Poisoning

Question 1

Routes for poison

Answer 1

Ingestion
Inhalation
Absorption
Injection

Question 2

S/S of poisoning (general)

Answer 2

Scene: odors
flames/smoke
open/empty/spilled/out-of-place containers
overturned/damaged plants

Patient: Nausea/vomiting
chest/abd. px
SOB
Altered LOR
Seizures
burns on/around mouth
diarrhea
rash

Question 3

Key components of poisoning

Answer 3

Scene assessment
Remove casualty from source
Primary assessment
911: poison control centre, EMS (ask for PC they will give more info, follow their directions)

Question 4

If you suspect patient poisoned- try to get the answers to these questions

Answer 4

What type of poison was it?
How did the contamination occur?
When did it occur?
Do you know the quantity of the poison?

Question 5

Poisoning: Ingestion

Answer 5

call EMS ask for PC
PC may ask you to:
1. induce vomiting
2. use activated charcoal
3. give patient water to drink
ONLY DO under PC consent and direction

Question 6

S/S of Ingestion poisoning

Answer 6

an open container of poison nearby
burns on mouth
Unusual odor
↑ saliva / abnormal colour
cramps, vomiting, diarrhea
seizures
Dizziness
Unresponsive
Burn sensations (mouth, throat, or stomach)

Question 7

Poisoning: Inhaled

Answer 7

Call EMS ask for PC
protect yourself and patient (scene safe)
perform interventions for resp. arrest/distress

Carbon Monoxide poisonings: most common, deprives body of O2, hypoxia

Question 8

Specific S/S of inhaled poisons

Answer 8

Resp. arrest/ distress/ dyspnea
irritated eyes, nose, or throat
dizziness
vomiting
seizures
cyanosis
Unresponsiveness
unusual smell in air/ on patients breath

Question 9

Poisoning: absorbed

Answer 9

EMS/ask for PC
common causes:
1. poison ivy
2. poison sumac
3. poison oak
4. other dry and wet chemicals

Tx. apply a cream or ointment designed to reduce itching/blistering
suggest oral antihistamine
px. should be assessed by physician
If exposed to wet or dry chemicals, refer to the care for chemical burns

Question 10

S/S of absorbed poisons

Answer 10

itching
red rash
swelling
bumps, streaking, and weeping blisters

Question 11

Poisoning: Injected

Answer 11

EMS/ask for PC

most common = animal bites/stings

if animal present do not catch (take notes)
key = identifying any potential anti-venins

Question 12

Injected - Stingers (bees/wasps)

Answer 12

only fatal if anaphylactic reaction
- examine the affected area to see if the stinger is embedded in the skin

Question 13

Injected - spiders

Answer 13

only north american spiders that are venomous =
black widow
brown recluse

Question 14

S/S of black widow and brown recluse bites

Answer 14

BLACK WIDOW
1. raised, round, red mark
2. cramping pain in the thighs, shoulders, and back abdominal muscles
3. restlessness and anxiety
4. dizziness
5. headache
6. excessive sweating
7. weakness
8. can range from mildly irritating to unbearable

BROWN RECULSE:
1. slight stinging sensation
2. a blood blister that appears within 2-8 hours
3. a bulls-eye pattern around the bite

Question 15

Injected - snakes

Answer 15

most snakes in canada = not venomous but treat all snakebites as venomous

Place patient in RTD, call EMS and ask for poison control
1. keep injury site still
2. remove jewelry and tight clothing if bite on limb
3. wash the wound w/ water
4. cover the bite w/ a clean, sterile, dry dressing

Question 16

Substance Misuse and Abuse

Answer 16

most common = ASA + sleeping pills
drug - any substance that is taken to affect the function of the body
medication - a drug used to prevent or treat a disease or condition

Question 17

Categorizes of substance misuse and abuse

Answer 17

Stimulants
Depressants
Hallucinogens

Question 18

Stimulants

Answer 18

affect CSN = speed up physical and mental activity
ingested (some absorbed or inhaled)
temporary feeling of alertness, improve task performance and prevent sleepiness

EX. asthma meds, meth, cocaine, crack, caffeine, nic

S/S:
in some instances, misuse or abuse can disrupt normal heart rhythms, cause resp emergencies and can be fatal

Question 19

Hallucinogens

Answer 19

change mood sensations, thought, emotion and self-awareness
mid-altering effects such as panic, paranoid delusions, vivid hullucinations, prodound depression, tension and anxiety
person my be irrationl and feel threatened by attempted help

Question 20

Depressants

Answer 20

affect CNS & slow down physical + mental activity
common medical purpose
depressants will relieve anxiety, promote sleep, depress respirations, relieve pain, relax muscles, impair coordination and judgment

Question 21

Opioids

Answer 21

are a class of depressants that include morphine, heroin, and fentanyl
high risk of fatal overdose due to control of respiration and cause respiratory arrest

Question 22

S/S of Opioid overdose

Answer 22

Severely reduced LOR or unresponsive
severely constricted pupils or rolled-back eyes
limp muscles
slow or absent pulse
slow or absent respiration, possible gurgling or snoring sounds
low SpO2
cold, pale, or blue skin, specially on nail beds and lips
vomiting

Question 23

Risk for Opioid Poisoning

Answer 23

mixing drugs
change in tolerance or health leading to increase sensitivity to drugs as prescribed
previous experience with non-fatal opioid poisoning, leading to risk-taking behaviour
Variation in strength, content and/or supplier of their “street” drugs

Question 24

Naloxone

Question 25

Opioid Overdose treatment

Answer 25

if person is not breathing, or is displaying agonal respirations, immediately start compression only CRP

naloxone may be re-administered every 3-5 minutes if there is no improvement in the person’s conditions

Transfer of Care:
time, route, dose, change in condition

Question 26

Designer Drugs

Answer 26

Manufactured or modified from other drugs or other common household products

no medicinal purposes

Question 27

General Care for Misuse and substance abuse

Answer 27

not the time to pass judgement
form of poisoning, so follow the same protocol of care (EMS, poison control)

Ask bystandard:
What was taken, how much was taken, when was it taken

Be careful that someone may be irrational, aggressive, violent, or withdrawn