1. Chapter 35 Poisoning and Allergic Reactions

2. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 2 Overview  Poisoning  Ingested Poisons  Inhaled Poisons

3. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 3 Overview  Injected Poisons  Absorbed Poisons  Allergic Reactions

4. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 4 Poisoning  General assessment –If poison is still present on scene, it may pose a hazard to EMTs

5. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 5 Poisoning  General assessment –Obtain specific history of poisoning event Name of poisonous substance Exact time of exposure Treatments before EMS arrival Determine patient’s weight

6. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 6 Poisoning  General management –Make sure the scene is safe to enter –Treat life-threatening problems first –Consult medical control for further instructions on management

7. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 7 Poisoning  General management –Transport patient Include any containers with the substance –Be alert to signs of decompensation –Call for ALS

8. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 8  Some therapies for poisoned patients are dependent upon accurate identification of the substance involved.

9. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 9 Ingested Poisons  Most common route  May be intentional  Signs and symptoms vary greatly –Usually affect the GI tract and the airway  Manage ABCs  May use activated charcoal

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11. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 11 Inhaled Poisons  If poison is airborne, it could affect the responding EMTs  Respiratory complaints are common  Remove patient from area  Manage ABCs

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13. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 13 Injected Poisons  Not very common –May result from animal or insect bite  Signs and symptoms depend on the specific poison

14. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 14 Injected Poisons  Manage patient –Maintain safety at the scene –Remove patient from danger –Keep affected body part lower than heart –Keep patient still –Administer oxygen

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16. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 16 Absorbed Poisons  Can be absorbed through skin or injure skin upon contact  Skin irritation, burns, itching may be common  Ensure scene safety –Trained providers must decontaminate patient –Substance should be removed

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18. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 18 Stop and Review  Name the ways poisons can enter the body.  What are the signs and symptoms related to each of these routes of poisoning?  When is activated charcoal used?  Why is it important to contact medical control and call for ALS?

19. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 19 Allergic Reactions  The immune system in some individuals can be very sensitive to some substances –Unable to fight against these substances  Some reactions may be severe and cause life-threatening events

20. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 20 Allergic Reactions  Many body systems are affected  Rash and hives may occur  Airway can become inflamed and swollen  Blood vessels may dilate in severe reactions

21. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 21 Allergic Reactions  Signs and symptoms: Mild allergy –Warm, red skin –Hives –Itching –Localized swelling –Itchy, watery eyes –Headache –Runny nose

22. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 22 Courtesy of the CDC Public Health Image Library

23. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 23 Allergic Reaction  Signs and symptoms: Severe reaction –Throat tightness –Shortness of breath –Cough –Wheezing –Stridor –Hoarseness –Tachypnea –Tachycardia –Hypotension –Dizziness

24. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 24 Allergic Reaction  Assessment –Manage the airway and provide high-flow oxygen –Treat for hypoperfusion if evident –Assist with ventilations if necessary –Transport immediately –Repeat the ongoing assessment frequently

25. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 25 Allergic Reaction  Allergic reactions can progress rapidly without proper treatment  If patient has known allergy, an EpiPen may have been prescribed by a physician  Epinephrine dilates bronchioles and constricts blood vessels

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27. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 27 Stop and Review  Explain the difference between mild and severe allergic reactions.  Why is airway management important in the treatment of the patient with an allergic reaction?  When is the epinephrine autoinjector used?