Any substance whose chemical action can damage body structures or impair body functions
The knowing misuse of any substance to produce a desired effect
1. What substance did you take? 2. when did you take it (or become exposed?) 3. How much did you ingest? 4. What actions have been taken (vomiting, poison control)? 5. How much do you weigh?
Transport to hospital
Take suspicious materials, containers. Provides key info on name/concentration of drug, specific ingredients, # of pills originally in bottle, name of manufacturer, prescribed dose
How poisons enter body
1. Ingestion 2. Inhalation 3. Injection 4. Absorption
80% of poisonings. Poison enters by mouth.
Treatment of ingested poison
Keep an eye on airway (many drugs lead to vomiting or depress respiratory system). Check mouth for burns.
1. MED CONTROL! 2. Shake bottle vigorously 3. Drink with straw and covered cup 4. Record time administered 5. Prepare for vomiting
Salmonella bacterium causes severe GI symptoms within 72 hours.
Staphylococcusis a common bacteria that grows in foods kept too long.
Results from improperly canned foods.
Find out where patient ate. Expect N/V/D. Diarrhea very dangerous to elderly and young (leads to tachycardia and dehydration, which in turn leads to poor perfusion of vital organs)
Treatment for food poisoning
Recognize need for transport. Give O2. BLS, treat for shock, transport.
Scene safety #1 priority. Move patient to fresh air immediately. All patients require immediate transport.
Ex: Gasoline, freon, glue, markers. Action: Fast-acting CNS depressant. Halogenated hydrocarbons make patient super-sensitive to own epinephrine (risk of cardiac arrest). Treatment: Scene safety, respiratory intervention, gentle handling (prepare for cardiac arrest)
Effects of inhalants
Range from mild drowsiness to coma and often causes seizure. Patient at high risk for cardiac arrest, so keep patient from exerting themselves.
Signs/Symptoms of inhaled poison
Depends on type/how much/how long/size of patient. Difficulty breathing (lung sounds clear with CO2, fluid with Chlorine), Chest tightness, Cough, Hoarseness, Dizziness and confusion, Seizures
Treatment for inhaled poisons
Scene safety, Remove patient from source, Airway/Breathing interventions, Prepare for respiratory and cardiac arrest
Substances damage skin, mucous membranes, eyes. Substance should be removed as rapidly as possible. Eyes should be irrigated. DO NOT irrigate if substance is reactive.
Treatment for absorbed poisons
Dust off dry chemicals (with full PPE), Flush continuously with water for 15-20 minutes, Check MSDS sheets to see if substance reacts with water (elemental sodium, phosphorous), Flush eyes with water w/ nasal cannula method, transport
Usually the result of drug overdose. Impossible to remove or dilute poison once injected. Transport promptly.
Prescription drugs container labels
Important to know: 1. Type of drug 2. How many pills in the bottle 3. Date of prescription 4. Name on prescription (person who took drug may not know effects) 5. Concentration of drugs (need to know how much they took)
Signs of distress and AMS signal systemic reaction. Don't be fooled into thinking conscious/alert/oriented patient is stable -- systemic reactions take time to develop
Consider decontamination before transport. Bad ABCs or poor general impression requires immediate transport.
Poison Focused Physical Exam
Focus on area of body or route of exposure. Baseline vitals important. Treatment based on: type of poison, when they were exposed
Support ABCs. Dilute/decontaminate depending on poison. Dilute airborne exposure with O2. Consider activated charcoal.
Detailed Physical Exam
At a minimum, needed on patients who: have extensive chemical burns, other significant trauma, are unresponsive. ABCs are priority.
Need for increased amount of drug to have same desired effect
Overwhelming desire or need to continue using an agent
Most commonly abused in U.S. Action: Powerful CNS depressant that acts as sedative and hypnotic.
Alcohol intoxication treatment
Respiratory support w/ signs of serious CNS depression. Transport for evaluation by doctor. Remember: IT COULD BE OTHER MEDICAL PROBLEM!
Alcohol withdrawal signs/symptoms
Patients with alcohol withdrawal (delirium tremors) may experience: agitation/restlessness, fever, sweating, confusion/disorientation, delusions/hallucinations, seizures
Most opioids have medicinal purposes (except for heroin). Action: CNS depressant causing severe respiratory distress, decreased RR, decreased LOC, pinpoint pupils.
codein, Tylenol 3, hydrocodone (vicodin), oxycodone (percocet), morphine, oxycontin
Scene safety, support ABCs, try to shake them gently or talk loudly to wake them, O2, transport
1. Barbiturates (phenobarbital) 2. Benzodiazepines (xanax, valium, rohypnol) Action: CNS depressant (respiratory distress and AMS). Treatment: airway, activated charcoal, transport
CNS stimulants. Drugs: amphetamine, methamphetamine, cocaine (seizures, cardiac disorders). Action: hypertension, tachycardia, dilated pupils.
Signs and symptoms of speed (6)
1. Hyperactivity 2. Dilated pupils 3. Increased body temp 4. Rapid HR 5. Rapid breathing 6. Hypertension
Produces euphoria, relaxation and drowsiness. Impairs short term memory and ability to work. Transport rarely needed.
LSD, PCP, psilocybin mushrooms. Alter individual's sense of perception. Action: hypertension, tachycardia, anxiety, paranoia.
Block parasympathetic nerves (parasympatholytic). Overdose blocks electrical conduction system, causing seizure within 30 minutes. "Hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter."
Commonly used on farms or nerve agents for warfare, but also in mushrooms. Overstimulate body functions controlled by parasympathetic nervous system.
SLUDGE (signs and symptoms of cholingerics)
Salivation, Lacrimation, Urination, Defecation, GI irritation, Eye constriction/Emesis
Treatment for cholingerics
BSI. My require field decontamination. Priority after decontamination is to decrease secretions in mouth and trachea. Provide airway support.
Signs and symptoms of overdose: N/V, Hyperventilation, Ringing in ears, Confusion, Seizures
Overdosing common. Symptoms may not appear until it's too late. Liver failure not apparent for full week.
Methyl alcohol and ethylene glycol are more toxic than ethyl alcohol. May be taken by chronic alcoholics who cannot obtain drinking alcohol. More often taken by someone attempting suicide
If you suspect plant poisoning: Assess the patient's airway and vital signs. Notify poison control center. Take the plant to the emergency department. Provide prompt transport.