victim swallows toxic
substance• Most poisonings happen by ingestion.• Common among children• Some substances can block airway.• Analgesics are most common poisoning.• Most exposures to plants are minor.
Recognizing Ingested Poisons• Abdominal pain, cramping• Nausea or vomiting• Diarrhea• Burns, stains, odor near or in mouth• Drowsiness or unresponsiveness• Poison containers nearby
Care for Ingested Poisons (1 of 3)
• DetermineAge and size of victimWhat and how much poison ingestedWhen it was taken
• If corrosive or caustic, have victim sip cold water or milk.
• Responsive victim, call Poison Control Center. Can advise if medical care is needed
Care for Ingested Poisons (2 of 3)
• Unresponsive victim, call 811 or 990
• Place victim in recovery position.
• Do not induce vomiting.
• Give activated charcoal if advised.
Care for Ingested Poisons(3 of 3)
• Activated charcoalBlack powder that binds to poison
• Does not absorb all drugs well• Save containers, plants, and vomit
Alcohol Intoxication• Alcohol is a depressant.• Most commonly abused drug in US.• Often implicated as cofactor in other
types of accidents• Can cause belligerent, combative
behavior• Can be life-threatening• Take condition seriously
Recognizing Alcohol Intoxication
• Odor of alcohol• Unsteadiness, staggering• Confusion• Slurred speech• Nausea and vomiting• Flushed face• Seizures can also result.
Care for Alcohol Intoxication• Look for injuries.• Monitor breathing.• Recovery position• Call poison control center.• If victim becomes violent, leave scene and
await police.• Provide emotional support.• If victim is unresponsive, await EMS.• Move person to a warm place.
Drug Emergencies• Drug classifications:
Uppers (stimulants)—amphetamines, cocaine, caffeine
Downers (sedative-hypnotic)—barbiturates, tranquilizers, marijuana, narcotics
Hallucinogens—LSD, mescaline, peyote, PCP
Volatile chemicals—glue, cement, paint solvent, gasoline, spray paint, nail polish remover
Sympathomimetics• Stimulants (“uppers”)• Produce excitement• Amphetamines, methamphetamines• Taken by mouth or injected• Cocaine• Crack
Recognizing Sympathomimetic Use
• Disorganized behavior• Hyperactivity• Restlessness• Anxiety or great fear• Paranoia• Delusions
Care for Sympathomimetic Users
• Check breathing.• Call poison center or 811 or 990.• Check for injuries.• Place in recovery position.• Give reassurance, emotional support• If violent, seek safety until police arrive.• Seek medical care.
Hallucinogens
• Produce changes in mood, sensory awareness
• Hear colors, see sounds• Cause hallucinations, bizarre
behavior• Protect user from hurting self
Recognizing Hallucinogen Use• Visual hallucinations• Intensity of vision and
hearing
Care for Hallucinogen Use• Check breathing.• Call poison center or 811 or 990.• Check for injuries.• Place in recovery position.• Give reassurance, emotional support• If violent, seek safety until police arrive.• Seek medical care.
Marijuana
• Flowering hemp plant• Estimated 20 million
people use marijuana daily in US
Recognizing Marijuana Overdose
• Euphoria, relaxation, drowsiness• Short-term memory loss• Impaired capacity for complex
thinking and work• Depression, confusion• Altered perception of time• Anxiety, panic• Hallucinations
Care for Marijuana Overdose• Check breathing.• Call poison center or 811 or 990.• Check for injuries.• Place in the recovery position.• Give reassurance, emotional support• If violent, seek safety until police arrive.• Seek medical care.
Depressants• Often prescribed as part of legitimate
medicine• People may solicit prescriptions from
several physicians.• Includes:
Opiates (narcotics)Sedative hypnotics (barbiturates
and tranquilizers)
Recognizing Sedative-Hypnotic Drug Use
• Drowsiness, sleepiness• Slurred speech• Slow breathing rate
Opiates• Pain relievers named for opium• Heroin, codeine, morphine• Frequently abused• Addicts may start with
appropriate prescription
Recognizing Opiate Overdose• Reduced breathing rate• Pinpoint pupils• Sedated condition,
unresponsiveness
Care for Depressant Overdose• Check breathing.• Call poison center or 811 or 990.• Check for injuries.• Place recovery position.• Give reassurance, emotional support• If violent, seek safety until police arrive.• Seek medical care.
Abused Inhalants
• Glue, gasoline, lighter fluid, nail polish• Similar effects to alcohol• Can die of suffocation• Can change heart rhythm• Can cause permanent brain damage
Recognizing Abused Inhalant• Mild drowsiness, unresponsiveness• Slurred speech, clumsiness• Seizures• Slow breathing rate• Smell of solvents
Care for Abused Inhalant• Check breathing.• Call poison center or 811 or 990.• Check for injuries.• Place in recovery position.• Give reassurance, emotional support• If violent, seek safety until police arrive.• Seek medical care.
Carbon Monoxide Poisoning • Leading cause of poisoning death in US each
year• Invisible, tasteless, odorless, colorless,
nonirritating gas• Can be unintentional poisoning or suicide• Can occur in older car, extended time in
running car, or from faulty furnaces, water heaters, kerosene heaters
• Causes hypoxia
Recognizing Carbon Monoxide Poisoning (1 of 2)
• Headache• Ringing in ears• Chest pain• Muscle weakness• Nausea and vomiting• Dizziness and visual changes• Unresponsiveness• Respiratory and cardiac arrest
Recognizing Carbon Monoxide Poisoning (2 of 2)
• Symptoms come and go.• Symptoms worsen and
improve in certain places and at certain times.
• Nearby people have similar complaints.
• Pets seem ill.
Care for Carbon Monoxide Poisoning
• Remove victim from environment immediately.
• Call 811 or 990.• EMS can give 100% oxygen for 30 or 40
minutes to reverse CO poisoning.• Monitor breathing.• Place unresponsive, breathing victim in
recovery position.• Seek medical care.
Plant-Induced Dermatitis(1 of 2)
• Poison ivy, poison oak, poison sumac
• 15-25% of exposed people will have incapacitating swelling, blisters
• Oil oozes out from plant when brushed.
Plant-Induced Dermatitis(2 of 2)
• Oil not visible on human skin• Spread by direct contact• Can stay active for months or years• Smoke from burning plants can cause
severe dermatitis• Difficult to identify plants• Leaves grow in groups of three
Recognizing Plant-Induced Dermatitis
• Rash• Itching• Redness• Blisters• Swelling• The greater the amount of skin affected,
the greater the need for medical care.• Onset usually occurs 1-2 days after
contact.
Care for Plant-Induced Dermatitis
• Clean skin with soap and cold water as soon as possible.
• Apply rubbing alcohol liberally, then remove with water.
• Lukewarm bath and colloidal oatmeal• Wet compresses with aluminum acetate• Calamine lotion or baking soda paste• Corticosteroid ointment and oral
corticosteroid
Stinging Nettle• Plant with stinging hairs on stem
and leaves• Stinging hair is touched• Fine needlepoint penetrates skin• Injects chemical irritant
Recognizing Stinging Nettle Poisoning
• Can affect anyone• Effects limited to exposed area• Immediate response• Redness• Rapid, intense burning• Itching• Reaction lasts hours, not days
Care for Stinging Nettle Poisoning
• Wash exposed area with soap and water.
• Apply:Cold, wet packColloidal oatmeal, hydrocortisone
cream, or calamine lotionOver-the-counter antihistamine