1. Substance Abuse and Poisonings Chapter 17

2. Identifying the Patient and the Poison Poison- any substance who’s chemical reaction can damage body structures or impair body functions – Poisons act by changing the normal metabolism of cells or by destroying them – Poisonings may act: Acutely (heroin overdose) Chronically (alcohol abuse) Substance abuse- the misuse of any substance to produce a desired effect – Symptoms and signs of poisoning or overdose will vary depending upon the substance Poison- any substance who’s chemical reaction can damage body structures or impair body functions – Poisons act by changing the normal metabolism of cells or by destroying them – Poisonings may act: Acutely (heroin overdose) Chronically (alcohol abuse) Substance abuse- the misuse of any substance to produce a desired effect – Symptoms and signs of poisoning or overdose will vary depending upon the substance

3. Ingestion- (swallowing) If the patient has ingested a poison you may want to ask the following questions: – What did you take? – When did you take it? – How much did you take? – What actions have been taken? – How much do you weigh? – Also, investigate the scene If the patient has ingested a poison you may want to ask the following questions: – What did you take? – When did you take it? – How much did you take? – What actions have been taken? – How much do you weigh? – Also, investigate the scene

4. How Poisons Get Into the Body Inhalation Absorbed / surface contact Ingested Injected Inhalation Absorbed / surface contact Ingested Injected

5. Administration of Activated Charcoal When a poison has been ingested DO NOT induce vomiting Administer activated charcoal by mouth and transport immediately When a poison has been ingested DO NOT induce vomiting Administer activated charcoal by mouth and transport immediately

6. Specific Poisons Over time a patient who routinely misuses a substance will need increasing amounts to achieve the same effect; this is called developing a tolerance. Addiction- an overwhelming desire to continue using the substance Over time a patient who routinely misuses a substance will need increasing amounts to achieve the same effect; this is called developing a tolerance. Addiction- an overwhelming desire to continue using the substance

7. Alcohol The most commonly abused drug in the united states is alcohol It is a powerful CNS depressant that – Dulls the sense of awareness, slows reflexes, and reduces reaction time – Sedative- decreases activity and excitement – Hypnotic- induces sleep A person in alcohol withdraw may experience Delirium tremens (DT’s)- frightening hallucinations characterized The most commonly abused drug in the united states is alcohol It is a powerful CNS depressant that – Dulls the sense of awareness, slows reflexes, and reduces reaction time – Sedative- decreases activity and excitement – Hypnotic- induces sleep A person in alcohol withdraw may experience Delirium tremens (DT’s)- frightening hallucinations characterized

8. Opiods – CNS depressants and may cause severe respiratory depression – Patient may appear sedated, cyanotic, and have pin point pupils – The only way to reverse the effects is the administration of Narcan (which must be done by ALS) http://www.youtube.com/watch?v=8xU_vcb3kso – CNS depressants and may cause severe respiratory depression – Patient may appear sedated, cyanotic, and have pin point pupils – The only way to reverse the effects is the administration of Narcan (which must be done by ALS) http://www.youtube.com/watch?v=8xU_vcb3kso

9. Sedative - Hypnotic Drugs CNS Depressant which exhibits signs and symptoms similar to alcohol Does not produce desired effects by itself and usually taken with alcohol or Opiods These are sometimes given to people as a “knock out drug” such as rohypnol CNS Depressant which exhibits signs and symptoms similar to alcohol Does not produce desired effects by itself and usually taken with alcohol or Opiods These are sometimes given to people as a “knock out drug” such as rohypnol

10. Sympathomimetics CNS stimulants that frequently cause hypertension, tachycardia, and dilated pupils Common substances include: – Cocaine – MDMA ecstasy – Meth – Speed CNS stimulants that frequently cause hypertension, tachycardia, and dilated pupils Common substances include: – Cocaine – MDMA ecstasy – Meth – Speed

11. Hallucinogens Alter an individual’s sensory perception which causes severe behavioral changes that can cause a person to become violent or self destructive Most common include: LSD PCP Mushrooms – The person may not be aware of ingestion if it has been laced into another drug Alter an individual’s sensory perception which causes severe behavioral changes that can cause a person to become violent or self destructive Most common include: LSD PCP Mushrooms – The person may not be aware of ingestion if it has been laced into another drug

12. Anticholinergic Have properties that block the parasympathetic nerves and may cause cardiac arrhythmias Common substances include: – Atropine – Benadryl – Anti depressants Have properties that block the parasympathetic nerves and may cause cardiac arrhythmias Common substances include: – Atropine – Benadryl – Anti depressants

13. Cholinergic Nerve gasses designed for chemical warfare Over stimulate normal body functions Signs and symptoms include: DUMBELS or SLUDGE – Defication – Urination – Miosis (pupil constriction) – Bronchorrhea (discharge of mucus from lungs) – Emesis – Lacrimation (tearing) – Salivation Nerve gasses designed for chemical warfare Over stimulate normal body functions Signs and symptoms include: DUMBELS or SLUDGE – Defication – Urination – Miosis (pupil constriction) – Bronchorrhea (discharge of mucus from lungs) – Emesis – Lacrimation (tearing) – Salivation

14. Food Poisoning There are 2 main types of food poisoning The organism itself causes disease – The organism that causes the disease is called salmonella and symptoms appear within 72 hours of ingestion The organism produces toxins that cause disease – The toxin is called Staphylococcus and symptoms will appear within 3-4 hours of ingestion or as long as 8-12 hours There are 2 main types of food poisoning The organism itself causes disease – The organism that causes the disease is called salmonella and symptoms appear within 72 hours of ingestion The organism produces toxins that cause disease – The toxin is called Staphylococcus and symptoms will appear within 3-4 hours of ingestion or as long as 8-12 hours