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POISONING AND OVERDOSE
• PoisoningAny substance that can harm the bodyTypes• Chemicals• ToxinsEffects:• Destroys the skin• Suffocates• Systemic—depress or over stimulate CNS
dependent upon……….
• Nature of poison
• Concentration
• Age, weight, general health
• IngestedPatient Assessment• Substance• When exposure occurred• How much was ingested• Over how long a period • Interventions prior to your arrival• Weight• Effects
Activated Charcoal
• a form of carbon that has been processed to make it extremely porous and thus to have a very large surface area available for adsorption or chemical reactions.
• just one gram of activated carbon has a surface area of approximately 500 m² (or about 2.17 tennis courts)
• Not an antidote
reduces the amount of poison available for the body to absorb
• Absorbs many poisons but not all
Contraindications
• Cannot swallow
• AMS
• Ingestion of acids or alkalis
• Swallowed gasoline
Care• Identify and treat life-threats• Transport decision• Focused Hx. and PE
SAMPLE• Remove any remnants or pill fragments• Baseline VS• Take all bottles and labels
Consult Medical Control
• Repeat and follow directions carefully
• Pediatric
Give weight
Estimated amt. of poison ingested
INHALED POISONS
• CO
• Chlorine gas
• Ammonia
• Agricultural chemicals and pesticides
• CO2
Scene Safety• Protective clothing• Self-contained breathing apparatus
if trained• Many inhaled poisons can be absorbed through
the skin• If you don’t have the proper training or
equipment…………..
STAY OUT!!!
Assessment
• Exact name of substance
• When did exposure occur
• Period of exposure
• Interventions pta
• Effects of substance and interventions
Care
• Airway
• Breathing
• Move to a safe place
non-urgent move
urgent move
emergency move
• Treat any immediate life-threats
• Transport decision
• Focused Hx. and PE
• O2
• Bottled, containers and labels
CO
• Most common inhaled poison
• Car exhaust and fire supression
• Odorless, colorless, tasteless
Signs and symptoms• Headache
a band around the head• Dizziness• Breathing difficulty• Nausea• Cyanosis• AMS
• Consider a possibility when there are vague flu-like complaints and a group of people.
May begin to feel better immediately after being
removed from source
Smoke Inhalation
• Difficulty breathing
• Coughing
• Breath with smoky or odorous smell
• Carbon residue in mouth and nose
• Black residue in sputum
• Singed nose hairs
Absorbed Poisons
• Absorption can take place with little or no damage to the skin
Assessment
• Exact name of substance
• When did exposure occur
• Period of exposure
• Interventions pta
• Effects of substance and interventions
Care
• ABCs and Life-threats
• Transport decision
• Remove contaminated clothing
be cautions of becoming contaminated
• Remove the poison:
• Powders
brush off
• Liquids
Irrigate at least 20 minutes
• Eyes
Irrigate for at least 20 minutes
Do not neutralize acids and alkalis
• Alcohol and Substance Abuse
• May have underlying trauma from falls
• May have underlying medical problems
diabetes, GI bleed
• Alcohol and drugs are commonly taken together
Patient Assessment
• Scene Safety
• You may need to obtain SAMPLE from other sources
Signs and symptoms of alcohol abuse• Odor of ETOH on breath or clothing• Swaying and unsteadiness• Slurred speech, rambling, incoherent• Flushed with sweating & c/o being warm• Nausea/vomiting• Poor coordination• Slowed reaction time
• Blurred vision
• Confusion
• Hallucinations
• Lack of memory
• AMS
Signs and symptoms of alcohol withdrawl• Confusion• Unusual (insane) behavior• Hallucinations• Gross temor of hands• Profuse sweating• Seizures
Transport seizure related DTs ASAP
Care• Determine if drugs and alcohol mixed• BSI; Scene safe• ABCs• LOC and GCS• Monitor VS and be alert for shock• Protect from self-injury and yourselves
*restrain
• If patient refuses
Substance Abuse
Patient Care
• BSI
• Scene safe
• ABCs
• Never touch or taste any suspected illicit drug
• Treat for shock
• Talk to your patient to establish rapport and determine LOC and GCS
• Perform Rapid or Detailed PE
carefully assess for head injury
• Inspect for “tracks”
• Protect from harm or harming others
• If pt. creates unsafe scene, GET OUT
• Transport as soon as possible
• Contact medical direction
• Monitor VS
• Be aware of possible seizures
• Many drug users may appear calm at first then become violent----be on the alert