Transcript POISONING AND OVERDOSE

POISONING AND OVERDOSE
• Poisoning
Any substance that can harm the body
Types
• Chemicals
• Toxins
Effects:
• Destroys the skin
• Suffocates
• Systemic—depress 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)
• 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
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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 don’t 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
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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
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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
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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