Ch. 14 - Poisoning

A poison is a substance that causes injury, death, or impairment of an organism through chemical action (as opposed to the biological action of a bacteria or virus). The effects range from mild irritation to death. A poisonous substance could be a solid, liquid, or fume (gas or vapour).

Transcript

1. Ch 14 Poisoning Ch 14 – Pg 259 Ch 14– Pg 259 Poisoning
2. Poisoning A poison is a substance that causes injury, death, or impairment of an organism through chemical action. There are four routes through which a poison can enter the body: 1. Ingestion 2. Inhalation 3. Absorption 4. Injection Ch 14– Pg 259
3. Poison Control Centres Medical professionals in these centres have access to information about virtually all poisonous substances, and can direct you on how to proceed. Dispatchers are also able to contact them and may monitor discussions to provide additional information to responders. Ch 14 – Pg 261 BC Drug and Poison Information Centre (DPIC) 1-800-567-8911
4. Questions When You Suspect Poison 1. What type of poison was it? 2. How did the contamination occur (inhalation, ingestion, absorption, injection) 3. When did it occur? 4. What was the quantity of poison (if known) Ch 14– Pg 261
5. General Care for Poisoning The specific interventions required for poisoning vary based on a number of factors. If you have proper equipment and qualifications, limit further exposure to the poison. Never put yourself at risk: if necessary, request properly qualified personnel. Avoid giving the patient anything by mouth unless advised to do so by Poison Control Staff. Ch 14 – Pg 262
6. Ingested Poisons Signs and Symptoms: • An open container of poison nearby • Burns around the mouth • Unusual odour on the breath • Increased production of saliva or saliva that is an abnormal colour • Abdominal cramps, vomiting, or diarrhea • Seizures • Dizziness or drowsiness • Unresponsiveness • A burning sensation in the mouth, throat, or stomach Ch 14 – Pg 262
7. Ingested Poisons Care: Call EMS/911 and/or DPIC for care instructions Ch 14 – Pg 262
8. Inhaled Poisons Signs and Symptoms: • Respiratory distress or dyspnea • Respiratory arrest • Irritated eyes, nose, or throat • Dizziness • Vomiting • Seizures • Cyanosis of the lips • Unresponsiveness • An unusual smell in the air or on the person’s breath Ch 14 – Pg 262
9. Inhaled Poisons Care: • Take steps to ensure that you are not exposed • If you know or suspect the substance is still in the air, the scene may not be safe • All suspected/confirmed inhaled poisonings should be Rapid Transport Category • Provide intervention for respiratory distress or arrest as necessary Ch 14 – Pg 262-263
10. Carbon Monoxide Poisoning CO is odourless, colourless, tasteless. CO is found in fumes that are produced when fuel is burned in vehicles, small engines, stoves, lanterns, grills, fireplaces, gas ranges, and furnaces. CO replaces O2 in the blood, slowly depriving the body of O2 . S&S are essentially those of hypoxia and affect the central nervous system and the heart. Ch 14 – Pg 263
11. Carbon Monoxide Poisoning Signs and Symptoms: • Red skin and lips • Headache • Dizziness, confusion, DLOR • Weakness or fatigue • Pale or cyanotic skin • Nausea or vomiting • Chest pain, high or irregular PR • Seizures • Impaired hearing and vision • Low BP • Respiratory distress or arrest Mild CO poisoning is often mistake for food poisoning or gastroenteritis. Pay attention to headaches and similar flu-like symptoms reported by multiple people living in the same dwelling, particularly in colder times of the year when homes are being actively heated. Care: Remove patients from the scene and provide supplemental O2 . Rapid Transport Category Ch 14 – Pg 263
12. Absorbed Poisons Many cause only minor irritation (ex: poison ivy, poison sumac, and poison oak). If patient is exposed to a wet or dry chemical immediately causing burns, refer to care for chemical burns (pg 189) Ch 14 – Pg 263
13. Absorbed Poisons Care: • Wash the affected area with cool water immediately and pat dry • Keep the area clean and dry • Instruct the patient to see a physician if the condition worsens. Ch 14 – Pg 263
14. Injected Poisons Insect stings and animal bites are among the most common sources. Care varies based on the species causing the sting or bite. If the animal is still present, do not attempt to capture it, as this can put you at risk. Instead, make a note of any memorable feature, such as distinctive patterns or colouration. Antivenins are available for many particular types of venom. Ch 14 – Pg 265
15. Opioid Overdose Opioids are a class of depressants that includes morphine, heroin, and fentanyl. In higher quantities, they bind to receptors in the brain that control respiration, rapidly causing respiratory arrest. Ch 14 – Pg 272
16. Opioid Overdose Signs and Symptoms: • Severely reduced LOR or unresponsiveness • Slow or absent respirations • <8 breaths/min • Low SpO2 • Possibly gurgling or snoring sounds • Slow or absent pulse • Severely constricted pupils or rolled-back eyes • Limp muscles • Cold and pale or cyanotic skin • Vomiting Ch 14 – Pg 272
17. Opioid Overdose Care: Ch 14 – Pg 272 Unresponsive and BREATHING NORMALLY • Administer naloxone and monitor the patient closely Unresponsive and in RESPIRATORY ARREST • Administer naloxone • Provide assisted ventilations and monitor pulse closely Naloxone may be re-administered every 3 minutes if no improvement in the person’s condition. Rapid Transport Category
18. Marine Life Can give painful stings that may cause allergic reactions, paralysis, and even cardiac or respiratory arrest. A patient stung in the water should be removed as soon as possible. Rapid Transport Category: • Patient has a history of allergic reaction to marine-life stings • Stung on the face or neck • Develops severe problems, such as dyspnea Ch 14 – Pg 266
19. Jellyfish, Man-of-War, or Sea Anemone • Soak affected area in vinegar to deactivate the toxin • Rubbing alcohol or baking soda may also be used • Do not rub the wound or apply fresh water or ammonia • If pieces of the marine creature are still attached, deactivate the toxin before attempting to remove them Ch 14 – Pg 267
20. Stingray, Sea Urchin, or Spiny Fish • Flush the wound thoroughly • Sterile saline or clean water • Immobilize injured part, and soak in water that is as hot as the patient can tolerate for ~30min or until the pain subsides • Carefully clean the wound and apply a bandage • Remind the patient to watch for signs of infection and check with a healthcare provider to determine whether a tetanus shot is required Ch 14 – Pg 267