Transcript Chapter 15 Poisoning

Emergency Medical Response
Lesson 24: Poisoning
You Are the
Emergency Medical Responder
Your police unit is summoned to a residence on a
report of an unconscious person. When you arrive
and size-up the scene, you discover parents with
their 2-year-old child. The mother is distraught
and says she found her toddler on the kitchen
floor very drowsy. She noticed that the under-thesink cabinet door was open, and there was a
bottle of liquid kitchen cleaner lying next to the
child. She called 9-1-1 because he was not
responding when she tried to wake him up.
Emergency Medical Response
Poison
 Any substance that causes injury, illness or
death if it enters the body
 Toxins are poisonous substances produced by
microorganisms that can cause certain diseases
but also are capable of stimulating neutralizing
antibodies or antitoxins
 Every person will/can react to poisons differently
Emergency Medical Response
Poison Control Centers
 Specialized health care centers that provide
information on poisons and suspected poisoning
emergencies
 24-Hour Poison Help Hotline: 1-800-222-1222
 U of U
 Pharmacists, physicians, nurses, toxicologists
 70% of poison exposure cases can be managed
over the phone
Emergency Medical Response
Poison Control Centers
 Poison Control Information
 Name, phone number, county, and zip code
 Victim's age and weight
 Any symptoms the victim has related to the
poisoning
 Time the poisoning took place
 Name of the substance or poison
 Amount of the substance or poison
 Current health problems of the victim
 Medicines the victim is taking
Emergency Medical Response
How Poisons Enter the Body
 Absorption
 Skin / Mucus
membranes
 Injection
 Bites, stings
needles
 Ingestion
 Swallowed
 Inhalation
 Breathes
Poison Ivy.
© Shutterstock.com/Tim Mainiero
Poison oak
© Shutterstock.com/Dwight Smith
Poison sumac
Courtesy of www.poison-ivy.org
Emergency Medical Response
Ingested Poisons
 Young children and elderly higher risk
 Foods are the most common
 Bacterial food poisoning (Salmonella or E.
coli)
 Chemical food poisoning (containers lined
with zinc, cadmium, copper, lead or mercury)
 Drugs or medications
 Household items
Emergency Medical Response
Signs and Symptoms of
Ingested Poisons
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Nausea, vomiting
Chest, abdominal pain
Difficulty breathing
Sweating
LOC
Seizures
Headache, dizziness
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Weakness
Irregular pupils
Burning/tearing eyes
Abnormal skin color
Burn injuries
Emergency Medical Response
 Lips
 Around mouth
Providing Care for
Ingested Poisons
 Call more advanced medical personnel / PCC
 Do not give anything to eat/drink unless told to
do so
 If patient vomits, save some in plastic bag
 Induce vomiting only if instructed to do so
 Unconscious
 Corrosive substance
 Pregnant (last trimester)
Emergency Medical Response
Ingested Poisons
Ipecac
 Action
 Local irritant & vomit
center stimulation
 Onset of action
 20-30 minutes in
97% people
 Advantages
 Easy to use
 Was over-thecounter
 Disadvantages
 Poison can pass into small
intestine during 20-30
minute wait for vomiting
 Delays additional care,
can’t be mixed with
activated charcoal
 Only 30% - 50% stomach
contents recovered = leaves
50% - 70% poison
 Complications
 Aspiration, esophageal
rupture, death
 Karen Carpenter
Emergency Medical Response
Inhaled Poisons
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Carbon monoxide
Carbon dioxide
Chlorine gas
Ammonia
Sulfur dioxide
Nitrous oxide
 Chloroform
 Dry cleaning solvents
 Fire extinguisher
gases
 Industrial gases
 Hydrogen sulfide
Emergency Medical Response
Signs and Symptoms of
Inhaled Poisons
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Difficulty breathing
Chest pain
Nausea or vomiting
Headache, dizziness
Altered mental status
Seizures
Cyanosis
Emergency Medical Response
Providing Care for
Inhaled Poisons
 Follow appropriate safety precautions to ensure
you do not inhale the substance and become
poisoned as well
 Remove patient from source without
endangering yourself
 Call more advanced medical personnel / PCC
 Administer oxygen as soon as possible
 Toxic fumes - may have to call hazard material
team
Emergency Medical Response
Absorbed Poison
 Enters the body through skin or mucus
membranes of the eyes, mouth, and nose
 Plants
 Poison ivy
 Poison oak
 Poison sumac
 Dry chemicals
 Wet chemicals
 Topical medications
Emergency Medical Response
Signs and Symptoms of
Absorbed Poisons
 Traces of the liquid, powder or chemical on the
patient’s skin
 Skin that looks burned, irritated, red, or swollen
 Blisters that ooze fluid or a rash
 Itchy skin
Emergency Medical Response
Providing Care for
Absorbed Poisons
 Follow appropriate safety precautions to ensure
you do not come into contact with the substance
and become poisoned as well - BSI
 Brush / flush with water at least 20 minutes
 Eyes, do not rinse into good eye!
 Call more advanced medical personnel / PCC
Emergency Medical Response
Activity
You arrive at a local nursery in response to a call
that an employee was splashed in the face and
on the neck with a liquid chemical to kill weeds.
The employee is conscious and is complaining
that his skin and eyes feel “like they are on fire.”
Emergency Medical Response
Injected Poison
 Bites or stings of insects, spiders, aquatic life,
animals or snakes
 Drugs or misused medications injected with a
hypodermic needle
Emergency Medical Response
Signs and Symptoms of
Injected Poisons
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Bite or sting mark at point of entry
Stinger, tentacle or venom sac near entry site
Redness, pain, tenderness around entry site
Signs of allergic reaction
 Itching, hives, rash
 Weakness, nausea, dizziness
 Severe allergic reactions
 Anaphylaxis
Emergency Medical Response
Providing Care for
Injected Poisons
 Scene size-up / standard precautions
 Primary assessment – provide care for
conditions found
 Apply ice/cold pack if appropriate
 Provide specific care – chapter 16
 Call more advanced medical personnel / PCC
Emergency Medical Response
You Are the
Emergency Medical Responder
You complete your assessment and find that the
toddler is unresponsive and his respiratory and
pulse rates are extremely slow. He also has some
redness around his mouth and lips, and there is a
strong odor of bleach. Based on your findings, you
suspect poisoning.
Emergency Medical Response
Enrichment
Carbon Monoxide & Cyanide Poisoning
 Carbon Monoxide (CO) and Cyanide result from fires,
industrial accidents, and Weapons of Mass Destruction
(WMD)
 CO is the leading cause of poisoning deaths in the US
 It is colorless, odorless, and tasteless
 CO is a byproduct of combustion, therefore at-risk
individuals include:
 Boats, Bar-B-Que inside a closed garage
 Sleeping inside a running car
 Faulty furnace, wood stove, or water heater
Emergency Medical Response
Carbon Monoxide Poisoning
Signs and Symptoms
 Dull throbbing
headache
 Nausea or vomiting
 Bluish skin color
 Chest pain
 Confusion
 Convulsions
 Dizziness
 Drowsiness
 Fainting
Hyperactivity
Impaired judgment
Irritability
Loss of consciousness
Low blood pressure
Muscle weakness
Rapid or abnormal
heart beat
 Shock
 Shortness of breath
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Emergency Medical Response
Cyanide Poisoning
Signs and Symptoms
 Ingestion or absorption  Large, concentrated/intense
exposure
 Dizziness
 Convulsions
 Headache
 Loss of consciousness
 Nausea and vomiting
 Low blood pressure
 Rapid breathing
 Lung injury
 Rapid heart rate
 Respiratory failure
 Restlessness
leading to death
 Weakness
 Slow heart rate
Emergency Medical Response
Care for Carbon Monoxide Poisoning
 Ensure that EMRs are properly outfitted for safety
 Remove the patient from the situation as quickly
as possible
 Alert ER staff and physicians about the suspicion
of CO poisoning
 Inform the patient that he or she may have a
blood test to confirm diagnosis
 Monitor and treat everyone in the area
 Administer emergency oxygen
 Home CO detector
Emergency Medical Response
Care for Cyanide Poisoning
 Observe for signs and symptoms of cyanide
poisoning
 Seek medical attention immediately
 Seek fresh air or rest in a half-upright position
 Administer emergency oxygen
 Wear protective clothing
 Rinse eyes with plenty of water
 Read CO and cyanide Enrichment pages 368-371
Emergency Medical Response
Enrichment
Administering Activated Charcoal
 Give within 1 hour of ingestion (ideally) only if directed
by medical control or the PCC and the patient is fully
conscious and alert
 Not for patients who have overdosed on cyanide or
swallowed acids or alkalis
 Mix it thoroughly with water and give through a straw or
use an opaque container
 Dosage:
• 1 g per kilogram of patient’s weight
• 30 to 100 g for adult
• 12 to 25 g for child or infant
Emergency Medical Response