POISONING AND OVERDOSE

• PoisoningAny substance that can harm the bodyTypes• Chemicals• ToxinsEffects:• Destroys the skin• Suffocates• Systemic—depress or over stimulate CNS

dependent upon……….

• Nature of poison

• Concentration

• Age, weight, general health

• IngestedPatient Assessment• Substance• When exposure occurred• How much was ingested• Over how long a period • Interventions prior to your arrival• Weight• Effects

Activated Charcoal

• a form of carbon that has been processed to make it extremely porous and thus to have a very large surface area available for adsorption or chemical reactions.

• just one gram of activated carbon has a surface area of approximately 500 m² (or about 2.17 tennis courts)

• Not an antidote

reduces the amount of poison available for the body to absorb

• Absorbs many poisons but not all

Contraindications

• Cannot swallow

• AMS

• Ingestion of acids or alkalis

• Swallowed gasoline

Care• Identify and treat life-threats• Transport decision• Focused Hx. and PE

SAMPLE• Remove any remnants or pill fragments• Baseline VS• Take all bottles and labels

Consult Medical Control

• Repeat and follow directions carefully

• Pediatric

Give weight

Estimated amt. of poison ingested

INHALED POISONS

• CO

• Chlorine gas

• Ammonia

• Agricultural chemicals and pesticides

• CO2

Scene Safety• Protective clothing• Self-contained breathing apparatus

if trained• Many inhaled poisons can be absorbed through

the skin• If you don’t have the proper training or

equipment…………..

STAY OUT!!!

Assessment

• Exact name of substance

• When did exposure occur

• Period of exposure

• Interventions pta

• Effects of substance and interventions

Care

• Airway

• Breathing

• Move to a safe place

non-urgent move

urgent move

emergency move

• Treat any immediate life-threats

• Transport decision

• Focused Hx. and PE

• O2

• Bottled, containers and labels

CO

• Most common inhaled poison

• Car exhaust and fire supression

• Odorless, colorless, tasteless

Signs and symptoms• Headache

a band around the head• Dizziness• Breathing difficulty• Nausea• Cyanosis• AMS

• Consider a possibility when there are vague flu-like complaints and a group of people.

May begin to feel better immediately after being

removed from source

Smoke Inhalation

• Difficulty breathing

• Coughing

• Breath with smoky or odorous smell

• Carbon residue in mouth and nose

• Black residue in sputum

• Singed nose hairs

Absorbed Poisons

• Absorption can take place with little or no damage to the skin

Assessment

• Exact name of substance

• When did exposure occur

• Period of exposure

• Interventions pta

• Effects of substance and interventions

Care

• ABCs and Life-threats

• Transport decision

• Remove contaminated clothing

be cautions of becoming contaminated

• Remove the poison:

• Powders

brush off

• Liquids

Irrigate at least 20 minutes

• Eyes

Irrigate for at least 20 minutes

Do not neutralize acids and alkalis

• Alcohol and Substance Abuse

• May have underlying trauma from falls

• May have underlying medical problems

diabetes, GI bleed

• Alcohol and drugs are commonly taken together

Patient Assessment

• Scene Safety

• You may need to obtain SAMPLE from other sources

Signs and symptoms of alcohol abuse• Odor of ETOH on breath or clothing• Swaying and unsteadiness• Slurred speech, rambling, incoherent• Flushed with sweating & c/o being warm• Nausea/vomiting• Poor coordination• Slowed reaction time

• Blurred vision

• Confusion

• Hallucinations

• Lack of memory

• AMS

Signs and symptoms of alcohol withdrawl• Confusion• Unusual (insane) behavior• Hallucinations• Gross temor of hands• Profuse sweating• Seizures

Transport seizure related DTs ASAP

Care• Determine if drugs and alcohol mixed• BSI; Scene safe• ABCs• LOC and GCS• Monitor VS and be alert for shock• Protect from self-injury and yourselves

*restrain

• If patient refuses

Substance Abuse

Patient Care

• BSI

• Scene safe

• ABCs

• Never touch or taste any suspected illicit drug

• Treat for shock

• Talk to your patient to establish rapport and determine LOC and GCS

• Perform Rapid or Detailed PE

carefully assess for head injury

• Inspect for “tracks”

• Protect from harm or harming others

• If pt. creates unsafe scene, GET OUT

• Transport as soon as possible

• Contact medical direction

• Monitor VS

• Be aware of possible seizures

• Many drug users may appear calm at first then become violent----be on the alert