EC Chp 21 Poisoning & Overdose Flashcards
A Poison is…
Any substance that can harm the body, sometimes seriously enough to create a medical emergency. These include…
Medications, petroleum products, cosmetics, and pesticides.
More than 1 mil cases reported annually.
A Toxin is…
A poisonous substance to humans secreted by bacteria, plants or animals.
Some examples of toxins are…
Houseplants, including the rubber plant and certain parts of holiday plants such as mistletoe and holly berries. In addition contaminants in food may produce toxins can be deadly (botulism)
Botulism
contaminants in food may produce a deadly toxin called clostridium botulinum
For most poisonous substances, the reaction is far more serious for what age groups
The very young, and the elderly and people who are already ill
4 ways you can be exposed to poisons
- Ingested Poison: rat poison, lye, drain cleaners
- Inhaled Poison: sprays, cleaning fluid
- Absorbed Poison: household cleaners, insecticides
- Injected Poison: drugs
Ingested poisons are…
Poisons that are swallowed.
These include industrial chemicals, meds, improperly prepared or stored food, plant materials, petroleum products
Inhaled poisons are
Poisons that are breathed in; take the form of gases, vapors, and sprays.
Ex. Carbon monoxide, ammonia, chlorine, insect sprays, and gases from volatile liquid chemicals.
Absorbed poisons are
Poisons taken into the body through unbroken skin.
Many are corrosive or irritants then be slowly absorbed into the body tissues and the bloodstream possibly causing widespread damage.
Injected poisons are…
Inserted through the skin and enter the body through a means that penetrate the skin. Most common are illicit drugs, other are venoms or insect stingers.
Food poisoning occurs when
Food has been improperly handled or cooked. Caused by several different bacteria that grow and frequently happens when raw meat, poultry, or fish is left at room temp before being cooked.
Food poisoning symptoms can occur when?
May occur a day or so after ingestion
OR
Usually within hours ingestion. Both show nausea, vomiting, abdominal cramps, diarrhea and fever.
Activated Charcol does what?
It works through ADsorption with many poisons and prevents them from being absorbed in the body. (Clings and reduces amount of poison or sucks in)
Been manufactured to have many cracks and crevices
When administering activated charcoal ALWAYS do what?
Contact medical direction to see whether or not you should use the activated charcoal.
Contraindications of Activated Charcoal
- Patients who cannot swallow
- Patients with altered mental status might choke on it
- Patients whom ingested acids or alkalis (can cause further damage)
- Patients who have accidentally swallowed while siphoning gas
- not used for food poisoning.
Syrup of Ipecac
a traditional treatment for poisoning is syrup of ipecac that causes vomiting with just 1 dose.
Results in on average removal of less than 1/3 of the stomach contents
has potential to aspirate vomitus
Syrup of Ipecac vs. Activated Charcoal
Syrup of Ipecac can make the patient aspirate vomitus, so it is rarely used today and activated charcoal is the 1st choice for health care providers.
Dilution
Thinning down or wearing by mixing with something else. Ingested poisons are sometimes diluted by drinking water or milk.
What is the amount of water or milk usually instructed to drink for dilution in adults and children.
1-2 glasses for adults
.5 -1 glass for children
Antidote
A substance that will neutralize the poison or its effects.
However there only a few genuine antidotes for very few poisons.
For advanced treatments for poisons you can do two things…
Administer of antidotes
Kidney dialysis
When a child is poison what is important to find out?
Childs weight & age
Estimated amount of poisonous substance that was ingested.
Remember that many inhaled poisons can also be absorbed through the skin.
Go only where your protective equipment and clothing will allow you to go safely to perform your mission.
When inhaled poison occurs what info should be gathered ASAP?
- What Substance was involved
- When did the Exposure occur
- Over how long a period did the exposure occur?
- what interventions has anyone taken?
- what effects is the patient experiencing from the exposure?
The most common cause of hospitalization of overdose patients is?
Acetaminophen - nausea, vomiting, jaundice is a delayed sign and may be no signs or symptoms.
The patient can have their liver recover from an Acetaminophen overdose as long as they are given the antidote within _____ hours?
12 hours
During the first 4-12 hours of acetaminophen overdose the patient may experience what signs and symptoms?
Loss of appetite,
Nausea, and Vomiting
It isn’t until a day or two later that the patient experiences RUQ pain and Jaundice
The single most important treatment for inhaled poisoning after the patients airway is opened is
To administer high concentration oxygen.
Carbon Monoxide (CO) is one of the most common inhaled poisons. It is usually associated with
Motor vehicle exhaust and fire supression
Also, wood burning stove, charcoal and indoor cooking areas without adequate ventilation,
What makes Carbon Monoxide so dangerous
It is odorless, colorless, and tasteless so you will not be able to directly detect its presence without special equipment.
Signs and symptoms of Carbon Monoxide poisoning
And always suspect when patient has flulike who has been in an enclosed area.
Headache “a band around the head” Dizziness Breathing difficulty Nausea Cyanosis Altered mental status
What is the antidote for Carbon Monoxide poisoning?
Oxygen, but may take time to “washout” from the bloodstream
Smoke Inhalation is associated with thermal burns and effects from chemical poisons. As an EMT you will mostly like find?
Irritated (reddened, watering) eyes Difficulty breathing, coughing Carbon residue in patients mouth and nose Black sputum coughed up by patient Nose hair singed from air.
Detergent Suicide is
A suicide method made popular in Japan by maxing two easily obtained chemicals in which a person can cause the release of toxic hydrogen sulfide gas. (Toilet cleaner and bath salts)
Or strong household cleaner and source of sulfur (often a pesticide)
Hydrogen sulfide is best known for its _____ odor. And what does it do in the bloodstream?
Rotten egg
Takes the place of oxygen, bonds with iron cells and preventing the oxygen from getting where its needed.
Most Severe cases of Hydrogen Sulfide exposure cause what?
Fluid will collect in the lungs and cause pulmonary edema death
With Absorbed poison, what do you do after treating immediate life threats?
Have the patient remove the contaminated clothing
Remove the poison by
- Powders: brushing powder off patient
- Liquids: Irrigate with clean water for at least 20 min
- Eyes: Irrigate with clean water for at least 20min
You should NOT “neutralize acids or alkalis with solutions such as…
Dilute Vinegar or baking soda
Poison control centers can be reached when and how?
24hours by dialing the 800 number of 222-1222
To provide laypeople and health care providers with info and advice
Alcohol abuse has a potent effect on a persons_______ system
Central nervous System
Chronic Drinkers (alcoholics) oftentimes have derangements in….
Blood sugar levels,
Poor nutrition,
GI bleeding potential
Delirium Tremens (DTs)
A severe reaction that can be part of alcohol withdrawal, characterized by sweating. Trembling, anxiety and hallucinations. Severe alcohol withdrawal with the DT’s can lead to death
Remember
A patient under the influence of alcohol cannot make an informed refusal of treatment or transport.
Most common chemical substances that are abused are?
Uppers: caffeine, amphetamines, and cocaine
Downers: sleeping pill, or tranquilizer
Narcotics: (codeine, OxyContin) producing stupor or sleep to relieve pain
Hallucinogens: LSD & PCP, mushrooms.
Volatile Chemicals: produce vapors that are inhaled “huffing”
Uppers do what to the user
Excite the user, affect the central nervous system. Increased pulse and breathing rates, Rapid speech, dilated pupils, Without sleep for long periods Restless, hyperactive
Downers to what to the patient
Sluggish, sleeping and lacking typical coordination of body and speech
Pulses and breathing rates are low
Narcotic patient usually show …
Reduced rate of pulse and rate and depth of breathing
Pupils are constricted (pinpoint size)
Lowering skin temp
Patient is very sleeping
Comas are com,mon an respiratory and cardiac arrest.
Volatile Chemical patients appear ?
Dazed or show temporary loss of contact with reality,
May develop a coma
*Linings of their nose and mouth may show swollen membranes
Or numb “tingling” feeling inside the head.
Hallucinogens are
Mind affecting drugs that act not he nervous system produce an intense state of excitement or distortion. They are dissolved in the mouth and absorbed in the mucus membranes
*fast pulse rate, dilated pupils and a flushed face
