1. Copyright © 2015 Cengage Learning® 1 Chapter 10 Poison Control

2. Copyright © 2015 Cengage Learning® 2 Introduction What is a poison? –Substance taken into the body by ingestion, inhalation, injection, or absorption that interferes with normal physiological functions In some cases, only a small amount of a substance can cause severe tissue damage directly (e.g., corrosives) In other cases, the substance can be beneficial in small amounts, but lethal in excessive amounts (e.g., overdose of medication)

3. Copyright © 2015 Cengage Learning® 3 Introduction (cont’d.) What should be done if poisoning is suspected? –Best policy: contact a Poison Control Center directly, or through an emergency care facility Instructions can be given by phone for appropriate emergency treatment based on the type of poison and the patient’s condition, age, and size

4. Copyright © 2015 Cengage Learning® 4 Poisoning by Ingestion Most common type of poisoning –Highest risk: children between the ages of one and five Before 2004, it was recommended that the emetic ipecac syrup be given to induce vomiting Now a topic of concern and no longer recommended

5. Copyright © 2015 Cengage Learning® 5 Poisoning by Ingestion (cont’d.) What are the concerns regarding ipecac? –Outcomes failed to justify its effectiveness –Adverse effects, such as persistent vomiting could interfere with other treatment –Evidence of widespread abuse of ipecac by people with anorexia and bulimia

6. Copyright © 2015 Cengage Learning® 6 Poisoning by Ingestion (cont’d.) First step to take in any poisoning –Contact the local Poison Control Center Number can be obtained by calling the national toll-free Poison Control number: 1-800-222-1222 –Be prepared to give details regarding the poison and the age, weight, and health status of the individual who took the poison, as well as allergies

7. Copyright © 2015 Cengage Learning® 7 Poisoning by Ingestion (cont’d.) Vomiting could be injurious and should be avoided under certain conditions –Ingestion of corrosive substances, volatile petroleum products, and convulsants –If patient is semiconscious, inebriated, in shock, convulsing, or has no gag reflex –If patient is less than one year old or has cardiac or vascular disease Patient should be immediately transported

8. Copyright © 2015 Cengage Learning® 8 Poisoning by Ingestion (cont’d.) Antidotes may be required in poisoning with CNS depressants –Gastric lavage is no longer recommended Cautions for personnel caring for poisoning victims –Be sure to save emesis –Closely monitor the vital signs –Observe closely for confusion, tremors, convulsions, visual disturbances, etc.

9. Copyright © 2015 Cengage Learning® 9 Poisoning by Inhalation Requires symptomatic treatment –Fresh air, oxygen, and CPR if indicated Example: carbon monoxide poisoning –Quickly robs tissues of vital oxygen –High percentage oxygen therapy or even oxygen under pressure (hyperbaric oxygen) in severe cases may be needed

10. Copyright © 2015 Cengage Learning® 10 External Poisoning of Skin or Eyes What type of treatment is needed? –External poisons should be flushed from the skin for 20 minutes or eyes for 30 minutes with a continuous stream of water –Patient should be transported to an emergency care facility for further treatment as required –Systemic absorption of poisons through the skin may require administration of an antidote

11. Copyright © 2015 Cengage Learning® 11 Poisoning by Sting and Snakebite What type of treatment is needed? –Poisoning by insect sting should be treated by cleansing the area, removing the stinger, and applying an icepack to the site –Watch for possible anaphylactic reaction in case of allergy CPR and administration of epinephrine and corticosteroids may be required Transport to an emergency care facility immediately if indicated

12. Copyright © 2015 Cengage Learning® 12 Poisoning by Sting and Snakebite (cont’d.) –Do not apply ice or apply a tourniquet to a snakebite Venom is very irritating and may cause sloughing of the tissues Keep the patient quiet in order to slow circulation, and transport the patient, lying down, to an emergency care facility for antivenom injections

13. Copyright © 2015 Cengage Learning® 13 People at Risk Poisonings are the leading cause of health emergencies for children –Major cause of death because of natural curiosity and active lifestyle Keep all chemicals in a locked cupboard Be vigilant when visiting with older adult friends or relatives Be aware that the most common sources for poisoning in children under six are cosmetics and personal care products

14. Copyright © 2015 Cengage Learning® 14 People at Risk (cont’d.) Health care practitioners –Can play a major role in reducing the number of accidental poisonings in children by stressing preventive measures to parents Older adults are also at risk –Overdoses of medication –Toxic reactions from medications –Impaired vision

15. Copyright © 2015 Cengage Learning® 15 People at Risk (cont’d.) Obtain the number of the nearest Poison Control Center –The wrong treatment is often more dangerous than none –Also good source of information regarding poisonous plants, insects, snakes, reptiles, and poisonous marine organisms such as stingray and jellyfish