Chapter 18

1. Chapter 18 Poisoning

2. Types of Poisons • Ingested (swallowed) • Through the mouth • Inhaled (breathed) • Through the lungs • Absorbed (contact) • Through the skin • Injected • Through needlelike device

3. Ingested (Swallowed) Poisons • Occurs when victim swallows toxic substance • Most poisonings happen by ingestion. • Common among children • Some substances can block airway. • Analgesics are most common poisoning. • Most exposures to plants are minor.

4. Recognizing Ingested Poisons • Abdominal pain, cramping • Nausea or vomiting • Diarrhea • Burns, stains, odor near or in mouth • Drowsiness or unresponsiveness • Poison containers nearby

5. Care for Ingested Poisons (1 of 3) • Determine • Age and size of victim • What and how much poison ingested • When it was taken • If corrosive or caustic, have victim sip cold water or milk. • Responsive victim, call Poison Control Center at 800-222-1222 • Can advise if medical care is needed

6. Unresponsive victim, call 9-1-1 Place victim in recovery position. Do not induce vomiting. Give activated charcoal if advised. Care for Ingested Poisons (2 of 3)

7. Care for Ingested Poisons(3 of 3) • Activated charcoal • Black powder that binds to poison • Does not absorb all drugs well • Save containers, plants, and vomit

8. Alcohol Intoxication • Alcohol is a depressant. • Most commonly abused drug in US. • Often implicated as cofactor in other types of accidents • Can cause belligerent, combative behavior • Can be life-threatening • Take condition seriously

9. Recognizing Alcohol Intoxication • Odor of alcohol • Unsteadiness, staggering • Confusion • Slurred speech • Nausea and vomiting • Flushed face • Seizures can also result.

10. Care for Alcohol Intoxication • Look for injuries. • Monitor breathing. • Recovery position • Call poison control center at 800-222-1222. • If victim becomes violent, leave scene and await police. • Provide emotional support. • If victim is unresponsive, await EMS. • Move person to a warm place.

11. Drug Emergencies • Drug classifications: • Uppers (stimulants)—amphetamines, cocaine, caffeine • Downers (sedative-hypnotic)—barbiturates, tranquilizers, marijuana, narcotics • Hallucinogens—LSD, mescaline, peyote, PCP • Volatile chemicals—glue, cement, paint solvent, gasoline, spray paint, nail polish remover

12. Sympathomimetics • Stimulants (“uppers”) • Produce excitement • Amphetamines, methamphetamines • Taken by mouth or injected • Cocaine • Crack

13. Recognizing Sympathomimetic Use • Disorganized behavior • Hyperactivity • Restlessness • Anxiety or great fear • Paranoia • Delusions

14. Care for Sympathomimetic Users • Check breathing. • Call poison center or 9-1-1. • Check for injuries. • Place in recovery position. • Give reassurance, emotional support • If violent, seek safety until police arrive. • Seek medical care.

15. Hallucinogens • Produce changes in mood, sensory awareness • Hear colors, see sounds • Cause hallucinations, bizarre behavior • Protect user from hurting self

16. Recognizing Hallucinogen Use • Visual hallucinations • Intensity of vision and hearing

17. Care for Hallucinogen Use • Check breathing. • Call poison center or 9-1-1. • Check for injuries. • Place in recovery position. • Give reassurance, emotional support • If violent, seek safety until police arrive. • Seek medical care.

18. Marijuana • Flowering hemp plant • Estimated 20 million people use marijuana daily in US

19. Recognizing Marijuana Overdose • Euphoria, relaxation, drowsiness • Short-term memory loss • Impaired capacity for complex thinking and work • Depression, confusion • Altered perception of time • Anxiety, panic • Hallucinations

20. Care for Marijuana Overdose • Check breathing. • Call poison center or 9-1-1. • Check for injuries. • Place in the recovery position. • Give reassurance, emotional support • If violent, seek safety until police arrive. • Seek medical care.

21. Depressants • Often prescribed as part of legitimate medicine • People may solicit prescriptions from several physicians. • Includes: • Opiates (narcotics) • Sedative hypnotics (barbiturates and tranquilizers)

22. Recognizing Sedative-Hypnotic Drug Use • Drowsiness, sleepiness • Slurred speech • Slow breathing rate

23. Opiates • Pain relievers named for opium • Heroin, codeine, morphine • Frequently abused • Addicts may start with appropriate prescription

24. Recognizing Opiate Overdose • Reduced breathing rate • Pinpoint pupils • Sedated condition, unresponsiveness

25. Care for Depressant Overdose • Check breathing. • Call poison center or 9-1-1. • Check for injuries. • Place recovery position. • Give reassurance, emotional support • If violent, seek safety until police arrive. • Seek medical care.

26. Abused Inhalants • Glue, gasoline, lighter fluid, nail polish • Similar effects to alcohol • Can die of suffocation • Can change heart rhythm • Can cause permanent brain damage

27. Recognizing Abused Inhalant • Mild drowsiness, unresponsiveness • Slurred speech, clumsiness • Seizures • Slow breathing rate • Smell of solvents

28. Care for Abused Inhalant • Check breathing. • Call poison center or 9-1-1. • Check for injuries. • Place in recovery position. • Give reassurance, emotional support • If violent, seek safety until police arrive. • Seek medical care.

29. Carbon Monoxide Poisoning • Leading cause of poisoning death in US each year • Invisible, tasteless, odorless, colorless, nonirritating gas • Can be unintentional poisoning or suicide • Can occur in older car, extended time in running car, or from faulty furnaces, water heaters, kerosene heaters • Causes hypoxia

30. Recognizing Carbon Monoxide Poisoning (1 of 2) • Headache • Ringing in ears • Chest pain • Muscle weakness • Nausea and vomiting • Dizziness and visual changes • Unresponsiveness • Respiratory and cardiac arrest

31. Recognizing Carbon Monoxide Poisoning (2 of 2) • Symptoms come and go. • Symptoms worsen and improve in certain places and at certain times. • Nearby people have similar complaints. • Pets seem ill.

32. Care for Carbon Monoxide Poisoning • Remove victim from environment immediately. • Call 9-1-1. • EMS can give 100% oxygen for 30 or 40 minutes to reverse CO poisoning. • Monitor breathing. • Place unresponsive, breathing victim in recovery position. • Seek medical care.

33. Poison ivy, poison oak, poison sumac 15-25% of exposed people will have incapacitating swelling, blisters Oil oozes out from plant when brushed. Plant-Induced Dermatitis(1 of 2)

34. Plant-Induced Dermatitis(2 of 2) • Oil not visible on human skin • Spread by direct contact • Can stay active for months or years • Smoke from burning plants can cause severe dermatitis • Difficult to identify plants • Leaves grow in groups of three

35. Recognizing Plant-Induced Dermatitis • Rash • Itching • Redness • Blisters • Swelling • The greater the amount of skin affected, the greater the need for medical care. • Onset usually occurs 1-2 days after contact.

36. Care for Plant-Induced Dermatitis • Clean skin with soap and cold water as soon as possible. • Apply rubbing alcohol liberally, then remove with water. • Lukewarm bath and colloidal oatmeal • Wet compresses with aluminum acetate • Calamine lotion or baking soda paste • Corticosteroid ointment and oral corticosteroid

37. Stinging Nettle • Plant with stinging hairs on stem and leaves • Stinging hair is touched • Fine needlepoint penetrates skin • Injects chemical irritant

38. Recognizing Stinging Nettle Poisoning • Can affect anyone • Effects limited to exposed area • Immediate response • Redness • Rapid, intense burning • Itching • Reaction lasts hours, not days

39. Care for Stinging Nettle Poisoning • Wash exposed area with soap and water. • Apply: • Cold, wet pack • Colloidal oatmeal, hydrocortisone cream, or calamine lotion • Over-the-counter antihistamine