Transcript Swallowed Poisons

LESSON 14
POISONING
© 2011 National Safety Council
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Introduction
• Poison: any substance that enters or touches body with injurious
or life-threatening effects
• Poisons enter body by being swallowed, injected, inhaled or
absorbed
• Over 2 million poisoning incidents occur in United States every year
• About 29,000 deaths from accidental poisoning
• Some take a poison intentionally in suicide attempt or to experience
substance’s effects
• This chapter includes overdose of alcohol and drugs, and
venomous bites and stings
© 2011 National Safety Council
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Swallowed Poisons
• Most cases of poisoning involve swallowed substances
• Effects may be immediate or delayed
• Give emergency care as soon as possible
• Patient may be unresponsive, confused and disoriented
• Most important thing is recognition
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Assess the Situation
• Look for containers nearby or clue of substance or
product use
• Ask others at scene what happened
• Try to find out how much person may have swallowed
and how long ago
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Signs and Symptoms of
Swallowed Poisons
• Specific signs and symptoms vary
• May look and feel ill
• Abdominal pain
• Nausea, vomiting, diarrhea
• Altered mental status, unresponsive
• Burns, stains or odors around mouth
• Dilated or constricted pupils
• Abnormal breathing
© 2011 National Safety Council
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Emergency Care for
Swallowed Poison
• Perform standard patient care
• Condition may change rapidly
• Emergency care depends on patient’s condition
• Follow local protocol for oxygen
• For unresponsive patient:
- Ensure EMS has been activated
- Check breathing and provide BLS
- Put breathing, unresponsive patient in recovery position (preferably
on left side)
- Monitor breathing and vital signs
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Emergency Care for
Swallowed Poison (continued)
• For responsive patient:
- If mouth or lips burned by corrosive chemical, rinse with
cold water (without swallowing)
- Follow local protocol to call Poison Control Center (PCC)
or medical direction – follow their directions
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Emergency Care for
Swallowed Poison (continued)
• For responsive patient:
- Don’t give food or drink unless instructed by PCC or
medical direction
- Don’t attempt to induce vomiting
- Don’t follow instructions on household product labels
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Poison Control Centers
• Provide information and treatment advice for all types of
poisonings
• Can be reached at 1-800-222-1222
• Has more accurate information
• Follow local protocol for calling PCC, medical direction
or waiting for EMS
• PCC also can advise on poisoning prevention
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Inhaled Poisons
• Gases and fumes at home
and work
• Examples:
- Paints
- Thinners
- Chemicals
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Inhaled Poisons
• Include gases that may
escape from pipelines or
transport tanks
• If you smell gas or there’s
evidence of a leak, stay away
• Allow hazardous materials
team to handle
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(continued)
Carbon Monoxide
• Invisible, odorless and tasteless
• May be present from:
-
Exhaust
Faulty furnace
Kerosene heater
Industrial equipment
Fireplace
Wood stove
Fire
• Exposure to large amounts can be lethal
• Results in more fatal unintentional poisonings in United States
than any other poison
© 2011 National Safety Council
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Assessing Inhaled Poisoning
• Perform standard assessment
• Do not enter scene without protection
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Signs and Symptoms
of Inhaled Poison
• Breathing difficulty
• Headache
• Dizziness, lightheadedness, confusion, weakness
• Nausea, vomiting
• Chest pain
• Convulsions
• Changing levels of responsiveness
© 2011 National Safety Council
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Emergency Care for
Inhaled Poisoning
• Perform standard patient care
• Immediately move patient to fresh air
• Monitor breathing and vital signs, give BLS as needed
• Put unresponsive patient in recovery position
• Loosen tight clothing around neck or chest
• Administer O2
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Alcohol and Drug Emergencies
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Drugs
• Illicit drugs and prescription drugs cause a wide variety
of behaviors and effects
• You do not need to know the drug taken to provide
emergency care
• Consider possibility of drug abuse or overdose when
behavior or signs and symptoms cannot be explained
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Assessing Alcohol
and Drug Emergencies
• Perform standard assessment
• Question patient and others at scene; give information
to arriving EMS
• Assess for injuries or illness; don’t assume alcohol or
drug is only factor involved
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Signs and Symptoms
of Alcohol Poisoning
• Smell of alcohol about person
• Flushed, moist face
• Vomiting
• Slurred speech, staggering
• Fast heart rate
• Impaired judgment and motor
skills
• Agitated or combative behavior
• Changing levels of
responsiveness, coma
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Signs and Symptoms of
Drug Abuse or Overdose
• Similar to alcohol poisoning
• Dilated or constricted pupils
• Stumbling, clumsiness,
drowsiness, incoherent speech
• Difficulty breathing (very slow or
fast)
• Changing levels of
responsiveness
• Unusual or erratic behavior
• Agitated or combative behavior
• Presence of drug paraphernalia
© 2011 National Safety Council
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Emergency Care for
Alcohol and Drug Emergencies
• Perform standard patient care
• For responsive patient:
- Protect patient from injury
- Don’t let patient lie on back
- Care for any injuries
- Follow local protocol to call PCC and follow instructions
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Emergency Care for
Alcohol and Drug Emergencies (continued)
• For unresponsive patient:
- Position patient in recovery position (preferably on left side)
- Be prepared for vomiting
- Give BLS if needed
- Keep patient warm in cold environments
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Emergency Care for
Alcohol and Drug Emergencies (continued)
• For injured intoxicated patient:
- Don’t rely on patient’s perception of injury
- Give care as for unresponsive patient
- If possible spinal injury, don’t move patient
© 2011 National Safety Council
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Emergency Care for
Alcohol and Drug Emergencies (continued)
• Provide care for any condition that occurs (seizures,
shock, cardiac arrest, etc.)
• Keep patient from harming self or others
• Do not try to induce vomiting
• If patient is hostile or violent, stay away and call law
enforcement
• When illegal drugs are involved, this is also a crime scene
© 2011 National Safety Council
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Alcohol Withdrawal
• Withdrawal from alcohol dependence may cause
delirium tremens:
- Confusion, disorientation, agitation
- Altered perception such as hallucinations or illusions
• Other signs and symptoms include:
- Hand trembling, head shaking
- Nausea, vomiting
- Seizures
• Give same emergency care as for intoxicated patient
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Poisonous Bites and Stings
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Snake Bites
Poisonous snakes include:
• Rattlesnakes
• Copperheads
• Water moccasins
(cottonmouths)
• Coral snakes
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Poisonous Bites and Stings
• Spiders
 Black widow
 Brown recluse
• Some scorpion species
• Portuguese man-of-war and
some jellyfish
• Stings from bees, wasps, etc.
can be life-threatening in
patients with severe allergies
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Assessing Bites and Stings
• Perform standard assessment
• Try to identify biting or stinging creature, but do not
capture it
• Check skin for signs of bite or sting
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Signs and Symptoms
of Many Bites and Stings
• Pain or burning, redness and swelling at site
• Depending on species:
- Difficulty breathing
- Numbness or muscle paralysis
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Signs and Symptoms
of Many Bites and Stings (continued)
• Depending on species:
- Nausea and vomiting
- Blurred vision
- Drowsiness or confusion, weakness
- Signs of shock
• Possible allergic reaction
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Emergency Care for
Bites and Stings
• Perform standard patient care
• Have patient lie down and stay calm
• Wash wound with water with or without soap
• Remove jewelry and tight clothing before swelling begins
• Don’t use tourniquet
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Emergency Care for
Bites and Stings (continued)
• Don’t cut wound or suck venom
• With bee or wasp sting, remove stinger and venom sac
by scraping it away gently
• Put cold pack on sting site
• For spider bite, keep bite area below level of heart
• With snake bite on extremity, wrap extremity with snug,
but not tight, elastic bandage
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Emergency Care for
Bites and Stings (continued)
1. Watch for allergic reaction,
treat for shock
2. Follow local protocol to
assist with patient’s
medication (EpiPen)
3. Place unresponsive patient
in recovery position
4. Monitor breathing and vital
signs
5. Give BLS as needed
© 2011 National Safety Council
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Jellyfish or Portuguese
Man-of-War Sting
• Wash sting area with vinegar as soon as possible to
inactivate venom
• Remove any remaining tentacles
• To reduce pain, immerse area in water as hot as can be
tolerated as long as pain is felt
• If hot water is unavailable, use a dry hot pack
preferably, or a dry cold pack to reduce pain
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