PREHOSPITAL EMERGENCY CARE CHAPTER Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Prehospital Emergency Care, 10 th edition.

PREHOSPITAL EMERGENCY CARE CHAPTER Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Prehospital Emergency Care, 10 th edition Mistovich | Karren TENTH EDITION Part I Toxicologic Emergencies 22

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Learning Readiness Objectives Please refer to page 605 of your text to view the objectives for this chapter.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Learning Readiness Key Terms Please refer to page 606 of your text to view the key terms for this chapter.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Setting the Stage Overview of Lesson Topics  Poisons and Poisoning  Ingested, Inhaled, Injected, and Absorbed Poisons

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Case Study Introduction EMTs Trisha Trujillo and Brian Long have just obtained the chief complaint and some preliminary information from from the mother of a two-year-old boy, named John. John was found with an open container of lamp oil, and because he had some of the substance around his mouth, his mother believes he may have drunk some of it. John is awake and alert, and he seems a little scared at the commotion now going on in his home.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Case Study What additional questions should the EMTs ask John and his mother? What information do they need about the product that may be involved? What resource will be helpful in assisting the EMTs with treatment and transport decisions?

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Introduction Poisoning may be accidental or intentional. Many calls to poison control centers involve children. There are special problems associated with drug and alcohol emergencies.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisons and Poisoning A poison is any substance that impairs health or causes death by its chemical. Moist poisonings are accidental, and involve young children. Other causes of poisoning include suicide and homicide. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisons and Poisoning Toxicology is the study of toxins and antidotes. Overdose of drugs or medications is a type of poisoning. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisons and Poisoning Poisons can enter the body by four routes.  Ingestion  Inhalation  Injection  Absorption continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisons and Poisoning Signs and symptoms depend on the specific poison and the route of entry into the body. Always be prepared for patient deterioration in a suspected poisoning. Monitor the mental status, airway, and breathing. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisons and Poisoning Most care for poisoning patients is supportive.  Intervene in airway, breathing, oxygenation, and circulation as needed.  Monitor mental status.  Be prepared for vomiting.  Frequent reassessment continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisons and Poisoning Few antidotes are available. Treatment is geared toward limiting or preventing absorption of the poison, and treating signs and symptoms.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Emptying of the stomach and absorption from the small intestine varies. Always determine when the substance was ingested. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Commonly ingested substances  Over-the-counter medications  Illegal drugs  Household products  Cleaning agents continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Commonly ingested substances  Foods  Insecticides  Petroleum products  Plants continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Factors in ingested poisoning include:  Not understanding directions for medications  Combining alcohol and drugs  Storing poisons in food or drink containers  Poisons within reach of children continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Poisoning is the number one cause of accidental death among children. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Assessment-based approach  The scene size-up can give valuable clues to the substance involved. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Assessment-based approach  Primary assessment Assess mental status. Assess the airway, anticipate vomiting; intervene as needed. Provide positive pressure ventilation as needed. Maintain oxygenation (SpO 2 94% or higher). Assess circulation. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Assessment-based approach  Secondary assessment History Consider that multiple substances may be involved. Consider the trustworthiness of the history from a patient who has overdosed. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Ask the following:  What substance was ingested?  Was alcohol also ingested?  When was the substance ingested?  Over what time period did the ingestion occur?  How much of the substance was taken? continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Ask the following:  Has anyone attempted treatment?  Does the patient have a psychiatric history?  Are there any underlying illnesses?  How much does the patient weigh?  What medications are available at the scene? continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Physical exam  Focus on complaints; if the mental status is altered perform a complete secondary assessment.  Vital signs continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Signs and symptoms  History of ingestion  Swelling of mucous membranes of the mouth  Nausea, vomiting  Diarrhea  Altered mental status continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Discoloration or burns around the mouth are signs of possible poisoning. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Signs and symptoms  Abdominal pain, tenderness  Burns or stains around the mouth; pain in the mouth or throat  Unusual breath or body odors  Respiratory distress  Altered heart rate continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Signs and symptoms  Altered blood pressure  Dilated or constricted pupils  Warm and dry or cool and moist skin  Altered mental status  Coma  Seizures continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Emergency medical care  Maintain the airway, protect from aspiration.  Assist inadequate ventilations.  Maintain oxygenation.  Prevent further injury. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Emergency medical care  Consult medical direction or poison control center; activated charcoal may be ordered.  Bring the substance to the hospital.  Reassess frequently. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Activated charcoal  May occasionally be used with ingestion of certain substances  No evidence that it improves outcomes  Risk of aspiration continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Activated charcoal  Absorbs certain toxins, preventing them from being absorbed into the body  If given, it should be given within one hour of ingestion of the poison.  Must be administered only under medical direction continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Ingested Poisons Activated charcoal  Never give to a patient with altered mental status or inability to swallow  Do not give in cases of ingestion of acids or alkalis.  Usual dosage 1g/kg

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Place the activated charcoal in a cup with a lid. A straw may also help to improve the patient's willingness to drink the charcoal.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Inhalation of vapors and fumes Many poisonings from inhalation occur as a result of fire. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Common inhaled poisons  Carbon monoxide  Carbon dioxide  Chlorine gas  Fumes from liquid chemicals and sprays continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Common inhaled poisons  Ammonia  Sulfur dioxide  Anesthetic gases  Solvents used in dry cleaning, degreasing agents, fire extinguishers continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Common inhaled poisons  Industrial gases  Incomplete combustion of natural gas  Hydrogen sulfide  Nitrogen dioxide continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Intentional inhalation of certain substances, such as propellants, is called huffing. Huffing can result in displacement of oxygen from the lungs, and can have toxic effects and cause damage to the alveoli. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Commonly abused inhalants  Paints  Freon  Gas propellants  Glue  Nitrous oxide  Amyl nitrate  Butyl nitrate continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Assessment-based approach  Scene size-up Be aware of your own safety; note odors or fumes. Some inhaled poisons are colorless and odorless. Placards continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Assessment-based approach  Scene size-up If hazardous materials are involved, request resources. Do not enter the scene unless it is safe. Determine the number of patients. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Protect yourself. Have trained rescuers remove the patient from the toxic environment. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Assessment-based approach  Primary assessment Assess and closely monitor the airway. Assess and closely monitor breathing. Assist inadequate breathing. For adequate breathing, apply oxygen by nonrebreather mask. Assess circulation. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Administer oxygen to the inhaled poisoning patient. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Assessment-based approach  Secondary assessment Consider trauma History Physical exam continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Ask the following:  Does the history suggest a suicide attempt?  Did the exposure occur in an open or a confined space?  How long was the exposure? continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Signs and symptoms  History of toxic inhalation  Difficulty breathing  Chest pain, tightness; burning in chest or throat  Cough, stridor, wheezing, or crackles  Hoarseness continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Signs and symptoms  Copious secretions  Oral or pharyngeal burns  Dizziness  Headache  Confusion  Seizures  Altered mental status continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Signs and symptoms  Seizures  Altered mental status  Cyanosis  Respiratory rate increased or decreased continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Signs and symptoms  Nausea, vomiting  Paint on lips  Paint, glue, chemicals on face or lips  Signs of respiratory tract burns (singed nasal hairs, soot in sputum or throat) continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Emergency medical care  Protect yourself; use SCBA or await specialized rescue team.  Get the patient out of the environment.  Place the patient in a position of comfort.  Ensure an open airway. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Inhaled Poisons Emergency medical care  Positive pressure ventilation for inadequate breathing  Oxygen by nonrebreather mask for adequate breathing  Bring all information available about the substance to the receiving facility.  Reassess frequently.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved You have arrived at a greenhouse where there is a report of a worker inhaling a sprayed pesticide. The person who meets the ambulance urges you to hurry, stating that the patient is not responsive and seems to be having difficulty breathing. Click on the first action you should take. A.Open the airway.Open the airway. B. Obtain information about the nature of the exposure. C. Begin positive pressure ventilation. D. Remove the patient's clothing and decontaminate him.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Include intentional injection of drugs and animal or insect bites or stings. Effects can be local and systemic. Anaphylaxis may occur in response to insect stings. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Assessment-based approach  Scene size-up Drug paraphernalia Indications of bites or stings continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Assessment-based approach  Primary assessment Mental status Airway Breathing Oxygenation Circulation continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Assessment-based approach  Secondary assessment History Physical exam continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Ask the following:  Is there a history of drug use?  Time lapse between exposure and onset of signs and symptoms?  What type of animal or insect bit or stung the patient? continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Signs and symptoms  Dizziness  Chills  Fever  Nausea/vomiting  Euphoria continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Signs and symptoms  Sedation  High or low blood pressure  Pupillary changes  Needle tracks  Pain at injection site continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Signs and symptoms  Trouble breathing  Abnormal skin findings  Possible paralysis  Swelling and redness at injection site continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Emergency care  Maintain the airway.  Positive pressure ventilations for inadequate breathing  Maintain adequate oxygenation. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Injected Poisons Emergency care  Be alert for vomiting.  Protect yourself from the source of the bite or sting.  Bring all information available about the substance to the hospital.  Reassess.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Absorbed poisons can cause skin irritation or burns and are absorbed through the capillaries in the skin or mucous membranes. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Assessment-based approach  Scene size-up Note containers or plants in the environment. Wear gloves and other protective gear as needed. Call for additional resources, as needed. Remove the patient from the area. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Assessment-based approach  Primary assessment Assess the mental status. Assess the airway and breathing. Inspect for any poison remaining on the patient or his clothing. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Assessment-based approach  Secondary assessment History Physical exam continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Signs and symptoms  History of exposure  Traces of liquid or powder on the skin  Burns  Itching, irritation  Redness  Swelling continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Signs and symptoms of contact with a poisonous plant  Fluid-filled, oozing blisters  Itching and burning  Swelling  Pain  Rash continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Emergency medical care  Wearing gloves, remove the source of poison and the patient's contaminated clothing.  Monitor the airway and respiratory status. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Emergency medical care  Positive pressure ventilations for inadequate breathing  Maintain oxygenation (SpO 2 94% or higher). continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Absorbed Poisons Emergency medical care  Brush dry chemicals or solid toxins from the skin; consult medical direction about irrigation.  Irrigate for liquid poisons.  Irrigate the eye for eye exposure.  Reassess frequently.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Brush dry powder off the patient. Then flush with clean water to remove poison on the surface of the skin.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Irrigate chemical burns of the eye with clean water for at least 20 minutes.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Case Study Conclusion Trisha and Brian begin by removing John's clothes and having his mother help with rinsing him in the bathtub to remove any residue. As they do so, they examine him and monitor him for problems with his airway and breathing. The EMTs have decided to contact the Poison Control Center, as soon as they have collected additional information. They will include the guidance from Poison Control in their radio report to medical direction. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Case Study Conclusion John's mother had left him alone just long enough to put a load of clothes from the washing machine into the dryer. When she returned, she found John with the open bottle of lamp oil. She estimates that the event occurred about 15 minutes ago. The 16 oz. bottle was full, and now appears to have about an ounce gone. It appears that most of the oil is on John's clothing, but it is uncertain whether he ingested any of it. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Case Study Conclusion John's mother confirms that John has not vomited, but he did have a period of coughing before the ambulance arrived. John's airway is open, and his breathing is normal, with clear and equal breath sounds. He is active and denies pain in his mouth, throat, and abdomen. Because of the uncertainty of ingestion, the history of coughing, and the potential seriousness of hydrocarbon exposure, Poison Control recommends transport. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Case Study Conclusion The EMTs make sure John is warm, and they use his safety seat for transport. The ER physician thanks the EMTs, telling them that John will be observed for several hours for indications of aspiration or ingestion of hydrocarbons.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Lesson Summary Poisons can enter the body through ingestion, inhalation, injection, or absorption. Ingestion is the most common route of poisoning. There are few antidotes for specific poisons. continued on next slide

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Lesson Summary Care of the poisoned patient is largely supportive. Be aware of scene safety. Identify the substance and, if possible, transport it with the patient.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Correct! You do not yet have enough information to know if it is safe to enter the scene. You will need to know more about how the exposure occurred, what the substance, and how much is involved. You should consider requesting additional resources, if needed, to remove the patient from the area. Click here to return to the program. You do not yet have enough information to know if it is safe to enter the scene. You will need to know more about how the exposure occurred, what the substance, and how much is involved. You should consider requesting additional resources, if needed, to remove the patient from the area. Click here to return to the program.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Incorrect Although opening the airway is a critical step, you do not yet know if it is safe to approach the patient. Before undertaking any patient care steps, you must carefully evaluate scene safety by finding out more about the nature of the exposure. Click here to return to the quiz. Although opening the airway is a critical step, you do not yet know if it is safe to approach the patient. Before undertaking any patient care steps, you must carefully evaluate scene safety by finding out more about the nature of the exposure. Click here to return to the quiz.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Incorrect Although positive pressure ventilation is a critical step if the patient's breathing is inadequate, you do not yet know if it is safe to approach the patient. Before undertaking any patient care steps, you must carefully evaluate scene safety. Click here to return to the quiz. Although positive pressure ventilation is a critical step if the patient's breathing is inadequate, you do not yet know if it is safe to approach the patient. Before undertaking any patient care steps, you must carefully evaluate scene safety. Click here to return to the quiz.

Prehospital Emergency Care, 10 th edition Mistovich | Karren Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Incorrect If the patient has the substance on his skin or clothing, he will need to be decontaminated, both to protect you from exposure, and to prevent absorption of the substance through the patient's skin. However, you do not yet know if the scene is safe enough for you to approach the patient, so this is not the first step you would take. Click here to return to the quiz. If the patient has the substance on his skin or clothing, he will need to be decontaminated, both to protect you from exposure, and to prevent absorption of the substance through the patient's skin. However, you do not yet know if the scene is safe enough for you to approach the patient, so this is not the first step you would take. Click here to return to the quiz.

PREHOSPITAL EMERGENCY CARE CHAPTER Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Prehospital Emergency Care, 10 th edition.

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PREHOSPITAL EMERGENCY CARE CHAPTER Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Prehospital Emergency Care, 10 th edition.

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Presentation on theme: "PREHOSPITAL EMERGENCY CARE CHAPTER Copyright © 2014, 2010, 2008 by Pearson Education, Inc. All Rights Reserved Prehospital Emergency Care, 10 th edition."— Presentation transcript:

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