Chapter 18 Poisoning

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) Determine Age and size of victim What and how much poison ingested When it was taken If corrosive or caustic, have victim sip cold water or milk. Responsive victim, call Poison Control Center at 800-222-1222 Can advise if medical care is needed

Care for Ingested Poisons (2 of 3) Unresponsive victim, call 9-1-1 Place victim in recovery position. Do not induce vomiting. Give activated charcoal if advised.

Care for Ingested Poisons (3 of 3) Activated charcoal Black 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 at 800-222-1222. 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 9-1-1. 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 9-1-1. 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 9-1-1. 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 9-1-1. 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 9-1-1. 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 9-1-1. 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 pack Colloidal oatmeal, hydrocortisone cream, or calamine lotion Over-the-counter antihistamine