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POISONING

LESSON 14. POISONING. 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

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POISONING

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  1. LESSON 14 POISONING

  2. 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

  3. 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

  4. 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

  5. Signs and Symptoms ofSwallowed 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

  6. Emergency Care forSwallowed 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

  7. 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

  8. 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

  9. 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

  10. Inhaled Poisons • Gases and fumes at home and work • Examples: • Paints • Thinners • Chemicals

  11. Inhaled Poisons (continued) • 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

  12. 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

  13. Assessing Inhaled Poisoning • Perform standard assessment • Do not enter scene without protection

  14. Signs and Symptoms of Inhaled Poison • Breathing difficulty • Headache • Dizziness, lightheadedness, confusion, weakness • Nausea, vomiting • Chest pain • Convulsions • Changing levels of responsiveness

  15. 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

  16. Alcohol and Drug Emergencies

  17. 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

  18. Assessing Alcoholand 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. Poisonous Bites and Stings

  27. Snake Bites Poisonous snakes include: • Rattlesnakes • Copperheads • Water moccasins (cottonmouths) • Coral snakes

  28. 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

  29. 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

  30. 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

  31. 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

  32. Emergency Care forBites 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

  33. 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

  34. Emergency Care forBites and Stings (continued) • Watch for allergic reaction, treat for shock • Follow local protocol to assist with patient’s medication (EpiPen) • Place unresponsive patient in recovery position • Monitor breathing and vital signs • Give BLS as needed

  35. 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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