Poison
Any substance that can harm the body by altering cell structure or functions
Toxin
A poisonous substance secreted by bacteria, plants, or animals
What should be kept in mind in relation to how poison affects people?
The reaction is far more serious in the ill, very young, and elderly
Ingested poisons
Poisons that are swallowed
Inhaled poisons
Poisons that are breathed in
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Examples of ingested poisons
Common household and industrial chemicals, medications, improperly prepared or stored foods, plant materials, petroleum products, and agricultural products made specifically to control rodents, weeds, insects and crop diseases
Examples of inhaled poisons
Gases, vapors, sprays. Many are commonly used in the home, industry and agriculture. Carbon monoxide, carbon dioxide, ammonia, chlorine, insect sprays, and gases produced from volatile chemicals
Acetaminophen poisoning signs and symptoms
Nausea, vomiting, Jaundice is a late sign. There may be no signs or symptoms.
Acid and alkali poisoning signs and symptoms
Burns on or around the lips. Burning in the mouth, throat, and abdomen. Vomiting
Antiarrhythmic poisoning signs and symptoms
Bradycardia, hypotension, decreased consciousness, respiratory depression
Antidepressant poisoning signs and symptoms
Tachycardia, hypertension, nausea, tremors
Antihistamine/cough and cold poisoning signs and symptoms
Hyperactivity or drowsiness, rapid pulse, flushed skin, dilated pupils
Antipsychotic poisoning signs and symptoms
Drowsiness, coma, tachycardia
Aspirin poisoning signs and symptoms
Delayed signs and symptoms include: ringing in the ears, deep and rapid breathing, bruising
Food poisoning signs and symptoms
Different types of food poisoning have different signs and symptoms of varying onset. Most include abdominal pain, nausea, vomiting, and diarrhea, sometimes with fever.
Common with raw meat, poultry and fish
Ibuprofen and other nonsteroidal anti-inflammatory drug (NSAIDs) poisoning signs and symptoms
Upset stomach, nausea, vomiting, drowsiness, abdominal pain, gastrointestinal bleeding
Insecticide poisoning signs and symptoms
Slow pulse, excessive salivation and sweating, nausea, vomiting, diarrhea, difficulty breathing, constricted pupils
Petroleum product poisoning signs and symptoms
Characteristic odor of breath, clothing, vomitus. If aspiration has occurred, coughing and difficulty breathing.
Plant poisoning signs and symptoms
Wide range of signs and symptoms, ranging from none to nausea and vomiting, to cardiac arrest
Absorbed poisons
Poisons that are taken into the body through unbroken skin
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Injected poisons
Poisons that are inserted through the skin; for example, by needle, snake fangs, or insect stinger
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Examples of absorbed poisons
Insecticides, agricultural chemicals, plant materials, and certain forms of marine life
Examples of injected poisons
Illicit drugs injected with a needle, venoms from snake fangs or insect stingers
Pt assessment for most poisonings
1. What substance was involved?
2. When did the exposure occur?
3. How much was the pt exposed to?
4. Over how long a period did the exposure occur?
5. What interventions has the pt, family, or well-meaning bystanders taken?
6. What is the pt's estimated
Activated charcoal
A substance that absorbs many poisons and prevents them from being absorbed by the body
Activated charcoal trade names
SuperChar, InstaChar, Actidose, Liqui-Char, others
Activated charcoal indications
Poisoning by mouth
Activated charcoal contraindications
1. Altered mental status
2. Ingestion of acids or alkalis
3. Ingestion of gasoline
4. Food poisoning
5. Inability to swallow
Activated charcoal medication form
1. Premixed with water, frequently available in plastic bottle containing 12.5 grams of activated charcoal
2. Powder - should be avoided in the field
Activated charcoal dosage
1. Adults and children: 1 gram activated charcoal/kg of body weight
2. Usual adult dose: 25 to 50 grams
3. Usual pediatric dose: 12.5 to 25 grams
Activated charcoal administration
1. Consult medical direction
2. Shake container thoroughly
3. Since medication looks like mud, the pt may need to be persuaded to drink it. Providing a covered container and straw will prevent the pt from seeing the medication and so may improve pt compli
Activated charcoal actions
1. Absorbs (binds) certain poisons and prevents them from being absorbed into the body
2. Not all brands of activated charcoal are the same. Some absorb much more than others, so consult medical direction about the brand to use
Activated charcoal side effects
1. Some pt's have black stools
2. Some pt's may vomit, particularly to those who have ingested poisons that cause nausea. If the pt vomits, repeat the dose once.
Dilution
Thinning down or weakening by mixing with something else. Ingested poisons are sometimes diluted by drinking water or milk.
Antidote
A substance that will neutralize the poison or its effects.
There are only a few genuine antidotes, for a very small number of poisons.
Carbon monoxide poisoning signs and symptoms
CO prevents the normal carrying of oxygen by the red blood cells. Death may occur as hypoxia becomes more severe. Usually associated with motor-vehicle exhaust and fire suppression.
1. Headache, especially "a band around the head"
2. Dizziness
3. Breathin
Smoke inhalation poisoning signs and symptoms
Associated with fire scenes, often associated with thermal burns as well as with the effects of chemical poisons within the smoke.
1. Reddened, watering eyes
2. Difficulty breathing
3. Coughing
4. Breath that has a "smoky" smell or odor of chemicals invol
Detergent suicides
Mixing two chemicals to release toxic hydrogen sulfide gas. Usually a strong household cleaner and bath salts, or a pesticide. Best known for the rotten egg odor.
Hydrogen sulfide takes the place of oxygen, and bonds to the iron in cells, preventing oxyge
Phone number for poison control
1-800-222-1222
What should you consider when you have a pt with alcohol intoxication?
1. Take it seriously
2. Provide care to them the same you would for any other pt, treat them with dignity and respect
3. Consider possibilities of trauma injuries, or other medical emergencies that the pt doesn't realize they have, or can't tell you about
What other trauma and medical issues can give the appearance of intoxication?
1. Diabetes
2. Epilepsy
3. Head injuries
4. High fevers
5. Hypoxia
Alcohol abuse signs and symptoms
1. Odor of alcohol on the pt's breath or clothing
2. Swaying and unsteadiness of movement
3. Slurred speech, rambling through patterns, incoherent words or phrases
4. A flushed appearance to the face, often with the pt sweating and complaining of being wa
Withdrawl
Referring to alcohol and drug withdrawal in which the pt's body reacts severely when deprived of the abused substances
Delirium tremens (DTs)
A severe reaction that can be part of alcohol withdrawal, characterized by sweating, trembling, anxiety, and hallucinations. Severe alcohol withdrawal with this can lead to death if untreated.
Delirium tremens signs and symptoms
1. Confusion and restlessness
2. Unusual behavior, to the point of demonstrating "insane" behavior
3. Hallucinations
4. Gross tremor (obvious shaking) of the hands
5. Profuse sweating
6. Seizures (common and often very serious)
7. Hypertension
8. Tachycar
Substance abuse
A chemical substance being taken for other than therapeutic (medical) reasons
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Uppers
Stimulants such as amphetamines that affect the central nervous system to excite the user. Can relieve fatigue or create feelings of well-being
Examples of uppers
Amphetamines, biphetamines, cocaine, desoxyn, dextroamphetamine, methamphetamine, methylphenidate, preludin
Downers
Depressants, such as barbiturates, that depress the central nervous system, which are often used to bring on a more relaxed state of mind
Examples of downers
Barbiturates, amobarbital, pentobarbital, phenobarbital, secobarbital
Narcotics
A class of drugs that affect the nervous system and change many normal body activities. Their legal use is for their relief of pain. Illicit use is to produce and intense state of relaxation
Examples of narcotics
Codeine, demerol, dilaudid, fentanyl, heroin, methadone, morphine, opium, oxycodone/oxycontin, paregoric, acetominophen with codeine
Hallucinogens
Mind-affecting or mind-altering drugs that act on the central nervous system to produce excitement and distortion of perceptions
Examples of hallucinogens
DMT, LSD, mescaline, morning glory seeds, PCP, psilocybin (magic mushrooms), STP
Non-hallucinogenic mind-altering drugs
Hash, marijuana, THC
Volatile chemicals
Vaporizing compounds such as cleaning fluid, that are breathed in by the abuser to produce a high
Examples of volatile chemicals
Amyl nitrate, butyl nitrate, cleaning fluid, furniture polish, gasoline, glue, hair spray, nail polish remover, paint thinner, white-out fluids
Uppers signs and symptoms
1. Excitement
2. Increased pulse and breathing rates
3. Rapid speech
4. Dry mouth
5. Dilated pupils
6. Sweating
In repeated high doses the pt may have a complaint of having gone without sleep for long periods, restlessness, hyperactivity, and be apprehens
Downers signs and symptoms
1. Sluggish
2. Sleepy
3. Lacking of typical coordination of body and speech
4. Pulse and breathing rates are low, often to the point of a medical emergency
Narcotics signs and symptoms
1. Reduced pulse rate
2. Reduced depth of breathing
3. Lowering skin temperature
4. Constricted pupils (pinpoint)
5. Muscles are relaxed
6. Profuse sweating
7. Sleepy and no drive to do anything
In overdoses, coma is common; and respiratory or cardiac arr
Hallucinogens signs and symptoms
1. Fast pulse rate
2. Dilated pupils
3. Flushed face
4. Seeing or hearing things
5. Little concept of real time
6. May not be aware of the true environment
7. Often speaking nonsense
8. May become aggressive or be timid
Volatile chemicals signs and symptoms
1. Pt appears dazed
2. Shows temporary loss of contact with reality
3. May develop a coma
4. Linings of the nose and mouth may show swollen membranes
5. Pt may complain of a funny numb feeling, or tingling inside the head
6. Changes in heart rhythm may oc
Drug withdrawal signs and symptoms
1. Shaking
2. Anxiety
3. Nausea
4. Confusion and irritability
5. Hallucinations
6. Profuse sweating
7. Increased pulse and breathing rates