ch 22 Flashcards
What is toxicology
The study of the effects of poisons
What is a poison
Any substance that can impair health or cause death by chemical action
What is the most common route of poisoning
Ingestion
What are the four main routes of poison exposure
Ingestion inhalation injection absorption
What is the first step in treating a poisoning
Ensure scene safety and use standard precautions
What is the role of activated charcoal
It binds to certain poisons to prevent absorption in the GI tract
When is activated charcoal contraindicated
In cases of altered mental status or ingestion of caustics or hydrocarbons
What are signs of inhaled poisoning
Burning eyes sore throat cough chest pain dizziness confusion
What should you do first for inhaled poison exposure
Remove the patient from the source and provide oxygen
What is the concern with injected poisons like heroin or animal venom
Immediate effects with no way to remove the toxin
How are absorbed poisons commonly introduced
Through the skin or mucous membranes
What should you do for absorbed poison on skin
Avoid contamination remove clothing and flush skin with water
What are examples of common absorbed poisons
Pesticides acids alkalis plant toxins
What are signs of systemic poisoning
Nausea vomiting dizziness seizures altered mental status
What should you bring to the hospital when treating a poisoning patient
The substance container or labels if possible
What is a common sign of opioid overdose
Pinpoint pupils with respiratory depression
What is naloxone used for
Reversing opioid overdose effects
What is the mnemonic for identifying causes of altered mental status
AEIOU TIPS
What does AEIOU TIPS stand for
Alcohol Epilepsy Insulin Overdose Uremia Trauma Infection Psychosis Stroke
What is the national poison control number
1 800 222 1222
What patient history should you gather for poisoning
Substance amount route and time of exposure
What are common symptoms of ingested poisons
Burns around mouth GI pain vomiting altered mental status
Why is it important to determine the time of exposure
It helps guide treatment options like activated charcoal
What is the priority in managing any poisoning
ABCs airway breathing and circulation
What are signs of stimulant use
Agitation tachycardia dilated pupils hypertension hyperthermia
What are signs of sedative-hypnotic overdose
Drowsiness respiratory depression hypotension
What are common stimulants
Cocaine amphetamines methamphetamines
What are examples of sedative-hypnotics
Benzodiazepines barbiturates alcohol
What signs might indicate cholinergic poisoning
Salivation lacrimation urination defecation GI distress emesis
What is the mnemonic SLUDGE used for
Signs of cholinergic poisoning
What is the antidote for opioid overdose
Naloxone
Why should you always support ventilation before giving naloxone
Because hypoxia is the primary danger in opioid overdose
What are hallucinogens and how do they affect patients
Substances that alter perception mood and consciousness often causing anxiety or paranoia
What are signs of inhalant abuse
Dazed appearance chemical smell hallucinations cardiac dysrhythmias
What is delirium tremens
Severe alcohol withdrawal that can cause seizures hallucinations and death
What should you do if you suspect alcohol poisoning
Support airway prevent aspiration monitor vitals transport
What danger is associated with acetaminophen overdose
Liver failure
What danger is associated with aspirin overdose
Metabolic acidosis and increased bleeding
What is the first action for any suspected toxic exposure
Ensure personal and scene safety
When should you contact poison control or medical direction
Anytime poison type or treatment is unclear
What is the EMS concern with opioid overdose
Respiratory failure airway obstruction death
What are examples of opioids
Heroin morphine fentanyl oxycodone hydrocodone
What are the signs of stimulant overdose
Agitation hypertension tachycardia dilated pupils seizures
What is the EMS concern with stimulants
Cardiac arrhythmias seizures hyperthermia
What are examples of stimulants
Cocaine methamphetamine Adderall MDMA
What are signs of sedative-hypnotic overdose
Drowsiness slowed breathing slurred speech hypotension
What are examples of sedative-hypnotics
Benzodiazepines barbiturates alcohol
What is the EMS concern with sedative overdose
Respiratory depression and aspiration
What are signs of alcohol poisoning
Confusion vomiting hypothermia slow breathing unconsciousness
What is the concern with alcohol withdrawal
Seizures hallucinations delirium tremens
What are signs of hallucinogen use
Hallucinations anxiety tachycardia dilated pupils paranoia
What are examples of hallucinogens
LSD psilocybin mescaline PCP
What are dangers of hallucinogen use
Accidental injury violent behavior psychosis
What are signs of inhalant abuse
Dazed appearance chemical smell hallucinations sudden cardiac arrest
What is sudden sniffing death syndrome
Fatal heart rhythm caused by inhalant use
What are signs of anticholinergic poisoning
Hot dry skin dilated pupils tachycardia hallucinations
What are examples of anticholinergics
Antihistamines tricyclic antidepressants atropine
What are signs of cholinergic poisoning
Salivation lacrimation urination diarrhea GI cramps emesis
What are examples of cholinergic agents
Organophosphates nerve agents insecticides
What is the EMS concern with cholinergic agents
Airway compromise seizures respiratory failure
What are signs of acetaminophen overdose
Nausea vomiting liver failure over 24 to 72 hours
What is the EMS concern with acetaminophen overdose
Delayed onset of symptoms with potential for liver damage
What are signs of aspirin overdose
Ringing in ears hyperventilation vomiting altered mental status
What is the EMS concern with aspirin overdose
Metabolic acidosis and bleeding risk
What are signs of food poisoning
Nausea vomiting diarrhea fever weakness
What is the main treatment for food poisoning
Symptom support and rapid transport if severe
You arrive on the scene of a 30-year-old male who is unconscious and has slow shallow breathing. His pupils are pinpoint. What do you suspect
Opioid overdose
What is the first intervention for a suspected opioid overdose
Administer naloxone (Narcan) and support ventilation
A 25-year-old female has been found unresponsive in her bedroom after using an illicit drug. She is breathing 6 times per minute and her pupils are dilated. What is the most likely cause
Stimulant overdose (e.g. methamphetamine or cocaine)
What should you do first for a suspected stimulant overdose
Support airway and breathing monitor vitals and prepare for possible seizures
A 40-year-old male is found by his wife who reports he has been drinking heavily over the past 24 hours. He is now confused sweating and having tremors. What condition do you suspect
Alcohol withdrawal (delirium tremens)
What is the immediate priority for a patient with alcohol withdrawal
Support airway breathing and circulation
You respond to a call for a 50-year-old male complaining of chest pain after ingesting a bottle of acetaminophen. What is your first action
Assess the patient’s airway and breathing and prepare to transport to a facility for possible liver toxicity
A 45-year-old woman presents with confusion excessive drooling and sweating She reports working in her garden and using insecticide earlier today. What do you suspect
Cholinergic poisoning (possibly from organophosphates or insecticides)
How should you treat a patient with cholinergic poisoning
Remove the patient from the source administer atropine if indicated and provide supportive care including airway management
A 35-year-old male arrives at the ER with agitation hypertension and severe anxiety. He denies any known medical history but is sweating and has dilated pupils. What is the most likely cause
Stimulant overdose (e.g. cocaine and methamphetamine)
What is your treatment priority for stimulant overdose
Ensure a safe environment
A 20-year-old woman is found unconscious with a strong smell of chemicals on her breath. You suspect inhalant abuse. What is your immediate action
Ensure the patient’s airway is open and provide high-flow oxygen while preparing for possible sudden cardiac arrest
A 60-year-old male presents with slurred speech drowsiness and decreased respirations after taking several benzodiazepines for anxiety. What is your first action
Support airway and breathing and consider naloxone if an opioid overdose is also suspected
A 28-year-old man comes to your attention complaining of nausea vomiting and diarrhea after eating food at a local restaurant. What is the most likely cause
Food poisoning
What is your treatment focus for a suspected case of food poisoning
Symptomatic care and fluid replacement with early transport if dehydration or severe symptoms are present
