POISON is any substance (solid, liquid, gas) that tends to impair health or cause death when introduced
into the body or onto the skin surface. Can be life threatening.
Common Household Poison
1. Sleeping pills
2. Pain relievers.
3. Insect and rodent poisons
4. Kerosene
5. Denatured alcohol
6. Lye and acids including boric
7. Poisonous plants
8. Contaminated water
9. Fume
Ways in Which Poison May Occur
1. Ingestion
2. Inhalation
3. Absorption
4. Injection
Types
1. Ingested Poison is one that is introduced into the digestive tract by way of the mouth.
Suspect food poisoning if:
1. The victim ate food that “didn’t taste right” or that may been old, improperly prepared,
contaminated, left at room temperature for a long time, or processed with an excessive
amount of chemicals.
2. Several people who ate together become ill.
Signs and Symptoms
1. Altered mental status
2. History of ingesting poisons
3. Burns around the mouth
4. Odd breath odors
5. Nausea, vomiting
6. Abdominal pain
7. Diarrhea
Instances when vomiting should be induced
1. If unresponsive.
2. Cannot maintain an airway
3. Has ingested an acid, a corrosive such as lye, or a petroleum product such as gasoline or
furniture polish
4. Has a medical condition that could be complicated by vomiting, such as heart attack,
seizures and pregnancy.
First Aid
1. Place the victim on his or her left side
2. Monitor ABCs
3. Check for allergic reaction and assist in administration of prescribed medication for allergies.
4. Save any vomitus, spoiled foods, empty container and keep it with the victim if he or she is
taken to an emergency facility.
2. Inhaled poison is a poison breathed into the lungs.
Signs and Symptoms
1. History of inhaling poisons
2. Breathing difficulty
3. Chest pain
4. Cough, hoarseness, burning sensation in the throat
5. Cyanosis
6. Dizzines, headache
7. Seizures, unresponsiveness (advanced stages)
First Aid
1. Remove the victim from the toxic environment and into fresh air immediately.
2. Monitor ABCs
3. Seek medical attention
4. Absorbed Poison is a poison that enters the body through the skin.
Signs and Symptoms
1. History of exposures.
2. Liquid or powder on the skin
3. Burns
4. Itchiness, irritation
5. Redness, rash, blisters
First Aid
1. Remove the clothing
2. Then with a dry cloth blot the poison from the skin. If the poison is a dry powder, brush it
off.
3. Flood the area with copious amounts of water.
4. Continually monitor the patient’s vital signs.
5. Injected Poison is a poison that enters the body
through a bite, sting, or syringe.
A. Insect Bites
Signs and Symptoms
Stinger may be present
Pain
Swelling
Possible allergic reaction
First Aid
Remove stinger
Wash wound
Cover the wound
Apply a cold pack
Watch for signals of allergic reaction
B. Spider Bite / Scorpion Sting
Signs and Symptoms
Bite mark
Swelling
Pain
Nausea and vomiting
Difficulty of breathing or swallowing
First Aid
Wash wound
Apply a cold pack
Gett medical care to receive antivenin
Call local emergency number, if necessary
C. Animal Bites
Signs and Symptoms
Possible marks
Pain
Swelling
Possible allergic reaction
First Aid
If jellyfish – soak area in vinegar
If stay ray – soak in non – scaling hot water until pain goes away
If possible allergic reaction, assist in administration of prescribed medication
Clean and bandage the wound
Call local emergency number, if necessary.
D. Snake Bites
Signs and Symptoms
Bite mark
Pain
First Aid
Wash wound
Keep bitten part still, and lower than the heart.
Immobilize bitten extremity with elastic bandage to minimize venom uptake
Call local emergency number
E. Dog Bites
Signs and Symptoms
Bite mark
Bleeding
First Aid
If bleeding is minor – wash wound
Control bleeding
Apply antibiotic ointment
Cover the wound
Get medical attention if wound bleeds severely or if you suspect animal has rabies
Call local emergency number or contact animal control personnel.
General care for Poisoning
1. Remove the victim from the source of the poison
2. Care for any life threatening condition
3. Do not give the victim anything by mouth unless advised by medical professionals
Initial management
Initial management for all poisonings includes ensuring adequate cardiopulmonary function and
providing treatment for any symptoms such as seizures, shock, and pain.
Poisons that have been injected (e.g. from the sting of poisonous animals) can be treated by
binding the affected body part with a pressure bandage and by placing the affected body part in hot
water (with a temperature of 50°C). The pressure bandage makes sure the poison is not pumped
troughout the body and the hot water breaks down the poison. This treatment however only works
with poisons that are composed of protein-molecules.
Decontamination
If the toxin was recently ingested, absorption of the substance may be able to be decreased
through gastric decontamination. This may be achieved using activated charcoal, gastric
lavage, whole bowel irrigation, or nasogastric aspiration. Routine use of emetics (syrup of
Ipecac), cathartics or laxatives are no longer recommended.
Activated charcoal is the treatment of choice to prevent absorption of the poison. It is
usually administered when the patient is in the emergency room or by a trained emergency
healthcare provider such as a Paramedic or EMT. However, charcoal is ineffective
against metals such as sodium, potassium, and lithium, and alcohols and glycols; it is also not
recommended for ingestion of corrosive chemicals such as acids and alkalis.
Whole bowel irrigation cleanses the bowel, this is achieved by giving the patient large
amounts of a polyethylene glycol solution. The osmotically balanced polyethylene glycol solution
is not absorbed into the body, having the effect of flushing out the entire gastrointestinal tract.
Its major uses are following ingestion of sustained release drugs, toxins that are not absorbed by
activated charcoal (i.e. lithium, iron), and for the removal of ingested packets of drugs (body
packing/smuggling).
Gastric lavage, commonly known as a stomach pump, is the insertion of a tube into the
stomach, followed by administration of water or saline down the tube. The liquid is then
removed along with the contents of the stomach. Lavage has been used for many years as a
common treatment for poisoned patients. However, a recent review of the procedure in
poisonings suggests no benefit. It is still sometimes used if it can be performed within 1 hour of
ingestion and the exposure is potentially life threatening.
Nasogastric aspiration involves the placement of a tube via the nose down into the
stomach, the stomach contents are then removed via suction. This procedure is mainly used for
liquid ingestions where activated charcoal is ineffective, e.g. ethylene glycol poisoning.
Emesis (i.e. induced by ipecac) is no longer recommended in poisoning situations,
because vomiting is ineffective at removing poisons.
Antidotes
Some poisons have specific antidotes:
Poison/Drug Antidote
paracetamol (acetaminophen) N-acetylcysteine
vitamin K anticoagulants, e.g. warfarin vitamin K
opioids naloxone
iron (and other heavy metals) desferrioxamine, Deferasirox or Deferiprone
benzodiazepines flumazenil
ethylene glycol ethanol or fomepizole, and thiamine
methanol ethanol or fomepizole, and folinic acid
cyanide amyl nitrite, sodium nitrite and sodium thiosulfate
Organophosphates Atropine and Pralidoxime
Magnesium Calcium Gluconate
Calcium Channel Blockers (Verapamil, Diltiazem) Calcium Gluconate
Beta-Blockers (Propranolol, Sotalol) Calcium Gluconate and/or Glucagon
Isoniazid Pyridoxine
Atropine Physostigmine
Thallium Prussian blue
Hydrofluoric acid Calcium Gluconate
Anticholinergics Cholinergics (and vice-versa)
Enhanced excretion
In some situations elimination of the poison can be enhanced using :
diuresis
hemodialysis is a method for removing waste products such as creatinine and urea, as well as free water
from the blood when the kidneys are in renal failure.
hemoperfusion is a medical process used to remove toxic substances from a patient's blood. The
technique involves passing large volumes of blood over an adsorbent substance. The adsorbent
substance most commonly used in hemoperfusion are resins and activated carbon.[1] Hemoperfusion is
an extracorporeal form of treatment because the blood is pumped through a device outside the
patient's body.
Its major uses include removing drugs or poisons from the blood in emergency situations, removing
waste products from the blood in patients with renal failure, and as a supportive treatment for patients
before and after liver transplantation.
hyperbaric medicine also known as hyperbaric oxygen therapy (HBOT), is the medical use of oxygen at
a level higher than atmospheric pressure.
peritoneal dialysis Fluid is introduced through a permanent tube in the abdomen and flushed out either
every night while the patient sleeps (automatic peritoneal dialysis) or via regular exchanges throughout
the day (continuous ambulatory peritoneal dialysis).
exchange transfusion is used to remove one person's red blood cells or platelets and replace them
with transfused blood products.
Further treatment
In the majority of poisonings the mainstay of management is providing supportive care for the
patient, i.e. treating the symptoms rather than the poison.
