Poisons CERT Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 The following WSIB learning objectives have been met in this chapter: Poisons, Bites and Stings - Elective Module 15.1. Take measures to prevent poisoning 15.1.1. Recognize substances that cause poisoning: • Labeled poisons • Unidentified poisons 15.1.2. List five safety measures to prevent poisoning 15.2. Recognize poisoning 15.2.1. Define the term poison 15.2.2. List the four routes by which poisons enter the body 15.2.3. List four facts that help to determine the history of a poisoning emergency Poisons

Instructor Notes Continued 15.2.4. List the signs and symptoms of poisoning when a poison has been: • Taken by mouth • Inhaled • Absorbed • Injected 15.3. Provide first aid for poisoning 15.3.1. Describe the first aid for a conscious and unconscious casualty when a poison has been: I. Vomiting induced II. Vomiting not induced • Inhaled through the airway • Absorbed through the skin • Injected through the skin

Body Works Poisons can affect the body differently depending on the routes of entry and the substances entering. Once introduced into the body, poisons can quickly make their way to the blood stream where they move on to other tissues and organs of the body. Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: 15.2.1. Define the term poison Instructor Notes A toxin or a poison is any substance that causes a negative reaction when it enters the body. The number for poison control is (416) 813-5900 for the Toronto area, or 1-800-268-9017 for calls out of the Toronto Area. If the situation is immediately life threatening, call the local 911/EMS number. Poisons

Prevention Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: 15.1. Take measures to prevent poisoning 15.1.1. Recognize substances that cause poisoning: • Labeled poisons • Unidentified poisons 15.1.2. List five safety measures to prevent poisoning Instructor Notes Encourage class to participate in discussion. What do they do to minimize the potential of poisoning around the household? Learn what poison ivy, oak, and sumac look like and avoid any contact with them. Depending on the location throughout Canada, their appearance may differ. Install carbon monoxide detectors in all dwellings and test them often. Change the batteries when you change your clocks (twice a year). Poisons

Instructor Notes Continued Wear personal protective equipment (PPE) when using cleaning agents and chemicals. Keep toxic chemicals out of the reach and sight of children. Keep all medicines and vitamins locked away. When purchasing medicines and vitamins, make sure they are in child resistant bottles if you have children. Unwanted medicine can be dropped off at a local pharmacy for disposal. Never decant chemicals into any unlabeled bottles. Familiarize yourself with all Material Safety Data Sheets (MSDS) in your workplace. Learn how to store chemicals properly. Refer to MSDS sheets for storage and handling recommendations, as well as first aid instructions.

History Of The Scene What poison How much Route of entry When it was taken Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: n/a When poising occurs there is some vital information we need to find out to relay to poison control and EMS. This allows us to provide the appropriate first aid to the casualty and also allows EMS / Hospital to start preparing further treatment. This information is: What poison was involved. How much poison has entered the body. The route of entry the poison took. When the poison was taken.

Methods of Poisoning Inhale = Gases, solvents, vapours, and fumes. Ingest = Household cleaners, plants, over medicating, vitamins, herbal products and chemicals. Inject = Poisoning through injection may result from insects, poisonous snakes, bee stings, needles and drugs. Absorb = Items can be absorbed through skin and eyes. Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: 15.2.2. List the four routes by which poisons enter the body. Instructor Notes The signs and symptoms of poisoning vary depending on the route of entry and substance (chemicals) introduced. Once inside the body, poisons can quickly make their way into the blood stream and move to other tissues in the body. However, the body is also able to process and expel many toxins. One of the ways poisons may pass through the body is through the gastro-intestinal (GI) system, the means by which the body receives nutrients and filters out poisons. An ingested substance travels to the stomach, then to the small intestine where nutrients are absorbed into the blood stream. Blood passes through the liver, filtering many poisons. Poisons

Instructor Notes Continued Blood also passes through the kidneys to filter more toxins. The body disposes of the impurities through the urine. The remaining residue passes into the large intestine, and then goes to the anus where it is excreted.

Inhale Ingest Inject Absorb Signs and Symptoms Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: Instructor Notes Inhalation: Inhaled poisons may cause the following symptoms: Difficulty breathing, coughing, chest pain, headache, and or dizziness. Ingestion: Ingested poisons may cause casualty to feel or complain of: Nausea and vomiting/ Abdominal pain or cramps, diarrhea, discoloured lips, burn marks around the area of ingestion and there may be an odour on the breath. Poisons

Instructor Notes Continued Injection: Poisoning through injection may result from insects, fish, poisonous snakes, animals, needles, and drugs. A sign of this type of poisoning would include irritation around the point of entry but are otherwise specific to the poison. Absorption: Poisoning through absorption is the result of chemicals being absorbed through the eyes or skin. A sign of this type of poisoning would include irritation around the point of entry but are otherwise specific to the poison.

Inhaled Poisons Inhaled poisons may cause the following symptoms: Difficulty breathing Coughing Chest pain Headache Dizziness Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: 15.2. Recognize poisoning. Instructor Notes Inhalation Poisons that are inhaled may include poisonous gases, solvents, vapors or fumes. In addition to the effects of the specific poison, this method of introducing the poison may cause severe respiratory distress. Inhalation—Specific Signs and Symptoms Inhaled poisons may cause problems with: Difficulty breathing, coughing, chest pain, headache and dizziness. Poisons

Ingested Poisons Ingested poisons may cause casualty to feel or complain of: Nausea and vomiting Abdominal pain or cramps Diarrhea Discoloured lips Burn marks around the area of ingestion An odour on the breath Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 165 WSIB requirements: 15.2. Recognize poisoning. Instructor Notes - Ingestion Poisoning through ingestion may be the result of consumption of household cleaners, plants, drugs, alcohol, medications, vitamins, herbals, petroleum products, or chemicals. The poison may enter the circulatory system through the digestive tract. Ingestion—Specific Signs and Symptoms Ingested poisons may cause casualty to feel or complain of: Nausea and vomiting Abdominal pain or cramps Diarrhea Discoloured lips Burn marks around the area of ingestion An odour on the breath Poisons

Injected Poisons Signs and symptoms of this type of poisoning would include irritation around the point of entry but are otherwise specific to the poison. Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: 15.2. Recognize poisoning. Instructor Notes Poisoning through injection may result from insects, fish, poisonous snakes, animals, needles, drugs or puncture from a pressure hose. A sign of this type of poisoning would include irritation around the point of entry but are otherwise specific to the poison. Poisons

Absorbed Poisons Poisoning through absorption is the result of chemicals being absorbed through the eyes or skin. A sign of this type of poisoning would include irritation around the point of entry but are otherwise specific to the poison. Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: 15.2. Recognize poisoning. Instructor Notes Absorption Poisoning through absorption is the result of chemicals being absorbed through the eyes or skin. A sign of this type of poisoning would include irritation around the point of entry but are otherwise specific to the poison. Poisons

Poisoning Treatment Call Poison Control for specific treatment of poison: (416) 813-5900 or (800) 268-9017 Inhaled = Get fresh air. Ingested = Do not induce vomiting, contact poison control. Injected = Remove poison and wash area thoroughly. Absorbed= Remove poison and wash area thoroughly. Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 165 WSIB requirements: 15.3. Provide first aid for poisoning. Instructor Notes Begin your treatment with: ESM. If the poison is potentially life threatening, ensure that 911/EMS has been called. If the poison is not life threatening, call poison control for further direction. Specific treatment varies depending on the poison and method of poisoning. Provide first aid treatment and maintain ongoing casualty care Inhaled: If the casualty is conscious, get them into fresh air. If you are trained to administer oxygen, do so. Poisons

Instructor Notes Continued Absorbed: Flush the affected area with plenty of cool water. Injected: Remove the poison, if possible. If a stinger is still visible, remove it by scraping the skin with a plastic card in a downward motion. Ingested: Poison Control may ask you to induce vomiting. In that case, they will advise the best way to achieve this.

Poison Ivy (Wooded Area) Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 165 WSIB requirements: n/a. You may review this for general interest. Instructor Notes Most cases of poison ivy and oak can be cared for at home and do not require a trip to a doctor. However, a small percentage of people are highly allergic. If you break out in a rash within four hours of exposure and your eyes swell shut and blisters form, seek medical attention immediately. Otherwise, remove all clothes that have touched the plant. Wash skin with plenty of water. Keep your hands away from your eyes, mouth, and face. This picture was taken of poison ivy in a wooded area. In regards to poison ivy remember the saying “Leaves of three, let it be”. This saying also applies to other poisonous plants as well. Poisons

Poison Ivy (Beach) Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: n/a. You may review this for general interest. Instructor Notes Here is a picture of poison ivy at a beach. Notice the difference in appearance between poison ivy that grows in a wooded area versus at the beach. Poison ivy’s appearance does change depending on its location. However the following characteristic, remains the same: Leaves of three, leave it be Can grow as vine or bush If you compare one side of the leaf to the other, they don’t match. In fact, many have thought that a bug may have eaten the perimeter of the leaf. Poisons

Poison Ivy Rash Rash Swelling Itchy Blisters Blisters may ooze Presentation: Poisons Time Line: 20 minutes Participant manual page reference for slide: 164 WSIB requirements: n/a. You may review this for general interest. Instructor Notes A poison ivy rash is a type of skin irritation called allergic contact dermatitis. Poison ivy rash is caused by a sensitivity to an irritant found in poison ivy and similar toxic plants, such as poison oak and poison sumac. Each of these plants contains an oily resin called urushiol (u-ROO-she-ol) that can irritate the skin and cause a rash. Although the itching from a poison ivy rash can be quite bothersome, the good news is that a poison ivy rash or one caused by poison oak or poison sumac generally isn't serious. Poison ivy rash treatment consists of self-care methods to relieve itching until the reaction disappears. Definition and signs and symptoms taken from http://www.mayoclinic.com/health/poison-ivy Poisons