INSTRUCTOR GUIDE
TOPIC: HANDELING POISONING EMERGENCIES
TIME REQUIRED: 2 TO 3 HOURS
MATERIALS: Emergency Care, Brady 10th Edition
The Maryland Medical Protocols
Poison Treatment Kit
Patient assessment tools
Oxygen administration equipment
MOTIVATION: There are many chemicals and natural items in our environment that are poisonous to life.
They are treated at the BLS level everyday. Treatment by the EMT-B or First Responder can do much to
prevent further injury or death.
OBJECTIVE: (SPO) 1-1:
The student will be able to from memory identify, and provide care (at the BLS level) for
emergencies dealing with poisonings
Enabling Objectives
Review the following poisoning emergencies and provide the proper care
EO: - 1 Identify the types of poisons and the proper treatment at the BLS level
EO: - 2 identify the common examples of poisons that the student may see
EO – 3 identify the proper procedure for documenting poisoning incidents and information that is
needed
EO -- 4 Given scenarios the student should identify the type on poisoning and proper treatment
1
I.
Poisoning emergencies
A.
Causes
1.
2.
B.
Contact with a substance that causes harm to the body
Substances found naturally in nature or manmade
Types of poisonings
1.
Ingested- poisons that are swallowed
a. Signs and symptoms
(1)
Nausea & vomiting
(2)
Burns to mouth and upper airway
(3)
Unusual odors from the mouth
(4)
May see a wide range of problems depending on the poison
.
2.
3.
b.
Treatments
(1)
Check container for treatment
(b)
Contact Poison Control for assistance
(c)
Dilution with water
(d)
Activated charcoal
(e)
Contact poison control
Inhaled poisons that enter through the respiratory system
a.
Signs and systems
(1)
Headache
(2)
Dizziness
(3)
Breathing difficulty
(4)
Nausea
(5)
Cyanosis
(6)
Alter mental status
b.
Treatment
(1)
Remove the patient from the area of poison
(2)
Treat the patient with high consecration of oxygen
(3)
Treat the patient for shock
(4)
Consultation with poison control and hospital
Absorbed poisons that enter the body through the skin
a.
Signs and symptoms
(1)
Irritation of the skin
(2)
Chemical burns of the skin
2
b.
4.
II.
Treatment
(1)
Remove the substance from the skin
(2)
Identification of the substance ASAP
(3)
Large amounts of water to flush the skin
(4)
Never try to neutralize substance with other chemicals
Injected poisons injected into the body with needle or injected by a
snake or insect
a.
Signs and symptoms
(1)
Irritation at site of injection, bite, or insect sting
(2)
Anaphylactic shock
(3)
Seizures
b.
Treatment
(1)
Most importantly identify the substance!
(2)
Medical directions through EMS radio
(3)
Request ALS if not in route
(4)
Treat symptoms (which could be many depending
on the substance) as indicated
Examples of substances that are found in poisonings
A.
Ingested poisonings
1.
Both prescription and across the counter medications (examples below)
a.
b.
c.
d.
e.
f.
g.
2.
Acetaminophen
Aspirin
Laxatives
Codeine
Morphine
Hydrocodne
Alcohol
Common household and industrial chemicals (examples below)
a.
b.
c.
d.
Bleach
Pesticides
Cleaning products
Petroleum products
3
3.
Substances found in nature
a.
b.
c.
B.
Inhaled poisonings
1.
Most common examples
a.
b.
c.
2.
Carbon monoxide
Smoke from fire
Any substance that could replace the oxygen levels below
minimum breathing levels
Vented spaces where oxygen levels could go down
a.
b.
C.
Certain plants
Tainted or spoiled foods
Tainted water
Sealed storage tanks
Many houses are built air tight and malfunctioning heating
units can cause a problem
Injected poisonings
1.
Manmade causes
a.
b.
c.
2.
Injection into the blood stream with a needle
The drug may be cut with other substances to make it
go farther by the seller (common in street drugs)
Needles used in conjunction with street drugs, needles may be used
over and over again and are not clean
Natural causes
a.
b.
c.
Insect stings to the body
Depending on the insect there may be problems with the blood
stream circulating it or it may attack the nervous system
Snake bites can also be circulated by the blood stream or the
nervous system
4
D.
Absorbed poisoning
1.
Manmade causes
a.
b.
2.
Natural causes
a.
b.
III.
Chemicals such as alkalis or acids are absorbed through the skin
Mankind has developed chemical warfare weapons that are
absorbed through skin also
Although providers do not think about poisoning from natural
substances, many manmade poisons are made fro things found in
nature
Patients with serious cases of poison ivy or poison oak can have
serious reactions that can cause death
Documentation of poisonings
A.
Route of poisoning
1.
2.
3.
4.
B.
Ingested
Inhaled
Injected
Absorbed
Amount of poison involved
1.
2.
Calculate the amount of poison taken by the patient
If unable to do so estimate amount from what you find on the scene
C.
The amount of time since the patient took the poison or was exposed to it
D.
Times involved with incident
1.
2.
E.
Document time when ingested or exposure took place
How long of a period that has been
Interventions performed
1.
2.
3.
What the patient did
What family members or bystanders did
What interventions you performed
5
F.
Patient’s weight
1. patient’s weight will have effect on the rate of the poison’s effect
2. patient’s weight will be needed to calculate possible use of treatments to
counteract the poison
G.
Effects of poisoning
1. document effects of the poison
2. examples
a.
Vomiting
b.
Trouble breathing
c.
Dizziness
d.
chemical burns
H.
IV.
Effects of treatment on patient by anyone
Scenarios
Evaluation: Divide the class into small groups and have one student play the
victim. Provide the students with a copy of the Maryland Protocols, and a
poisoning treatment kit. Have a team of students evaluate and treat the problem.
Summary:
Student Performance Objective: The student will be able to from memory identify, and provide
care (at the BLS level) for emergencies dealing with poisonings
Review:
Review the four routes of poisoning
Ingested
Inhaled
Absorbed
Injected
Review the signs and symptoms of poisonings
Review the treatments for poisonings
6