Poisoning

1
Chapter 18

• Poisoning

2
Types of Poisons

• Ingested (swallowed)
• Through the mouth
• Inhaled (breathed)
• Through the lungs
• Absorbed (contact)
• Through the skin
• Injected
• Through needlelike device

3
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.

4
Recognizing Ingested Poisons

• Abdominal pain, cramping
• Nausea or vomiting
• Diarrhea
• Burns, stains, odor near or in mouth
• Drowsiness or unresponsiveness
• Poison containers nearby

5
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

6
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.

7
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

8
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

9
Recognizing Alcohol Intoxication

• Odor of alcohol
• Unsteadiness, staggering
• Confusion
• Slurred speech
• Nausea and vomiting
• Flushed face
• Seizures can also result.

10
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.

11
Drug Emergencies

• Drug classifications
• Uppers (stimulants)amphetamines, cocaine,
  caffeine
• Downers (sedative-hypnotic)barbiturates,
  tranquilizers, marijuana, narcotics
• HallucinogensLSD, mescaline, peyote, PCP
• Volatile chemicalsglue, cement, paint solvent,
  gasoline, spray paint, nail polish remover

12
Sympathomimetics

• Stimulants (uppers)
• Produce excitement
• Amphetamines, methamphetamines
• Taken by mouth or injected
• Cocaine
• Crack

13
Recognizing Sympathomimetic Use

• Disorganized behavior
• Hyperactivity
• Restlessness
• Anxiety or great fear
• Paranoia
• Delusions

14
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.

15
Hallucinogens

• Produce changes in mood, sensory awareness
• Hear colors, see sounds
• Cause hallucinations, bizarre behavior
• Protect user from hurting self

16
Recognizing Hallucinogen Use

• Visual hallucinations
• Intensity of vision and hearing

17
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.

18
Marijuana

• Flowering hemp plant
• Estimated 20 million people use marijuana daily
  in US

19
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

20
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.

21
Depressants

• Often prescribed as part of legitimate medicine
• People may solicit prescriptions from several
  physicians.
• Includes
• Opiates (narcotics)
• Sedative hypnotics (barbiturates and
  tranquilizers)

22
Recognizing Sedative-Hypnotic Drug Use

• Drowsiness, sleepiness
• Slurred speech
• Slow breathing rate

23
Opiates

• Pain relievers named for opium
• Heroin, codeine, morphine
• Frequently abused
• Addicts may start with appropriate prescription

24
Recognizing Opiate Overdose

• Reduced breathing rate
• Pinpoint pupils
• Sedated condition, unresponsiveness

25
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.

26
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

27
Recognizing Abused Inhalant

• Mild drowsiness, unresponsiveness
• Slurred speech, clumsiness
• Seizures
• Slow breathing rate
• Smell of solvents

28
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.

29
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

30
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

31
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.

32
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.

33
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.

34
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

35
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.

36
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

37
Stinging Nettle

• Plant with stinging hairs on stem and leaves
• Stinging hair is touched
• Fine needlepoint penetrates skin
• Injects chemical irritant

38
Recognizing Stinging Nettle Poisoning

• Can affect anyone
• Effects limited to exposed area
• Immediate response
• Redness
• Rapid, intense burning
• Itching
• Reaction lasts hours, not days

39
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