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Poisonings & Overdose. accidental or deliberate. Poison Any substance whose chemical action can damage body structures or impair body functions Substance Abuse The knowing misuse of any substance to produce a desired effect. Routes of Entry. oral ingestion (PO) inhalation

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poisonings overdose

Poisonings & Overdose

accidental or deliberate

slide2
Poison
  • Any substance whose chemical action can damage body structures or impair body functions

Substance Abuse

  • The knowing misuse of any substance to produce a desired effect
routes of entry
Routes of Entry
  • oral ingestion (PO)
  • inhalation
  • injection ( IV, SC, IM, IO)
  • absorption (SL, transcutaneous, PR)
ingested poison
Ingested Poison
  • accounts for 80% of all poisonings
  • accidental or deliberate
  • Activated charcoal – NOT used by EMT’s in LA County
  • ABCs and transport
inhaled poisons
Inhaled Poisons
  • Wide range of effects
  • YOUR safety is 1st
  • Move to fresh air immediately
  • Provide airway support and rapid transport
  • Bring contained agent or label to hospital
injected poisons
Injected Poisons
  • Usually deliberate (drug OD)
  • Impossible to remove or dilute
  • Can be counteracted (ALS)
  • ABC’s, high flow O2, rapid transport
absorbed poisons
Absorbed Poisons
  • Corrosives will damage the skin
  • Some drugs are absorbed SL or PR
  • Treat chemical burns
  • Do not irrigate Phosphorous or elemental Na
  • ABC’s, O2, rapid transport
inducing vomiting
Inducing vomiting
  • not within the EMT-1 scope of practice to induce vomiting
  • But, is the indicated treatment for many poisonings/overdose

THE 3 EXCEPTIONS - next slide please

no vomiting
No Vomiting
  • ALOC
  • Pts at risk for seizures
  • Injested caustics / hydrocarbons
tx injested caustics hydrocarbons
TX – Injested caustics/hydrocarbons
  • discourage vomiting
  • drink water or milk if available
  • rapid transport
anticholinergics
Anticholinergics
  • block the parasympathetic nerves
  • “Hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter”
  • seizure and death within 30 minutes
  • Have ALS backup or transport rapidly
cholinergic agents
Cholinergic Agents
  • nerve agents for warfare
  • organophosphate insecticide or wild mushrooms
  • overstimulate parasympathetic nerves
signs and symptoms of cholinergic poisoning
D Defecation

U Urination

M Miosis

B Bronchorrhea

E Emesis

L Lacrimation

S Salivation

S Salivation

L Lacrimation

U Urination

D Defecation

G GI irritation

E Eye constriction

Signs and Symptoms of Cholinergic Poisoning
slide14
Rx
  • SAFETY – avoid exposure
  • support ABC’s prn
  • suction
  • high flow oxygen
  • rapid transport
  • may be HazMat
drug categories
Drug Categories
  • Narcotics or opiates
  • Depressants - barbiturates - downers
  • Stimulants - uppers
  • Hallucinogens - including PCP
  • Designer
  • Hydrocarbons
narcotics or opiates
Narcotics or Opiates
  • ALOC
  • respiratory depression/hypoventilation
  • pinpoint pupils
  • hypotension
  • nausea/ vomiting
depressants sedative hypnotic
Depressants (sedative – hypnotic)
  • ALOC
  • respiratory depression /hypoventilation
  • pupils dilated
  • loss of coordination
  • slurred speech
  • bradycardia and hypotension
stimulants sympathomimetics
Stimulants (Sympathomimetics)
  • agitation & anxiety
  • dilated pupils
  • tachycardia
  • hypertension
  • rapid speech
  • seizures
hallucinogens
Hallucinogens
  • blank stare
  • visual hallucinations
  • tachycardia, hypertension
  • anxiety, agitation
hallucinogens20
Hallucinogens
  • inappropriate behavior
  • dilated pupils
  • nystagmus
  • hot flashes (equals naked patients)
  • seizures
hallucinogen pcp
Hallucinogen - PCP
  • phencyclidine
  • “slow motion man”
  • fast if violent
  • increased strength
  • nystagmus
  • rebound dilation
designer drugs
Designer Drugs

Chemically designed for a specific effect

  • Ecstasy
  • GHB

Overdose:

Respiratory arrest - Hallucinations - ALOC

hydrocarbons abused inhalants
Hydrocarbons (Abused Inhalants)
  • paint residue around mouth & hands
  • smell of paint or glue
  • coughing
  • choking
aspirin
Aspirin
  • Signs and symptoms
    • Nausea/vomiting
    • Hyperventilation
    • Ringing in ears
    • Confusion
    • Seizures
  • Transport promptly
acetaminophen
Acetaminophen
  • common overdose
  • not very toxic
  • liver failure
rx for all
Rx for All
  • protect self
  • ABC’s
  • high flow oxygen
  • position of comfort
  • transport
co poisoning
CO poisoning
  • headache
  • confusion
  • nausea & vomiting
  • dyspnea, tachypnea, tachycardia
  • unconsciousness
slide28
Rx
  • protect self
  • remove patient from source
  • ABCs
  • high flow oxygen
food poisoning
Food Poisoning
  • Salmonella bacterium
  • Staphylococcus
  • Botulism
care for food poisoning
Care for Food Poisoning
  • History is important
  • Transport promptly
  • bring some of the suspected food to the hospital
plant poisoning
Plant Poisoning
  • Several thousand cases each year
    • Assess the patient’s airway and vital signs.
    • Notify poison control center.
    • Take the plant to the emergency department.
    • Provide prompt transport.
the end

the end

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