Chapter 22 Part 1 Flashcards by Thomas Garcia | Brainscape

Q

Poison

A

Any substance—liquid

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Toxicology

A

The study of toxins

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Toxin

A

A drug or substance that is poisonous to a human and causes certain adverse effects that can potentially lead to death.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Overdose

A

A poisoning in which the patient has been exposed to an excessive dose of a drug.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Substance Abuse

A

The inappropriate use of a substance or medication.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Ingestion

A

A route by which a drug or substance can be swallowed with absorption occurring through the gastrointestinal tract.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Inhalation

A

Breathing a poison—typically a gas

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Injection

A

A route by which a poison can be injected under the skin

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Pulmonary Edema

A

Fluid leaking around and into the alveoli

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Bronchospasm

A

Contraction of the muscles in the bronchi and bronchioles

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Local Reaction

A

A reaction to a poison that typically causes edema (swelling) at the site of injection

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Systemic Reaction

A

A reaction that can occur from injection of a poison

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Accidental Poisoning

A

Poisonings that are unintentional and often involve young children.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Household Chemicals

A

Substances that are most often involved in unintentional or accidental poisonings.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Homicide

A

Intentional poisonings that result in the death of another person.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Suicide

A

Intentional poisonings that result in the death of the individual.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Gastrointestinal Tract

A

The system in the body through which ingested substances are absorbed

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Alveoli

A

Tiny air sacs in the lungs where gas exchange occurs

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Edema

A

Swelling caused by excess fluid trapped in the body’s tissues.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Signs and Symptoms

A

Indicators of poisoning that can vary based on the route of exposure and type of poison.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Respiratory Distress

A

Severe difficulty in breathing that can indicate the presence of an inhaled poison.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Delayed Effect

A

A situation where the signs and symptoms of poisoning may not present for several hours after exposure.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Acid Poisoning

A

Poisoning caused by contact with strong acids

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Injection Poisonings

A

Poisonings that can result from drug use or from bites and stings.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Hymenoptera

A

An order of insects that includes bees

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Anaphylactic Reaction

A

The most severe type of allergic reaction that can result from injection of venom.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Absorption

A

The process by which a poisonous substance can enter the body when it contacts the skin or mucous membranes.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Severe Absorption Poisoning

A

Results from pesticides and other lethal substances that contact the skin.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Organophosphates

A

Commonly found in certain pesticides

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Toxidromes

A

Signs and symptoms of poisoning that depend on the specific poison and the route of entry into the body.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Bradycardia

A

A condition that might occur from poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Tachycardia

A

A condition that might occur from poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Tachypnea

A

A condition that might occur from poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Hypotension

A

A condition that might occur from poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Hypertension

A

A condition that might occur from poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Corrosive Poison

A

A type of poison that can cause burns to the lips and inside the mouth.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Patent Airway

A

An airway that is open and unobstructed

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Positive Pressure Ventilation

A

A method provided for inadequate breathing to maintain adequate oxygenation.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Lateral Recumbent Position

A

The position in which a patient is placed to closely monitor the airway after ingestion of poison.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Mental Status Deterioration

A

A sudden decrease in mental status that can indicate rapid patient deterioration.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Emergency Care

A

Supportive care that must be established and maintained regardless of the poison or route.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Reassessments

A

Necessary actions to monitor the breathing status and prepare to ventilate if necessary.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Vomiting

A

A common occurrence in persons poisoned by ingestion

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Aspiration of vomitus

A

The act of inhaling vomit into the lungs

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Antidote

A

A substance that neutralizes the effects of the poison or toxic substance.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

True antidotes

A

Antidotes that are available for only a small number of poisons.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Treatment of poisons

A

Generally limits or prevents the absorption of the poison and manages any other signs and symptoms.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Supportive care

A

Care that supports the airway

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

ALS unit

A

An Advanced Life Support unit that can have medications to reverse the effects of certain toxins.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Naloxone (Narcan)

A

A drug that can reverse the effects of a narcotic (opioid) overdose.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Ingested poison

A

A poison that is swallowed and enters the gastrointestinal system.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Absorption of poison

A

Most of the absorption occurs in the small intestine

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Common causes of accidental ingestion

A

Taking too much prescribed medication

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Poisonous plants

A

Common household and backyard plants that can cause poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Scene size-up

A

The process of observing clues indicating an ingested poisoning during the assessment.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Primary assessment

A

A vital step in managing the poisoned patient that can provide clues about the time since ingestion.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Altered mental status

A

A change in mental state that indicates the poison is absorbed into the bloodstream and having systemic effects.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Common poisonous substances

A

Prescription medications

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Poisonous mushrooms

A

A high number of poisonings result from eating wild mushrooms.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Signs of poisoning

A

Clues such as overturned medicine bottles

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Gastrointestinal system

A

The system that ingests poisons

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Time since ingestion

A

Determining this can change the treatment the patient receives.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Poisoning emergencies

A

Commonly occur due to accidental ingestion

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Household products

A

Common items that can be poisonous

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Positioning and suctioning

A

Methods to prevent aspiration of vomitus in a poisoned patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Monitoring of airway

A

Close observation of the airway to prevent complications in a poisoned patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Alert and Oriented

A

Indication that the poison has not yet been absorbed in a large quantity or that a large quantity was not ingested by the patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Altered Mental Status

A

A condition that necessitates opening and clearing the airway.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Lateral Recumbent Position

A

Position to reduce the possibility of aspiration in a patient with altered mental status.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Oropharyngeal Airway

A

Device that may need to be inserted to effectively ventilate a poisoned patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Nasopharyngeal Airway

A

Another device that may be inserted to effectively ventilate a poisoned patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Inadequate Breathing

A

A condition that requires assessment of respiratory rate and quality.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Positive Pressure Ventilation

A

Intervention provided with a bag-valve mask or other ventilation device if respiratory rate or depth is inadequate.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Hypoxia

A

Condition that may require administration of oxygen via a nasal cannula.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Hypoxemia

A

Condition that may require administration of oxygen via a nasal cannula.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Poor Perfusion

A

Condition that may require administration of oxygen via a nasal cannula.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Cardiopulmonary Resuscitation Protocol

A

Action to proceed with if the pulse is absent.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Secondary Assessment

A

Most information about an ingested poisoning is obtained during this phase.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Common Poisons in Children

A

Plants

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Pupils and Skin Condition

A

Two extremely important areas to examine during the assessment of a poisoning patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Liquid Acid Ingestion

A

Likely to cause more severe tissue damage to the stomach lining than to the esophagus.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Ingested Alkali Substances

A

Cause more severe damage compared to liquid acids.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Patient History

A

Information that is crucial for managing a poisoning patient but may be difficult to obtain accurately.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Intentional Overdose

A

A scenario where the patient may be misinformed or trying to deceive regarding their history.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Accidental Death Cause in Children

A

Poisoning is the number one cause.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Respiratory Drive Depression

A

Many poisons can lead to this condition

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Chest Rise and Fall Monitoring

A

Important to closely monitor in a poisoned patient.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Skin Temperature

A

Color

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Substance Ingestion

A

The act of taking in a substance

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Alcohol Ingestion

A

The consumption of alcohol with a substance

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Time of Ingestion

A

The timing of when the patient ingested the poison

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Duration of Exposure

A

The span over which the substance was ingested or the patient was exposed

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Amount of Substance Taken

A

The quantity of the substance ingested

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Previous Treatment Attempts

A

Any prior attempts to treat the poisoning

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Psychiatric History

A

The patient’s mental health background that may suggest a possible suicide attempt.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Underlying Medical Conditions

A

Existing health issues

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Patient Weight

A

The patient’s weight

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Available Medications

A

Medications present in the house that could indicate the source of poisoning.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Physical Exam

A

An assessment of the patient’s body systems and areas of complaint to identify abnormalities.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Vital Signs

A

Measurements of physiological functions that have limited role in assessing poisoning severity.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Signs and Symptoms of Poisoning

A

Indicators of poisoning that can vary based on the ingested substance.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

History of Ingestion

A

Documentation of the patient’s past consumption of substances.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Swelling of Mucosal Membranes

A

Inflammation in the mouth caused by caustic substances.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Nausea

A

A feeling of sickness with an inclination to vomit.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Vomiting

A

The act of expelling the contents of the stomach through the mouth.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Diarrhea

A

Frequent and watery bowel movements

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Altered Mental Status

A

Changes in consciousness or cognitive function due to poisoning.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Abdominal Pain

A

Discomfort in the abdominal area

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Burns or Stains Around the Mouth

A

Injuries or discoloration around the mouth caused by corrosive poisons.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Unusual Breath Odors

A

Distinct smells on the breath that can indicate specific ingested toxins.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Toxin

A

Odor

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Hydrogen sulfide

A

Rotten eggs

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Naphthalene

A

camphor

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Cyanide

A

Bitter almonds

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Acetone

A

isopropanol

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Organophosphates

A

Garlic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Petroleum distillates

A

Gasoline

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Chloral hydrate

A

Pears

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Methyl salicylate

A

Mint

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Phosgene

A

Fresh mowed hay

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Respiratory distress

A

A condition indicating difficulty in breathing.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Altered heart rate

A

Tachycardia or bradycardia.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Altered blood pressure

A

Hypertension or hypotension.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Dilated or constricted pupils

A

Changes in pupil size indicating possible poisoning.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Warm and dry or cool and moist skin

A

Skin condition changes that may indicate poisoning.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Seizures

A

Sudden

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Activated Charcoal

A

A medication occasionally used in the emergency medical care of ingested poisonings.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Oropharyngeal airway

A

A device used to maintain an open airway.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Nasopharyngeal airway

A

A device used to maintain an open airway in unresponsive patients.

Q

Positive pressure ventilation

A

Ventilation method using a bag-valve-mask with supplemental oxygen.

Q

Nasal cannula

A

A device used to deliver supplemental oxygen.

Q

Lateral recumbent position

A

A position to place a patient to prevent aspiration in case of vomiting.

Q

Reassessment

A

The process of evaluating a patient’s condition after initial care.

Q

Poison control center

A

A resource for information on managing poisonings.

Q

Activated Charcoal

A

A special distilled charcoal that has been treated with superheated steam

Q

Administration of Activated Charcoal

A

Should be administered as early as possible and only in specific cases approved by medical direction.

Q

Indications for Activated Charcoal

A

May be used for a patient who has ingested poison by mouth

Q

Contraindications for Activated Charcoal

A

Should not be administered to a patient who has an altered mental status

Q

Dosage of Activated Charcoal

A

Unless directed otherwise

Q

Usual Adult Dose of Activated Charcoal

A

The usual adult dose is 25-50 grams.

Q

Usual Dose for Infants and Children of Activated Charcoal

A

The usual dose for infants and children is 0.5-1 gram per kilogram.

Q

Forms of Activated Charcoal

A

Available as premixed in water or as a powder

Q

Trade Names of Activated Charcoal

A

Some trade names include SuperChar

Q

Efficacy of Activated Charcoal

A

It is intended to limit the amount of poison absorbed by the intestines due to its capability to adsorb poison while it is still in the stomach or proximal portion of the intestines.

Q

Activated Charcoal Appearance

A

Activated charcoal looks like mud.

Q

Patient Administration Tips

A

The patient may be more willing to drink it if it is not visible

Q

Record Keeping

A

Record the time and the patient response after administering activated charcoal.

Q

Repeat Dose Notification

A

If the patient vomits

Q

Activated Charcoal Particle Size

A

Activated charcoal is produced to have a small particle size to increase its adsorptive properties.

Q

Surface Area Comparison

A

A standard dose of activated charcoal has roughly the same surface area as football fields.

Q

Laxative Agent in Activated Charcoal

A

Some activated charcoal products contain a laxative agent (cathartic) that helps speed it through the intestinal tract.

Q

Medical Direction

A

Consult medical direction or the poison control center before administering activated charcoal to any patient.

Q

Preparation of Activated Charcoal

A

Shake the container thoroughly; if too thick

Q

Settling of Activated Charcoal

A

If the activated charcoal settles

Q

Poison Control Center

A

Follow your protocol

Q

Limited Use of Activated Charcoal

A

Due to its limited efficacy

Q

Activated Charcoal

A

A substance that adsorbs poisons in the stomach

Q

Effectiveness of Activated Charcoal

A

Decreased by milk

Q

Common Side Effect of Activated Charcoal

A

Blackening of the stools.

Q

Vomiting After Activated Charcoal Administration

A

If the patient vomits

Q

Administration Precautions

A

Ensure the patient’s airway and mental status are adequate to prevent aspiration.

Q

Contraindications for Activated Charcoal

A

Do not administer to patients with altered mental status

Q

Use of Activated Charcoal in Prehospital Environment

A

Use activated charcoal that has been premixed with water.

Q

Common Brands of Activated Charcoal

A

Contain activated charcoal mixed with water in a plastic bottle.

Q

Powdered Activated Charcoal

A

Must be mixed with water before administration; discouraged in the field due to preparation issues.

Q

Inhaled Poisons

A

Toxic substances absorbed rapidly by the body

Q

Common Inhaled Poisons

A

Include carbon monoxide

Q

Huffers

A

Patients who inhale paints and propellants to achieve a high.

Q

Effects of Inhaled Toxins

A

Can lead to hypoxia by displacing oxygen in the alveoli

Q

Signs of Toxic Inhalation

A

Look for paint or other material on the lips or around the nose during the physical exam.

Q

Activated Charcoal Administration Guidelines

A

Only administer based on medical direction and/or poison control center advice.

Q

Activated Charcoal Absorption Limitations

A

Not effective for alcohol

Q

Patient Positioning During Administration

A

Place the patient in a sitting or lateral recumbent position to prevent aspiration.

Q

Reassessment During Administration

A

Check for abdominal pain or distress and watch for possible vomiting.

Q

Premixed Activated Charcoal

A

Recommended for use in the prehospital environment.

Q

Toxic Inhalation Prognosis

A

The longer the exposure without treatment

Q

Common Sources of Inhaled Poisons

A

Include industrial sites

Q

Anesthetic Gases

A

Include ether

Q

Incomplete Combustion of Natural Gas

A

A source of inhaled poisons that can lead to toxic exposure.

Q

Hydrogen Sulfide

A

Also known as sewer gas

Q

Nitrogen Dioxide

A

A toxic gas that can be produced from fermented grain.

Q

Commonly abused inhaled poisons

A

Paints

Q

Onset of inhaled poisons

A

Inhaled poisons typically have a more immediate onset than injected poisons.

Q

Effects of inhaled poisons

A

Inhaled poisons can destroy lung tissue

Q

Damage caused by inhaled toxins

A

An inhaled toxin can directly damage the alveoli when inhaled

Q

Signs and symptoms onset

A

Inhaled poisons often cause a rapid onset of signs and symptoms due to rapid absorption into the lungs and circulation.

Q

Carbon monoxide poisoning presentation

A

Young children and the elderly typically present with signs and symptoms of carbon monoxide poisoning before any other patients who have been exposed.

Q

Scene size-up importance

A

Ensuring your safety is of prime importance during the scene size-up.

Q

Peculiar odors and visible fumes

A

You should be acutely aware of peculiar odors or visible fumes during the scene size-up.

Q

Odorless gases

A

Some gases

Q

Self-contained breathing apparatus

A

Wear self-contained breathing apparatus before entering the scene if toxic fumes are present.

Q

Hazardous materials rescue

A

If you are not properly equipped or trained for hazardous materials rescue

Q

Assessing inhaled poison patients

A

Determine the number of persons at the scene who might have inhaled the poison; there are likely to be more patients than the one for whom EMS was originally called.

Q

Patient removal from toxic environment

A

Have trained rescuers remove the patient from the toxic environment.

Q

Primary assessment focus

A

Close assessment and management of the patient’s airway and ventilation status is important in inhaled poison patients.

Q

Altered mental status

A

If the patient has an altered mental status

Q

Ventilation assistance

A

If the rate is inadequate or the tidal volume is inadequate

Q

Maximizing oxygenation

A

Maximize oxygenation of the patient during ventilation by connecting oxygen to the ventilation device.

Q

High concentration oxygen administration

A

If breathing is adequate in both rate and depth

Q

Monitoring inhaled poisoning patients

A

Monitor the patient closely because he can deteriorate rapidly and begin to breathe inadequately.

Q

Assessing circulatory status

A

Assess the patient’s circulatory status by assessing the pulse and the skin color

Q

Secondary Assessment

A

During the secondary assessment

Q

History

A

Ask the patient or bystanders questions about what was inhaled

Q

Suicide Attempt History

A

Does the patient have a history that suggests a possible suicide attempt? This is more common in apparently intentional carbon monoxide poisonings.

Q

Exposure Location

A

Did the exposure occur in an open or a confined space? A confined space likely has highly concentrated amounts of the toxin and can lead to a severe toxic exposure.

Q

Duration of Exposure

A

How long was the patient exposed? The severity of the inhaled poisoning is associated with the duration of exposure to the toxin.

Q

Fire Exposure

A

Patients who are trapped in a fire are typically exposed to large amounts of toxic substances.

Q

Incomplete Combustion

A

Incomplete combustion of products releases toxic fumes

Q

Common Causes of Death in Fire

A

Most people who die in a fire do so from inhalation of toxic fumes and not from burns.

Q

Airway Injuries

A

The second most common cause of death in a fire is from airway injuries secondary to breathing in superheated air.

Q

Trauma in Fire

A

The third most common cause of death in a fire is from trauma.

Q

Physical Exam

A

If the patient is responsive enough to provide you with an adequate history

Q

Vital Signs

A

Obtain and record the patient’s vital signs.

Q

Signs and Symptoms of Inhaled Poisoning

A

Following are the signs and symptoms of inhaled poisoning: A history of inhalation of a toxic substance

Q

Signs of Respiratory Tract Burns

A

Signs of respiratory tract burns include: Singed nasal hairs

Q

Emergency Medical Care

A

Respiratory symptoms are typically the first to appear with inhalation injuries.

Q

Protecting from Toxic Fumes

A

Protect yourself from exposure to toxic fumes by wearing self-contained breathing apparatus or waiting for a specialized team to make the rescue.

Q

Patient Positioning

A

Place the patient in a supine position or position of comfort. Loosen all tight-fitting clothing

Q

Open Airway

A

Establish and maintain an open airway.

Q

Positive Pressure Ventilation

A

Start positive pressure ventilation with supplemental oxygen immediately if the patient has an inadequate tidal volume or respiratory rate.

Q

High Concentration Oxygen

A

Administer a high concentration of oxygen by nonrebreather mask initially for all inhaled poisoning patients regardless of the reading.

Q

Reassessment

A

Provide a reassessment en route to the hospital with attention to the patient’s airway and breathing.

Q

Injected Poisons

A

An injected poison is one that enters the body through a break in the skin

Q

Injected Poisons

A

Substances that can be introduced into the body through various means such as bites

Q

Anaphylactic Shock

A

A severe allergic reaction that can occur following an insect bite or sting.

Q

Common Sources of Injected Poisons

A

Includes stings from bees

Q

Immediate Reaction

A

The initial response at the injection site following exposure to injected poisons.

Q

Delayed Systemic Reaction

A

A later response that affects the body after the initial reaction at the injection site.

Q

Assessment-Based Approach

A

A systematic method to evaluate and provide emergency care for injected poisoning cases.

Q

Scene Size-Up

A

The initial evaluation of the environment for clues related to injected poisoning.

Q

Primary Assessment

A

The first step in evaluating a patient’s condition

Q

Pathophysiology of Injected Poisons

A

Injected poisons are absorbed into capillaries and can affect multiple organs throughout the body.

Q

Secondary Assessment

A

A detailed evaluation that includes obtaining a history and vital signs from the patient or bystanders.

Q

History Questions for Injected Poisons

A

Questions to ask include history of drug use

Q

General Signs and Symptoms of Toxic Injection

A

Includes weakness

Q

Emergency Medical Care for Toxic Injection

A

Involves protecting oneself and the patient from further injury and moving the patient away from any remaining threats.

Q

Weakness/Lethargy

A

A common symptom indicating reduced energy or responsiveness in a patient.

Q

Dizziness

A

A feeling of lightheadedness or unsteadiness often associated with toxic injection.

Q

Chills

A

A sensation of coldness that may occur as a symptom of injected poisons.

Q

Fever

A

An elevated body temperature that can be a response to injected toxins.

Q

Nausea/Vomiting

A

Gastrointestinal symptoms that may arise following toxic injection.

Q

Euphoria

A

An exaggerated feeling of well-being that can occur with certain toxic injections.

Q

Sedation

A

A state of calm or drowsiness that may result from injected poisons.

Q

High or Low Blood Pressure

A

Variations in blood pressure that can indicate a reaction to injected poisons.

Q

Pupillary Changes

A

Alterations in pupil size that may occur as a symptom of toxic injection.

Q

Skin Abscesses

A

Localized infections that can develop at the site of injection.

Q

Pain at the Site of Injection

A

Discomfort experienced where the poison was introduced into the body.

Q

Bees

A

Can sting only once and then lose their stinger.

Q

Wasps

A

hornets

Q

Oropharyngeal airway

A

Inserted if the patient does not have a gag reflex.

Q

Nasopharyngeal airway

A

Used if the patient has a depressed mental status but does not accept an oropharyngeal airway.

Q

Positive pressure ventilations

A

Begun with supplemental oxygen if the patient’s respirations are inadequate.

Q

Adequate oxygenation

A

Administer oxygen via a nasal cannula to achieve and maintain an oxygen saturation of 94% or greater.

Q

Lateral recumbent position

A

Position to help prevent aspiration in case of vomiting.

Q

Absorbed poison

A

Usually a chemical or substance from a poisonous plant that enters through the skin.

Q

Skin reactions from absorbed poisons

A

Range from mild irritation to severe chemical burns.

Q

Hydrofluoric acid exposure

A

Exposure of as little as 1% of the body surface can cause death.

Q

Scene Size-Up

A

Make note of any open containers of chemicals or poisonous plants in the environment.

Q

Primary Assessment

A

Carefully assess the patient’s airway and breathing.

Q

Secondary Assessment

A

Get a history from the patient or bystanders about the toxic substance that is likely to have been absorbed.

Q

History and Physical Exam

A

Obtain and record the patient’s vital signs.

Q

Suction

A

Used for vomitus or secretions.

Q

Reassessment

A

Provide attention to the airway and breathing and monitor for possible development of an anaphylactic reaction.

Q

Emergency care for poisoning

A

Follow steps of assessment to determine facts surrounding a possible absorbed poisoning.

Q

Protective gear

A

Wear gloves and other protective gear to ensure harmful substances do not contact your skin.

Q

Toxic substance

A

Take care to avoid contact with the toxic substance during assessment.

Q

Muscle paralysis

A

Some absorbed poisons can cause this and compromise the patient’s respiratory status.

Q

Excessive secretions

A

Can complicate the airway in cases of absorbed poisoning.

Q

Altered mental status

A

Secondary to the effects of the absorbed poison could cause the jaw and tongue to relax and block the airway.

Q

Vital signs

A

Should be obtained and recorded during the physical exam.

Q

Signs and Symptoms of Absorbed Poison

A

A history of exposure to a poisonous substance

Q

Signs and Symptoms of Contact with a Poisonous Plant

A

Fluid-filled

Q

Emergency Medical Care for Absorbed Poison

A

Protecting your hands with gloves

Q

Positive Pressure Ventilations

A

Begin positive pressure ventilations with supplemental oxygen if the patient’s respirations are inadequate.

Q

Oxygenation Maintenance

A

Maintain adequate oxygenation. If there are signs of respiratory distress

Q

Brushing Off Dry Chemicals

A

Brush any dry chemicals or solid toxins from the patient’s skin

Q

Flushing Contaminated Area

A

Contact medical direction to determine whether to flush the contaminated area.

Q

Irrigation of Liquid Poison

A

If the poison is liquid

Q

Irrigation of Eye with Poison

A

If the poison entered the eye

Q

Positioning During Eye Irrigation

A

Position the patient so water runs away from the unaffected eye

Q

Reassessment During Transport

A

Provide a reassessment en route to the hospital with attention to the status of the patient’s airway and breathing.

Q

Assessment Summary for Poisoning Emergency

A

The following findings may be associated with a poisoning emergency.

Q

Scene Size-Up for Poisoning

A

Is the poisoning due to ingestion

Q

Mechanism of injury

A

The process or event that caused the injury.

Q

Alcohol

A

drugs

Q

Empty medicine bottles

A

Containers that previously held medications

Q

Spilled chemicals

A

cleaning solvents

Q

Pieces of plants

A

Plant material that may indicate exposure to toxic flora.

Q

Position and location of the patient

A

The physical placement of the patient

Q

Confined spaces

A

Enclosed areas that may increase the risk of exposure to toxic substances.

Q

Peculiar odors

A

Unusual smells that may indicate the presence of toxic substances.

Q

More than one patient with similar signs and symptoms

A

Indicates a potential mass exposure to a harmful substance.

Q

Drug paraphernalia

A

Items associated with drug use that may indicate substance abuse.

Q

Insects

A

snakes

Q

Powdered or liquid substance on the skin surface

A

Indicates possible exposure to toxic materials.

Q

Paint or other chemicals on the patient’s lips or around the nose

A

May suggest inhalation or ingestion of harmful substances.

Q

Primary Assessment

A

Initial evaluation to determine the patient’s condition.

Q

General Impression

A

Overall assessment of the patient’s appearance and condition.

Q

Burns to skin from chemical exposure

A

Injuries resulting from contact with harmful chemicals.

Q

Vomitus or secretions in mouth

A

Presence of expelled contents that may indicate poisoning.

Q

Stings or bites to body with areas of swelling

A

Injuries that may indicate exposure to venomous creatures.

Q

Mental Status

A

Assessment of the patient’s consciousness and cognitive function.

Q

Airway

A

The passage through which air enters and leaves the lungs.

Q

Breathing

A

The process of inhaling and exhaling air.

Q

Circulation

A

The movement of blood throughout the body.

Q

Status: Priority Patient

A

Indicates a patient requiring immediate medical attention.

Q

Secondary Assessment

A

Further evaluation after the primary assessment to gather more information.

Q

History

A

Information regarding the patient’s past medical and exposure history.

Q

Physical Exam

A

A thorough examination of the patient’s body to identify injuries or symptoms.

Q

Vital Signs

A

Measurements of essential body functions

Q

Emergency care protocol: poisoning emergency

A

Guidelines for managing patients with suspected poisoning.

Q

Open Airway

A

Establish and maintain unobstructed airflow for patient.

Q

Positive Pressure Ventilation

A

Assisted breathing for inadequate respiratory function.

Q

Nonrebreather Mask

A

Delivers high concentration oxygen to patients.

Q

Lateral Recumbent Position

A

Patient lying on their side for airway protection.

Q

Ingested Poison

A

Toxins consumed, requiring airway and ventilation support.

Q

Inhaled Poison

A

Toxins breathed in, necessitating oxygen supply.

Q

Injected Poison

A

Toxins introduced via needle or sting, requiring scraping.

Q

Absorbed Poisoning

A

Toxins absorbed through skin, requiring decontamination.

Q

Food Poisoning

A

Illness from consuming contaminated food or toxins.

Q

A