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CH 16 – Poisoning
General Information:
-poisoning results when external substances enter the body
-90% of all poisonings occur in home
-Most unintentional poisoning occur in children under the age of 5. But fewer than 5% of
those children die
-Deaths in children has dropped in last 30 years while adults has gone up.
Why?
How poisons enter the body:
 Ingestion
 Injection
 Inhalation
 Absorption
Clues of poisoning:
 Odors
 Flames or smoke
 Containers that are open or out of place
 Plants partially eaten or disturbed
Common signs and symptoms of poisoning:
 Nausea
 Vomiting
 Diarrhea
 Chest or abdominal pain
 Breathing difficulty
 Sweating
 Loss of consciousness
 Seizures
 Burn injuries around the lips or tongue or on the skin
 Headache
 Dizziness
 Weakness
 Irregular pupil size
 Burning or tearing eyes
 Abnormal skin color
Poisoning Severity
 The type and amount of poison
 How and when it entered the body
 Victim’s size, weight, and age
General Principles for Poisoning Emergencies:
 Conduct scene size-up
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Remove victim from source of poison
Conduct initial assessment
Conduct physical exam and SAMPLE history
Summon more advanced medial personnel
Contact poison control center (PCC) as per local protocols
o If unconscious, call 911
Do not give anything to eat or drink
ONLY induce vomiting when told to do so by medical personnel. You would never
induce if:
 Victim is unconscious
 Victim is having a seizure
 Victim is pregnant
 Victim has ingested corrosive substance or petroleum product
 Victim is known to have heart disease.
Food poisoning:
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Approximately 33 million Americans affected by food poisoning each year.
Symptoms begin 1 to 48 hours after eating:
o Nausea
o Vomiting
o abdominal pain
o diarrhea
o fever
o dehydration
Most food poisoning can be prevented by proper cooking, refrigeration, and sanitation
Absorbed poisons:
Cause: poison ivy, poison oak, poison sumac, wet or dry chemicals
If chemicals contact the skin: brush off dry residue with gloved hand & flush with water
Injected poisons:
Signs & Symptoms affected by:
-type & location of bite or sting
-amount of poison injected
-time elapsed
-victim's size, wt., & age
Symptoms include:
At entry site:
-bite or sting mark
-stinger, tentacle, or venom sac
-redness
-swelling
-pain or tenderness
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Severe allergic reactions to bites & stings may bring on anaphylaxis, & result in a
breathing emergency
CARE FOR SPECIFIC BITES & STINGS
Insects:
-between 1 & 2 million Americans are severely allergic to venom or bees, wasps, hornets,
and
yellow jackets
-if highly allergic, one sting = anaphylaxis
-If highly allergic--call EMS immediately
-for most people, stings hurt, but are rarely life-threatening:
-scrape away the stinger
-wash & cover the site
-apply ice or cold pack
-watch for signs of allergic reactions
Note: Less than 100 deaths per year from insect bites
Ticks
ROCKY MT. SPOTTED FEVER
- wood or dog tick. Main sign: spotted rash that appears first on wrists or ankles, then
spreads rapidly
-early treatment is crucial--may die from kidney failure or shock
LYME DISEASE:
-deer ticks can be very small
-may not know you were bitten
-disease seen in 40 states symptoms:
-a rash at the site of the bite
-rash spreads up to 5-7"
-rash may have a bull's eye appearance, or in dark skin people, may look black &
blue like a bruise.
(Note: you may have Lyme disease without a rash.)
-fever & chills
-headache
-weakness or fatigue
-joint & muscle pain similar to the flu
Remove ticks: slowly with tweezers, wash with soap & water
Spiders:
Black widow-black w/ reddish hourglass-shaped marking on its underbody
Brown recluse - light brown w/ a darker brown violin-shaped marking on the top
of its body
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Scorpions - Southwestern US
Symptoms of black widow bite:
-sharp pain initially (BW); no pain initially for BR
-muscular rigidity in shoulders, back, & abdomen
-restlessness
-anxiety
-profuse sweating
-weakness
-drooping of eyelids
First aid:
-call EMS
Misc. symptoms of spider bites:
-mark indicating a possible bite
-severe pain
-blister, lesion, or swelling
-nausea & vomiting
-difficulty breathing or swallowing
-sweating or salivating profusely
-irregular heart rhythm
-muscular cramping or abdominal pain
Snakebite:
Guidelines for initial care of snakebite:
 Take victim to medical care immediately
 Wash wound if possible
 Immobilize affected part
 Minimize victim’s movement
 Keep affected part lower than heart
 Summon more advanced medical personnel
 Consider using a commercial suction kit if advanced medical care is more than 30
minutes away
Marine Life:
CALL EMS IF:
-history of allergic reactions
-stung on face or neck
-develops breathing problems
FIRST AID:
For jellyfish, sea anemone, or man-of-war stings: soak in vinegar. DO NOT: rub, use
fresh water or ammonia. For sting ray, sea urchin, or spiny fish: flush with water;
immobilize; soak in HOT water (or hot sand) for 30 min or until pain eases; clean &
bandage
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Domestic and Wild Animals:
Rabies is transmitted through saliva
-most common carriers: skunks, raccoons, cats, dogs, cows, bats, & foxes.
-rabies is fatal unless treated
Tetanus is potentially fatal; caused by transmission of toxin when bitten by animal or
human
symptoms:
-irritability
-headache
-fever
-painful muscular spasms (particularly stiffness of the jaw)
Takes 3 days to 5 wks for symptoms
Prevention:
-professionals clean wound
-immunization injections
All animal bites:
-get person away from animal
-contact animal control--do NOT try to capture animal
First aid:
Minor: wash w/ soap & water; then control bleeding & apply antibiotic ointment & a
dressing. Visit the Dr. Watch for infection.
Major: control bleeding; call EMS
Human bites:
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May be highly contaminated with bacteria
Require professional medical care immediately
Need to be washed with soap and water
Can bleed if severe; control severe bleeding
Anaphylaxis:
Cause: insect bites, stings, medications, foods, and chemicals.
Symptoms:
 swelling & redness
 hives
 itching
 rash
 weakness
 nausea or vomiting
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Care:
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dizziness
rapid or difficult breathing
burning skin and eyes
restlessness
slurred speech
dilated pupils
chest discomfort or pain
weak or rapid pulse
coughing or wheezing
assess airway and breathing
summon more advanced medical care if they have any trouble breathing or say
they feel their throat closing
help the victim in the most comfortable position
administer oxygen is available and you arte trained to do so
monitor ABCs and keep victim calm
Have victim use anaphylaxis kit if one is available.
Substance Misuse and Abuse:
Six major types of substances that are abused and misused are:
1. stimulants
2. hallucinogens
3. depressants
4. narcotics
5. inhalants
6. cannabis products
Depressants:
 Relieve anxiety
 Alter consciousness
 Promote sleep
 Relieve pain
 Relax muscles
 Impair coordination and judgment
Other substances:
 Designer drugs – are variations of other substances, such as narcotics and
amphetamines – ex -ecstasy
 Anabolic steroids
 Over the counter substances
Care for substance miscue and abuse:
 Your initial care does not require you know the substance
 Care as you would for poisoning
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The following factors may contribute to substance abuse:
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A lack of parental supervision
The breakdown of traditional family structure
A wish to escape unpleasant surroundings and stressful situations
The widespread availability of substances
Peer pressure and the basic need to belong
Low self-esteem, feelings of guilt or shame
Media glamorization
A history of substance abuse in the home or community environment
Preventing substance misuse:
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To prevent unintentional misuse or overdose:
 Read product information and take as directed
 Ask your doctor about side effects and drug interactions
 Never use anyone else’s prescription medication
 Always keep medication in marked containers
 Destroy out of date medications
 Always keep medications out of children’s reach