Ch.22 Toxicologic Emergencies Flashcards
Poison
Any substance that impairs health or causes death by its chemical action when it enters the body or comes in contact with skin.
Toxicology
The study of toxins, antidotes, and the effects of toxins on the body.
Antidotes
A substance that will neutralize the effects of a poison.
Antidote for narcotic OD
Naloxone
Rx for Carbon Monoxide
Oxygen
Rx for pesticide/nerve gas
- Atropine
- 2 Pam
Ingestion
-A drug or substance swallowed
•Absorbed into the GI tract
-Most common type of poisoning
Commonly ingested poisons
- Prescribed Meds
- Over-The-Counter meds
- Illegal drugs
- Household products and cleaning agents
- Insecticides and Poisons
S/Sx of poisoning
- Swelling or burns around the mouth ( especially with corrosive poisons like rat poisons, drain cleaners)
- Nausea/Vomiting/Diarrhea
- Altered mental status
- Abdominal Pain
Names brands of activated charcoal
- Actidose
- Actidose Aqua
Indications to use activated charcoal
- Ingested poisons
- Within one hour of ingestion
Contraindications for activated charcoal
- Altered mental status
- Acids of alkalis
- Cyanide
- Unable to swallow
Doseage for activated charcoal
- 1 gram/kg
- Adults 30-100g
- Children 12.5-25g
What does activated charcoal do?
Absorbs poisons in the stomach, preventing absorption into the bloodstream.
Activated charcoal Side effects
- Black stools
- Vomiting
- if pt vomits repeat dose*
Inhalation
- Breathing in a poison
- Rapid absorption through the lungs
Inhalation of poison can be …?
- Accidental
- illicit
- suicide
Common accidental inhalations
- Carbon Monoxide
- Chlorine
- Ammonia
Common abused inhalations
- Paints
- Gas propellants
- Nitrous Oxide
- Nitrogen & Helium
Inhalation S/Sx
- Difficulty breathing
- Chest Pain
- Airway and Respiratory sounds (Stridor, Hoarseness, Coughing, Wheezing, Crackles)
- Neuro issues (Dizzy, Headache, ALOC, Seizures)
Injection
Injected under the skin, into a muscle, or directly into a blood stream.
Common injected poisons
- Bee stings
- Spider Bites
- Snake Bites
- Illicit drugs
Injection S/Sx
- Injection site swelling
- Euphoria
- Nausea/Vomiting
- Weakness/Fever/Chills
Absorption
- Enter the body through skin or mucous membrane contact
- Plant or chemicals
Absorption S/Sx
- Liquid or powders on Pt’s skin
- Burns
- itching/redness/swelling
- Rashes
- Oozing blisters
Food poisoning
- Ingestion of food that contains bacteria or toxins
- Salmonella, E.coli
Food poisoning S/Sx
- Hours to days after ingestion
- Abdominal Pain
- Nausea/ Vomiting
- Gas
- Explosive Diarrhea
Carbon Monoxide poisoning
- Tasteless, colorless, odorless gas
- Caused by incomplete combustion
Main causes of CO poisoning
- Furnaces/ wood stoves
- Anything with a pilot light (water heaters, gas cooking stoves)
- Car exhaust (Common suicide cause)
Carbon monoxide S/Sx
- Headache
- Nausea/Vomiting
- Confusion
- Late sign- cherry red skin!
Terminology we use for pesticide exposure
- Salivation
- Lacrimation
- Urination
- Defecation
- GI Upset
- Emesis
- Miosis
Drug Abuse
Self administration of drugs in a manner not approved by medical or social patterns.
Overdose
Poisoning with drugs or alcohol
Withdrawal
Period of abstinence from a drug to which the body has become accustomed.
Alcohol withdrawals facts
- Tend to happen to people who have been heavy drinkers for long periods of time
- Brain accustomed to depressant effects of alcohol
- No person will detox the same
Alcohol withdrawal stage 1
- within 8 hours from last drink
- Nausea
- Insomnia
- Sweating
- Tremors
Alcohol withdrawal stage 2
- 8-72 hours since last drink
- worsening symptoms
- Hallucinations
Alcohol withdrawal stage 3
- 48 hours once last drink
- Major Seizures
Alcohol withdrawal stage 4
- Delirium Tremens
- 1-14 days since last drink
- Can last 3 days
Narcotics/Opioids
- Depressants derived from opium
- Heroin
- Vicodin
- OxyContin
- Percocet
- Codeine
Narcotics/Opioids S/Sx
- Respiratory depression or arrest
- Pinpoint pupils
- Hypotension
Indication to use Naloxone
Suspected opioid intoxication with respiratory depression
Contraindications for naloxone
Known hypersensitivity
Doseage for naloxone
Intranasal 2mg, 1mg in each nostril
Naloxone actions
- Opioid antagonist
- Binds to opioid receptors to reverse respiratory depression
Naloxone side effects
Acute withdrawal
Central nervous system (CNS) stimulants
- Excites the Central Nervous System
- Cocaine
- Crystal meth
- Crack
- Ecstasy/MDMA
- Diet pills
S/Sx CNS stimulants
- Excitability
- Tachycardia
- Hypertension
- Dilated pupils
CNS Depressants
-Depress the CNS
-Alcohol
-Benzodiazepines
•Xanax
•Ativan
•Valium
CNS Depressants S/Sx
- Euphoria
- Drowsy
- Dilated Pupils
- Sluggish Pupils
- Bradypnea
Hallucinogens
- Cause hallucinations, psychedelic drugs
- LSD
- PCP
- Mushrooms
- Bath Salts
- MDMA
- Ketamine
S/Sx hallucinogens
- Paranoia
- Anxiety
- Hallucinations
- Tachycardia
- Dilated pupils
