Critical care and Emergency Nursing Poisoning Poisoning – an overdose of drugs, medicaments, chemicals and biological substances

Assess airway patency Place patient in supine position Chin-lift and jaw thrust maneuver Remove foreign body (dentures, etc) Ensure Cervical fracture is r/o before intubation administer humidified air Bronchial toilet Breathing

Self-poisoning and parasuicide – deliberate ingestion of more than the therapeutic dose of a drug or a substance not intended for consumption

Cause of inadequate O2 Ventilatory failure Hypoxia Bronchospasm

Accidental poisoning a– non-intentional ingestion, overdose or exposure to substances

Substance abuse/dependence – maladaptive pattern of substance use with impairement or distress

General approach for poisoned individual
Emergency Stabilization Clinical Evaluation Elimination of the Poison Excretion of Absorbed Substance Administration of Antidotes Supportive Therapy and Observation Disposition

Common cause of hypoxia Alcohol Cyanide Organophosphates Carbon monoxide Opiates Quinines management ABG determination O2 via nasal cannula, face mask, mech. Vent. Administration of bronchodilators O2 may be contraindicated for the following:
Watusi Zinc phosphate paraquat

Emergency Stabilization ABC’s of Life Support for Poisoning Airway Breathing Circulation Treat Convulsion

Circulation Inadequate circulation may be due to the direct effect of the substance Hypotension (SBP <80mmHg; <age 40, SBP <90mmHg; >age 40)

Correct Metabolic Abnormalities Treat Coma Complications of Poisoning Airway obstruction Management Elevate legs by about 15 cm from horizontal plane (trendelenburg) Fluid challenge with 200 ml 0.9 NaCl (adults) FC D5 0.3 NaCl at 10ml/kg (children) Correct ventilation problems

Breathing Difficulties Circulatory Inadequacy Drug – induced CNS depression Electrolyte or metabolic Abnormalities

Airway

Severe poisonig (circulation) Insert CVL

0. ethanol Hook patient on telemetry/ cardiac monitor and monitor waveforms Monitor I and O Monitor V/S Watch out for signs of Hyperkalemia Hyperkalemia Management Treatment of etiology (metabolic abnormality correction. secondary effect of poison) Maintain adequate oxygenation Diazepam 5mg (adult).5 ug/kg/min form precipitate due to Na Benzoate ! Phenytoin 15-20mg/kg SIV LD not exceeding 50mg/min.3 NaCl Treat convulsion Effect of poison (INH) Cerebral hypoxia Hypoglycemia Muscle spasm Withdrawal reaction Decreased seizure threshold in epileptic patients Note: Never dilute phenytoin in Dextrose containing IVF to avoid crystallization For unknown etiology.9 NaCl.Monitor hydration status Infuse plasma expanders Dopamine 1. D5LR Pediatric Maintenance: D5 0. Crystalloid Solution adult maintenance: 0. not to exceed 60meq/L) Strychnine Theophylline Tricyclic Antidepressant (TCAD) Withdrawal from narcs.9 NaCl. it will Substances that can cause Hyperkalemia ACE inhibitors Beta Blockers Cardiac Glycosides carbon Monoxide Cyanide Oral Potassium K+ sparing diuretics Management Glucose-insulin infusion (50ml D50-50 and 10 units of insulin) Sodium bicarbonate/ calcium gluconate .3mg/kg (pediatrics) slow Iv push up to 20mg (intubate px prior to further administration of diazepam) Note: never dilute diazepam with any fluid. Maintenance of phenytoin at 100mg PO/IV q 6-8 hours Recommended iv fluids Hypotention: 0. diazepam.0 – 2. Pyridoxine (B6) may be used until seizure cease Correct metabolic abnormalities Poisons associated with convulsions Aminophyline Amphetamine Carbon monoxide Cocaine Cyanide Ethylene glycol Hypoglycemic agents INH Lead Lithium MAO inhibitors (monoamine Oxidase) Mefenamic Acid Opioids Organophosphates Phenothiazine Salicylates Common Metabolic and Electrolyte Abnormalities Hypokalemia Hyperkalemia Hypothermia Hyperthermia Hypoglycemia Hypocalcemia Hypokalemia Causes NaHCO3 Bronchodilators Corticosteroids Diuretics (Furosemide) mAnagement Infusion of KCL (40meq/hour.

100300mg/kg/day IV for pediatric Hypothermia Core temp <30 C Drugs associated Alcohol Carbon monoxide Opioids Sedative-hypnotics GA Phenothiazines TCAs Hyperthermia Core temp >40 C Drugs Associated Antihistamines amphetamines Isoniazid Phenytoin Salicylate Xanthines Treating Coma Antidote for Comatose poisoned px with unknown etiology Naloxone: 2. cyanide O.theophylline Hypocalcemia .free-base cocaine A.100 ml Monitor V/S Monitor I and O Monitor Pxs LOC Clinical evaluation Information to be elicited during history taking Time of exposure Mode of exposure Intake of other substances Circumstances prior to poisoning Current medication Past medical history Home remedies Poisons with delayed manifestation Ethyl glycol 6h Salicylate 12h Paracetamol 36h Paraquat 48h Methanol 48h Thyroxine 4wks Physical exam Tachycardia I.cocaine T.anticholinergics. 2.ethyl glycol.carbon monoxide.iron C. amphetamine S.25-4. 10ug/kg IV (P) Glucose: for suspected diabetic coma Thiamine: 100mg IV followed by 50-100ml D50-50 (for possible alcohol intoxication) Coma with known etiology Opiate overdose Naloxone: 2mg IV (caution needed for opiate abusers) Anticholinergics Cocaine Phenothiazines Quinidine Sulfonamides management Sponge bath Fanning Iced gastric or colonic lavage Iced water immersion Hypoglycemia Common in alcohol and salicylate toxicity due to prolonged glucose utilization and hepatic glycogen store depletion Management D50-50 at 50.Dialysis monitor I and O Monitor V/S Monitor ECG Common in watusi and jatropa seed ingestion Maybe complication from animal and insect bites Management Calcium Chloride over Calcium Gluconate for better retention of calcium.solvent T.0mg IV (A). ethanol F.5 mmol SIV. antihistamines.sympathomimetics.phenothiazine E.organophosphates P.theophylline Hypertension C. salicylate.

arsenic.methanol E.anticholinergics Hyperventilation C. DMSO Mothball.methylsalicylate Rotten egg. bronchoconstriction E.Beta Blockers A.cyanide.INH Narcotics/ opiates M.assess patient’s neurological status using the GCS Neurologic sign that can aid in etiologic agent identification Miosis C.chloral hydrate Garlic.anticholinergics N.ethanol D.opioids M.quinidine D. calcium channel blocker.sedative hypnotics H.check for presence of irregular rhythm or arrhyhtmia A.Sedatives Q. pilocarpine S.Hyperthermia S. cocaine I.caffeine A. hydrogen sulfide Pear.propanolol (Beta-blocker) A. codeine E.sympathomimetics. methamphetamine.bradycardia.lacrimation S. Wintergreen.salivation Sympthomimetics (cocaine.salicylates Hypoventilation C.sedayive-hypnotics Mydriasis A-antihistamines. DKA. organophosphates.nicotine Hypotension C.phenothyazines. antidepressants S.Theophylline and other xanthines S. diaphoresis U. INH.opiates.hypertension H. clonidine O.clonidine O.metals (heavy) B.ethylene glycol T.clonidine R.miosis. TCAD toxicity Aspiration pnenumonia: hydrocarbon ingestion Auscultate Patient’s heart.theophylline S.sulfur dioxide.diarrhea.clonidine. amphetamines) M. Opiate.miosis B.reserpine and other antihypertensive A.TCAD’s T.emesis L.sympathomimetics C. orgamophosphates P.digitalis Examine the Px’s skin Cutaneous bullae Diaphoresis Jaundice Dry skin and hyperpyrexia flushing Check characteristic of Px’s breath odor Bitter almonds.urination M. isoprop. muscle fasciculations B.Aromatic Hydrocarbons T.camphor Auscultate the patient’s lungs Rales may indicate apiration pneumonia or edema Pulmonary edema: pesticides.S.hypotension . carbamates) D.seizures Neurological Evaluation.cholonergics.B-blocker.antidepressant S.mydriasis T.digitalis Toxidromes Anticholinergics/ Antidepressants Hot as a hare (hyperthermia) Dry as a bone (dry Mucus) Red as beet (Flushed skin Blind as a bat (dilated pupils) Mad as a hatter (confusion/delirium) Cholinergics (organophosphates.organophosphates M.anticholinesterase C.heroin and other opiates Bradycardia P.carbamates O.tachycardia H.bradycardia H.

arrhythmogenic agents . then induce emesis by applying pressure on the posterior pharynx Ipecac Syrup – 30ml (A).iodides P – psychotropics (TCADS. Phenothyazines) E – Enteric Coated Medications (Salicylates) Conditions or Agents Predisposing to Metabolic Acidosis / Elevated ANION gaps M – methanol E – ethyl glycol T – toluene. iron) I . lead b.effective for patients who had ingested poison within an hour Mechanical emesis – instruct patient to take 1-2 glasses of warm water. convulsants. Ea: Urine exam. 10-15ml (P) in one glass water Radiographic Examination limited usefulness for visualizing toxins a. foreign bodies General Laboratory Examination CBC Urine pH Urine SG FBS BUN Creatinine Electrolytes ABG ECG Liver Function Test PT PTT Chest X-Ray Abdominal X-Ray Contraindication to Emesis Depressed sensorium Impaired gag reflex Late pregnancy Cardiac disease and aneurysm Ingestion of caustics.hypoventilation C.H.properly secure all collected specimen it not immediately examined. Toxicology Laboratory Uses confirm clinical impression predict prognosis determine therapy monitor therapy predict time course Toxicology Screen obtain to confirm history/clinical impression or for unknown agents or inconsistency between history and clinical effects substances detected vary depending on lab know what a negative result means! Radio.adding agents to px’s urine and evaluating the change in its color Specimen Collection.may be used to give ideas to diagnostic possibilities in a poisoning case. Blood: 5-10 ml either heparinized and clotted should be extracted and placed on ice Urine: 200ml (preferably first void) and sealed on a container and placed on ice All specimen collected should be placed on a sealed container and stored in freezer.cyanide. theophylline A – alcoholic ketoacidosis L – lactic acidosis A – aminoglycosides (uremic agents) C. lead. iron.coma Laboratory Examination Bedside Toxicology. iron D – diabetic Ketoacidosis G – grand mal seizures A – aspirin (salicylates) P – paraldehyde. hydrocarbons. phenoformin Elimination of the Poison External Decontamination Discard px’s clothing and thoroughly bathe or shower the patient when there is dermal exposure Copious irrigation of the eyes with free flowing water for 30 mins Health personnel involved in decontamination should wear protective devices Empty the stomach Induction of Emesis.opaque drugs C – chloral hydrate H – heavy metals (arsenic. carbon monoxide I – isoniazod.

repeat until return flow is clear Contraindication of gastric lavage Ingestion of caustics or kerosene Frank convulsion LIMIT gi aBSORPTION May be decreased by use of activated charcoal. Compounds that contain the -SH group are known as mercaptans and are responsible for the strong odors associated with certain animals. Since dimercaprol is water insoluble. Activated Charcoal lavage Activated charcoal is not systemically absorbed. 10-20 ml (P) lukewarm/ tepid water. its sodium salts are quite soluble in water. drugs and chemicals binds to its surface. fomepizole heavy metals DMSA. Lead Cadmium Iron Zinc Manganese Beryllium copper Treatment IV 15. CaEDTA. penicillamine methanol ethanol. such as skunks and ferrets. pralidoxime snakes(pit viper) Crotalidae antivenin.3-dimercapto-1-propanol) is a water- insoluble compound with an offensive odor. The commercial preparation: calcium disodium. and the resulting lead chelate is rapidly excreted in the urine.500 ml of dextrose 5% Over 1-2 hour period Twice daily Courses: drug 5-day/ rest period 2 days Deferoxamine (Desferal) Iron It is usually given only if the serum iron level exceeds 400.benefits those patients 6-12 hours post-ingestion Insert NGT (Fr 16). penicillamine iron deferoxamine Isoniazid pyridoxine lead DMSA. However. and cathartics. BAL. As an antidote for lead poisoning. calcium disodium EDTA exchanges its chelated calcium for lead. The calcium salt of EDTA.600 μg/dl IV 40 mg/kg Over 4 hours (15 mg/kg/h) Penicillamine (Cuprimine) Copper Lead mercury Orally half an hour before meals (capsules) 4 doses . Done with 50-60ml (A). BAL. it is dissolved in an oil base (often peanut oil) and injected intramuscularly. fomepizole nitrates/nitrites methylene blue opiates naloxone organophosphates atropine. placed px on trendelenburg with head turned to the left while inserting the tube and then place the pax on left lateral decubitus position. CroFab Chelating Agents Dimercaprol (BAL) Calcium Disodium Edetate (EDTA) Deferoxamine (Desferal) Penicillamine (Cuprimine) Dimercaprol (BAL) Dimercaprol (2. is also used in the treatment of acute cadmium and iron poisoning. administered intravenously. 10 parts coal to 1 part chemical 50-100 g in 200ml water (A) 1g/kg or 30-50 g in 100pl water (P) Antidotes POISON ANTIDOTES acetaminophen N-acetylcysteine anticholinergics physostigmine Benzodiazepines flumazenil beta blockers glucagon calcium channel calcium. neutralizing agents. The chelated metal cannot enter living cells and is rapidly excreted from the body.25 mg/kg (not more than 50 mg/kg/d) In 250.Gastric Lavage. Mercury Arsenic Gold Calcium DisodiumEdetate (EDTA) ETHYLENEDIAMINETETRAACE TIC ACID It is only slightly soluble in water. CaEDTA. glucagon blockers carbamates atropine carbon monoxide oxygen cyanide sodium nitrite/ sodium thiosulfate digoxin digoxin immune Fab ethylene glycol ethanol.

Breathing difficulty. History of inhaling poisons. Suspect food poisoning if: 1. hoarseness. 2. Sleeping pills 2. vomiting. the victim ate food that "didn't taste right" or that may have been old. syringes absorption. INGESTED POISON is one that is introduced into the digestive tract by way of the mouth.by mouth inhalation. Insect and rodent poisons 4. Itching. irritation. First Aid 1. Burns. 5. liquid or gas. Odd breath odors. Causes: 1. 6. Signs and Symptoms 1. Cannot maintain an airway open. several people who ate together become ill. INHALED POISON is a poison breathed into the lungs. Pain relievers 3. improperly prepared. 2. Remove the victim from the toxic environment and into fresh air immediately. or a petroleum product such as gosoline or furniture polish. 3. 2. Cough. a general form that covers a variety of conditions. First Aid 1. seizures and pregnancy. stings. 6. contaminated. Contaminated water 9. Cyanosis (bluish discoloration of skin and mucous membranes). Lye and acids including boric 7. 3. Signs and Symptoms 1. burning sensation in the throat. Poisonous plants 8. Dizziness. A poisoning emergency can be life threatening. 4. 3. Chest pain. headache. Seizures. Fume Instances when vomiting should not be induced 1. spoiled food analysis. If unresponsive. 7. a corrosive lye. History of exposures. 2. Has a medical condition that could be complicated by vomiting. that tends to impair health or cause death when introduced into the body or onto the skin surface. or proceesed with an excessive amount of chemicals. Liquid or powder on the skin 3. such as heart attack. 2. 5.by animal bites. Place the victim on its left side. 5. Remove the clothing. blisters. 7. Occasional accidental poisoning. 2. Burns around the mouth.by breathing injection. Common in suicide attempts. First Aid 1. rashes. Altered mental status. Signs and Symptoms 1. 4. Nauseas. History of ingesting poisons. 2. 4. Kerosene 5. ABSORBED POISON. also known as contact poison is a poison that enters the body through the skin. Ways in which poisoning may occur     ingestion. One form of ingestion poisoning is food poisoning. 3. Save any vomitus and keep it with the victim if the person is taken to an emergency facility. Save any empty container. Diarrhea. Redness. Try to identify the poison. Seek medical attention. Denatured alcohol 6.FIRST AID FOR POISONING Poison is any substance: solid. . 4.by skin contact Common Household Poison 1. 4. left at room temperature for a long time. Abdominal pain. unresponsiveness (advance stages). 2. Has ingested an acid.

Pain Swelling Possible allergic reaction First Aid 1. General Care for Poisoning 1. Bee sting Signs and Symptoms     Stingers may be present. Call local emergency number. side Semicortina locomotion winding curvature Semi-angular Rectangular Rough Vertical Nonconstrictor Oblongated Circular Smooth Round Constrictor Horeshoe shape      With fang marks 2. and lower than the heart. Marine Organisms Signs and Symptoms     Possible marks. Spider bite Signs and Symptoms Nite mark Swelling Pain Nausea and vomiting Difficulty breathing or swallowing. Call local emergency nunber or contact animal control personnel. 1. Survey the scene. or syringe. sting. 6. Wash wound. Apply a cold pack. 3.soak area in vinegar pain goes away. 4. Wash wound. 3. Get medical attention if wound bleeds severly or if you suspect animal has rabies. 4. If sting ray. 2. Conrinually monitor the patient's vital signs. First Aid 1. Wash wound. Cover the wound. Call emergency number. Control bleeding. blot the posion from the skin. 5. Movement Head Body Skin Pupil Ways/ manner of attack Bite marks First Aid 1. 3. Get medical care to receive antivenin. 3. Cover the wound. Get local emergency number. 5. 3. Remove stinger. if necessary. brush it off. 4. If jellyfish. 3. INJECTED POISON is a poison that enters the body through a bite. Clean and bandage the wound. Flood the area with copious amount of water. 2. Snake bite Signs and Symptoms   Bite mark Pain Comparative Characteristics of Snake CHARACTERISTIC VENOMOUS NONVENOMOUS 4. First Aid 1.soak in nonscalding hot water until . 3. Apply antibiotic ointment. 4. If bleeding is minor. With a dry cloth. if necessary. 2. Cortina. Apply a cold pack. Dog bite Signs and Symptoms Bite mark Bleeding First Aid 1. Pain Swelling Possible allergic reaction. Watch for signals of allergic reaction 2. If the poison is a dry powder. 4.   2. Keep bitten part still.wash wound.2. 5.

Some cause hyperactivity. for . and to additional available information. • 6. such as contaminated food. Many poisons. if taken in large amounts can causeliver problems and death. Vitamins: Vitamins. while others slow it. Toxidromes • • • • Drugs Drugs that are helpful in therapeutic doses may be deadly when taken in excess. Most poisons are swallowed (ingested). In excess. or household cleaning products. while others slow the heart. If the victim is conscious. do a secondary survey. they may cause signs and symptoms not typical of any single poison. Remove the victim from the source of the poison. while others shrink them. are substances meant for humans to eat. 4. If more than one person has the same signs and symptoms. This simple distinction may help narrow the possibilities.meaning to drink. 3. Foods • • • Some mushrooms are poisonous Drinking water contaminated by agricultural or industrial chemicals Food that has not been properly prepared or handled • • • • Warfarin (Coumadin): Coumadin is a blood thinner used to prevent blood clots. while others are painless. Confusion is often seen with these symptoms. only one of them may cause the skin and mouth to be very dry. Poisoning Symptoms The signs and symptoms seen in poisoning are so wide and variable that there is no easy way to classify them. while others cause drowsiness. such ascyanide. migraine headache prevention. paint thinners.2. especially A and D. Care for any life threatening condition. for example. then poisoning would be suspected. • • Some poisons enlarge the pupils. But poisons can also enter the body in other ways: • • • • By breathing Through the skin By IV injection From exposure to radiation Venom from a snake bite Poisoning Causes Poisons include highly toxic chemicals not meant for human ingestion or contact. and heart failure. Examples include: • • Beta blockers: Beta blockers are a class of drugs used to treat heart conditions (for example. When two or more poisons act together. Some increase the breathing rate. Some cause pain. and certain types of tremors. Do not give the victim anything by mouth unless advised by medical professionals Poison is anything that kills or injures through its chemical actions. The word poison comes from the Latin word . or workplace environment. coma. they can cause difficulty breathing. social phobia. while others dry the mouth and skin. abnormal heart rhythms) and other conditions. However. and they have a common exposure source. however. example. including foods and medicines. angina. Some result in excessive drooling.potare . water. high blood pressure. may make the heart beat quickly. Some speed the heart. 5. Do a primary survey. Two different poisons. It is the active ingredient in many rat poisons and may cause heavy bleeding and death if too much is taken. When the cause of the poisoning is unknown A big part of figuring out what type of poisoning has occurred is connecting the signs and symptoms to each other.

and many others. Librium). • For example: Jimson weed. after several months. a physician cannot order "every test in the book" when the diagnosis is unclear. History: As a family member or friend of a poisoned person. you can greatly assist the doctor and provide valuable clues by telling the doctor about these details: • Everything the person ate or drank recently Names of all prescription and over-the-counter medications the person is taking Exposure to chemicals at home or at work Whether others in the family or at work have been similarly ill or exposed Whether the person has any psychiatric history to suggest an intentional ingestion (suicide attempt) Testing: Many poisons can be detected in the blood or urine. dry hot skin. head injuries. days. ○ ○ ○ ○ • hepatitis. andcoma. ○ ○ ○ ○ stroke. retention of urine. marijuana. Cases of poisoning with a prolonged onset of symptoms are particularly dangerous because there may be a dangerous delay in obtaining medical attention. codeine). opioids (heroin. and laboratory studies will help reveal the cause of most poisonings. produces the anticholinergic toxidrome: Rapid heart rate. develop abnormalities of the nervous system. amphetamines (uppers). However. However. and vomiting). 7-12 hours may pass before the first symptoms begin (no appetite when normally hungry. appendicitis. • • Acetaminophen (Tylenol) is considered one of the safest drugs but is toxic to the liver when taken in large quantities. most paints contained lead.or may not be poisoning Some signs and symptoms of poisoning can imitate signs and symptoms of common illnesses. hallucinations. mental confusion. nausea and vomiting can also be found in many illnesses that have nothing to do with poisoning.Certain poisons cause what toxicologists call toxidromes . aspirin.a contraction of the words toxic and syndrome. Frequently. When the illness may be poisoning . Delayed onset of symptoms A person can be poisoned and not show symptoms for hours. a plant smoked or ingested for its hallucinogenicproperties. Young children would eat paint chips and. Most toxicology screens will detect: ○ ○ ○ ○ ○ ○ acetaminophen. Toxidromes consist of groups of signs and symptoms found together with a given type of poisoning. Most poisons either have no associated toxidrome or have only some of the expected features of the toxidrome. . gallbladder problems. benzodiazepines (Valium. Because it acts so slowly. Examples include: A toxicology screen or "tox" screen looks for common drugs of abuse. The tests ordered will be based on information revealed in the history and physical exam. Before 1970. Almost every possible sign or symptom of a poisoning can also be caused by a non–poison-related medical problem. physical examination. heart attack. The classic example of a very slow poison is lead. or months. nausea and vomiting are a sign (vomiting) and symptom (nausea) of poisoning. large pupils. nausea. Exams and Tests A combination of history. stomach ulcers. • • • • • • • For example. treatment must begin before all information is available.

and alcohol. This flushes the entire gastrointestinal tract before the poison gets absorbed. It may also be possible to reverse the harmful effect of a drug even if no antidote exists. but the gritty texture sometimes causes the person to vomit. the doctor will put a flexible. Some drugs affect the electrical activity of the heart. or petroleum products. A specific blood test will give serum levels of some drugs. Antidotes either prevent the poison from working or reverse the effects of the poison. special medicines (chelators) bind the poison in the bloodstream and cause it to be eliminated in the urine. digoxin (Lanoxin). During Operation Desert Storm. which can absorb potassium and other electrolytes from the bloodstream. It does not work with alcohol. Sugar given by mouth or IV is an effective treatment until the insulin wears off. Sometimes a person is unconscious for no obvious reason. and hepatitis and liver failure develop. other methods are needed. To be effective. the physician will treat signs and symptoms as needed. Once the poison is stuck to General supportive measures: When there are no specific treatments. the liver is damaged. ○ • If the person is unconscious.poison. Theolair. Mucomyst works as an antidote by bolstering the body's natural detoxification abilities when they are overwhelmed. but after a massive overdose. lithium (Lithobid). including phenytoin(Dilantin). a dangerously low blood sugar (hypoglycemia) will cause weakness. Respbid. • Antidotes: Some poisons have specific antidotes. Activated charcoal has no taste. such as astroke. caustics. Another "binder" is sodium polystyrene sulfonate (Kayexalate). lithium (Lithobid). Once the poison has moved past the stomach. all military personnel were issued atropine injectors when it was feared that the enemy would use nerve gas. Slo-Bid. in normal doses.org/prepared/ipecac. Allow medical personnel to decide if this treatment is appropriate. unconsciousness. When the poison is a heavy metal. • • • Do not give activated charcoal at home. Acetaminophen. A common antidote is N-acetylcysteine (Mucomyst). ○ • ○ Activated charcoal acts as a "super" absorber of many poisons.○ ○ • cocaine. An electrocardiogram (ECG) may reveal toxicity. and acetaminophen. For more information on this subject go to: http://www. • • ○ Ipecac was previously used to induce vomiting in poisoned patients where there was a chance to get the toxin out of the body. such as lead. theophylline (TheoDur. the charcoal in theintestine. Medical Treatment Elimination: Get rid of the unabsorbed poison before it can do any harm. and eventually death. the poison cannot get absorbed into the bloodstream. ○ • Whole bowel irrigation requires drinking a large quantity of a fluid calledGolytely. Slo-Phyllin). The poison control center will instruct you what to do or if an antidote is readily available. soft. which is used to neutralize acetaminophen (Tylenol) overdoses. ○ • If a person with diabetes takes too much insulin. . is one of the safest medications known. Theo-24. activated charcoal needs to be given as soon as possible after the poisoning. plastic tube into thewindpipe to protect the person from suffocating in his or her own vomit and to provide artificial breathing (intubation). Several advisory bodies such as the American Association of Poison Control Centers and the American Academy of Pediatrics have recommended that Ipecac NOT be used and that it should not even be kept in the household.asp Atropine is an antidote for certain nerve gases and insecticides. Uniphyl. A CT scan of the brain will help tell if there has been a structural change in the brain. Do not induce vomiting or give syrup of Ipecac.

Antiseizure medicines can be used to treat or prevent seizures. a sedative can be given to calm the person until the drug wears off. A ventilator can be used to breathe for anyone who has stopped breathing from a poisoning.• If the person is agitated or hallucinating. • • .

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