Poisoning

Dr Ahmad Aqel
 POISONING

Definition
A poison: substance that when
ingested, inhaled, absorbed,
applied to the skin, or produced
within the body in relatively small
amounts, injures the body by its
chemical action
 Ingested (Swallowed) Poisons

Corrosive poisons include

- alkaline and acid agents
Poisons that can cause tissue
destruction after coming
may be in contact with mucous
corrosive membranes
Examples: cleaners,
bleach, batteries acids
 Assessment

Neurologic
Airway Breathing Circulation
al status
 Assessment
Determine
the substance
the amount
the time since ingestion
age and weight of the patient
Health history
S&S
pain or burning sensations
redness or burn in the mouth or throat
pain on swallowing or an inability to swallow
vomiting, or drooling
Shock: Cardio-depressant effect of poison
 Interventions
An indwelling urinary catheter
monitor renal output/function
Blood specimens
determine the concentration of drug or poison
Remove the toxin or decrease its absorption
Water or milk to drink for dilution
Dilution is not attempted if:
Patient has acute airway edema or obstruction
There is esophageal, gastric, or intestinal burn or
perforation.
 Removing the toxins
Syrup of ipecac to induce vomiting in the alert
patient (never use with corrosive poisons)
Gastric lavage for the obtunded patient (Chart
71-11);
gastric aspirate is saved and sent to the laboratory
for testing (toxicology screens)
Activated charcoal administration if the poison
is one that is absorbed by charcoal
Cathartic, when appropriate
 Alert
Vomiting is never induced after ingestion of
caustic substances (acid or alkaline) or
petroleum distillates.
 Removing the toxins
Administer antidote (antagonist)
If antidote is ineffective
Multiple doses of charcoal, diuresis (for
substances excreted by the kidneys),
dialysis, or hemoperfusion.
Hemoperfusion involves detoxification of
the blood
Carbon Monoxide (CO) poisoning
Reduce the oxygen-carrying capacity of the
blood
S&S
headache
muscular weakness
palpitation
dizziness
confusion
coma
 CO poisoning
Unreliable assessment
Skin color
pink or cherry-red to cyanotic and pale
Pulse oximetry
Hemoglobin is saturated with CO
 Management
Carry the patient to fresh air immediately; open
all doors and windows
Loosen all tight clothing
Initiate CPR if required
Administer 100% oxygen
Prevent chilling; wrap the patient in blankets
Keep the patient as quiet as possible
Smoking and alcohol (any form) are not allowed
Hyperbaric oxygen
Oxygen until the carboxyhemoglobin level <
5%.12
 Food poisoning
The source and type of food poisoning
Food, gastric contents, vomitus, serum, and
feces are collected for examination
Botulism fatal food poisoning caused by
ingestion of food containing botulin
Botulin is a potent neurotoxin
Botulism is a serious form of food poisoning
that requires continual surveillance
 Assessment
VS
Level of consciousness
Central venous pressure
Intravascular fluid volume
Electrolyte
Acid base