POISONING AND OVERDOSE

Poisoning Any substance that can harm the body Types Chemicals Toxins Effects: Destroys the skin Suffocates Systemicdepress or over stimulate CNS dependent upon……….

Nature of poison Concentration Age, weight, general health

Ingested Patient Assessment Substance When exposure occurred How much was ingested Over how long a period Interventions prior to your arrival Weight Effects

Activated Charcoal a form of carbon that has been processed to make it extremely porous and thus to have a very large surface area available for adsorption or chemical reactions. just one gram of activated carbon has a surface area of approximately 500 m² (or about 2.17 tennis courts)gram

Not an antidote reduces the amount of poison available for the body to absorb Absorbs many poisons but not all

Contraindications Cannot swallow AMS Ingestion of acids or alkalis Swallowed gasoline

Care Identify and treat life-threats Transport decision Focused Hx. and PE SAMPLE Remove any remnants or pill fragments Baseline VS Take all bottles and labels

Consult Medical Control Repeat and follow directions carefully Pediatric Give weight Estimated amt. of poison ingested

INHALED POISONS

CO Chlorine gas Ammonia Agricultural chemicals and pesticides CO2

Scene Safety Protective clothing Self-contained breathing apparatus if trained Many inhaled poisons can be absorbed through the skin If you dont have the proper training or equipment………….. STAY OUT!!!

Assessment Exact name of substance When did exposure occur Period of exposure Interventions pta Effects of substance and interventions

Care Airway Breathing Move to a safe place non-urgent move urgent move emergency move

Treat any immediate life-threats Transport decision Focused Hx. and PE O2 Bottled, containers and labels

CO Most common inhaled poison Car exhaust and fire supression Odorless, colorless, tasteless

Signs and symptoms Headache a band around the head Dizziness Breathing difficulty Nausea Cyanosis AMS

Consider a possibility when there are vague flu-like complaints and a group of people. May begin to feel better immediately after being removed from source

Smoke Inhalation Difficulty breathing Coughing Breath with smoky or odorous smell Carbon residue in mouth and nose Black residue in sputum Singed nose hairs

Absorbed Poisons Absorption can take place with little or no damage to the skin

Assessment Exact name of substance When did exposure occur Period of exposure Interventions pta Effects of substance and interventions

Care ABCs and Life-threats Transport decision Remove contaminated clothing be cautions of becoming contaminated Remove the poison:

Powders brush off Liquids Irrigate at least 20 minutes Eyes Irrigate for at least 20 minutes Do not neutralize acids and alkalis

Alcohol and Substance Abuse May have underlying trauma from falls May have underlying medical problems diabetes, GI bleed Alcohol and drugs are commonly taken together

Patient Assessment Scene Safety You may need to obtain SAMPLE from other sources

Signs and symptoms of alcohol abuse Odor of ETOH on breath or clothing Swaying and unsteadiness Slurred speech, rambling, incoherent Flushed with sweating & c/o being warm Nausea/vomiting Poor coordination Slowed reaction time

Blurred vision Confusion Hallucinations Lack of memory AMS

Signs and symptoms of alcohol withdrawl Confusion Unusual (insane) behavior Hallucinations Gross temor of hands Profuse sweating Seizures Transport seizure related DTs ASAP

Care Determine if drugs and alcohol mixed BSI; Scene safe ABCs LOC and GCS Monitor VS and be alert for shock Protect from self-injury and yourselves *restrain

If patient refuses

Substance Abuse

Patient Care BSI Scene safe ABCs Never touch or taste any suspected illicit drug Treat for shock

Talk to your patient to establish rapport and determine LOC and GCS Perform Rapid or Detailed PE carefully assess for head injury Inspect for tracks Protect from harm or harming others If pt. creates unsafe scene, GET OUT

Transport as soon as possible Contact medical direction Monitor VS Be aware of possible seizures Many drug users may appear calm at first then become violent----be on the alert