Poisoning Ms Word

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POISONING

Definition

A poison is any substance that when ingested, inhaled, absorbed, applied to the

skin, or produced within the body in relatively small amounts of injuries in thebody by its chemical action..

Emergency treatment

1. To remove or inactivate the poison before it is absorbed2. To provide supportive care in maintaining vital organ system3. To administer a specific antidote to neutralize a specific poison4. To implement treatment that hastens the elimination of the absorbed

poison

I. Ingested ( Swallowed ) Poisons

- may be corrosive- Corrosive poisons include alkaline and acidagents that can cause tissue

destruction after coming in contact with mucous membranes

Alkaline products:- Lye- Drain cleaners- Bleach- Non-phosphate detergents

- Oven cleaners- Button batteries- Clinitest tablets-Acid products:- Toilet bowl cleaners- Pool cleaners- Metal cleaners- Rust removers- Battery acids

Signs and Symptoms- Pain- Burning sensations- Any evidence of redness or burn in the mouth or throat- Pain in swallowing or inability to swallow- Vomiting or drooling- Age and weight of the patient- Pertinent health history


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Managements- Control the airway, ventilation and oxygenation- Managing respiratory and its circulation in the absence of cerebral or renal

damage- Stabilized cardiovascular and other body functions

- Monitoring closely for changes in ECG, vital signs, neurologist status- Insert an indwelling urinary catheter to monitor renal function- Test for concentration of drugs or poison obtained by blood specimen- Determining what substance was taken, the amount, the time of ingestion- Give water or milk to drink for dilution for patient who ingested corrosive

poison- Doing gastric emptying procedure as prescribed such as: syrup of ipecac,

gastric lavage, gastric aspirate- Administer the specific chemical antagonist or physiologic antagonist to

reverse or diminish the effects of the toxin- Administering multiple doses of charcoal or diuresis, dialysis and

hemoperfusiion

II. Inhaled poisons: Carbon Monoxide poisoning

- may occur as a result of industrial or household incidents or attemptedsuicide

- carbon monoxide exerts its toxic effect by binding to circulatinghemoglobin and thereby reducing the oxygen-carrying capacity of theblood

-carboxyhemoglobin

is called carbon monoxide-bound hemoglobin whichdoes not transport oxygen

Signs and Symptoms- Headache- Muscular weakness- Palpation- Dizziness- Mental confusion- Skin color (range from pink or cherry red to cyanotic and pale is not a

reliable sign- Signs of permanent CNS damage- Psychoses- Spastic paralysis- Ataxia- Visual disturbances- Deterioration of personality


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Management- To reverse cerebral and myocardial hypoxia- To hasten carbon monoxide elimination

- Following general measures:-Carry the patient to fresh air immediately; open all doors and windows-Loosen all tight clothingInitiate CPR if required-Prevent chilling; wrap the patient in blankets-Keep the patient as quite as possible-Do not give alcohol in any form

- Administer 100% oxygen at atmospheric or hyperbaric pressure to reversehypoxia and accelerate the elimination of carbon monoxide

III. Skin Contamination Poisoning ( Chemical Burns)

- injuries from exposure to chemicals with large number of offending agentsdiverse action and metabolic effects

- the severity of chemical burn is determined by the mechanism of action,penetrating strength and concentration and amount and duration ofexposure of the chemical to the skin

Managements- The skin should be drenched immediately with running water from shower,

hose, or faucet- Water should not be applied to burns from lye or white phosphorusbecause of the potential for an explosion or deepening the burn

- A constant stream of water should continue as the patients clothing isbeing removed

- Prolonged lavage with generous amounts of tepid water is important- Identify and characteristics of the chemical agent for future treatment- Antimicrobial treatment- Debridement- Tetanus prophylaxis as prescribed- Plastic surgery if required for further wound management- Reexamined the affected area at 24 and 72 hours and in 7 days due to the

risk for understanding the extent and depth of these types of injuries


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IV. Food poisoning

- is sudden, explosive illness that may occur after ingestion of contaminatedfood or drink

- Botulism is a serious form of food poisoning that requires continual

surveillance

Signs and Symptoms- Fluid and electrolyte imbalances- Lethargy- Rapid pulse rate- Fever - Oliguria- Anuria

- Hypotension- Delirium- Hypovolemic shock

Assessment Food Poisoning- How soon after eating did the symptoms occur?- What was eaten in the previous meal?- Did anyone else become ill from eating the same food?- Did vomiting occur?- Did diarrhea occur?- Are any neurologic symptoms present?

- Does the patient have a fever?- What is the patients appearance?

Management- The key treatment is to determining the source and type of food poisoning- The suspected food should be brought to the medical facility and a history

obtained from the patient or family- Food, gastric contents, vomitus, serum, and feces are collected for

examination- Monitoring the patients respiration, blood pressure, sensorium, CVP( if

indicated) and muscular activity- Measure to control nausea are also important to prevent vomiting- Anti emetic medication is administered parenterally as prescribed if the

patient cannot tolerate fluids or medication orally- For mild nausea, the patient takes a sips of weak tea, carbonated drinks,

or tap water- After 12 to 42 hours if nausea and vomiting subsides the diet gradually

progress to a low-residue, blant diet

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Poisoning Ms Word