POISONING

PRESENTED BY:
BSN GROUP 1 IV-D
 WHAT IS POISON?

• Any substance which when administered in living body through any

route (inhalation, ingestion, surface absorption etc.) Will produce ill-
health or death by its action which is due to its physical chemical or
physiological properties.
 POISONING

• Poisoning is A contact with a substance that results in toxicity. Symptoms vary,

but certain common syndromes may suggest particular classes of poisons.
Diagnosis is primarily clinical, but for some poisonings, blood and urine tests
can help.
ROUTES OF POISONING
 NATURES OF POISONING

• Homicidal –killing of a human being by another human being by administering

poisonous substance deliberately.

• Suicidal – when a person administer poison himself to end his/her life.

• Accidental – example is household poisons, nail polish remover, acetone.
• Occupational – in professional workers. Example is insecticides, noxious, fumes
 GENERAL SIGNS AND SYMPTOMS OF POISONING

• Feeling and being sick • Breathing difficulties

• Diarrhoea • Producing more saliva than normal
• Stomach pain • Skin rash
• Drowsiness, dizziness or weakness • Blue lips and skin (cyanosis)
• High temperature • Burns around the nose or mouth
• Chills (shivering) • Double vision or blurred vision
• Loss of appetite • Mental confusion
• Headache • Seizures (fits)
• Irritability • Loss of consciousness
• Difficulty swallowing (dysphagia) • Coma, in severe cases
 DANGER SIGNS
o NO BREATHING o Asterixis
o WHEEZY OR NOISY BREATHING
o PULSE BELOW 50, ABOVE 10, OR ABOVE
110 BPM,

(IRREGULAR, OR VERY WEAK)

o NON-REACTING PUPILS
o CONTINUOUS SEIZURES
o TEMPERATURE >39 °C
o Severe abdominal tenderness
o Anuria
 TREATMENT
Emergency treatment is initiated with the following goals

 To remove or inactivate the poison before it is absorbed.

 To provide supportive care in maintaining vital organ system.
 To administer a specific antidote to neutralize a specific poison.
 To implement treatment that hastens the elimination of the absorbed poison.
 ASSESSMENT AND MANAGEMENT
ABC stabilization: ensure the patient has a patent airway. Give oxygen if oxygen saturation is low.
Give intravenous fluids for hypotension. (ECG, vitals an neurologic status are monitored closely.)

Blood sugar an opioid reversal: check blood glucose. Give dextrose if it is low. If suspicious of an
opioid overdose give an opioid antidote.

Therapeutic interventions
• Gastric emptying
• Enhanced elimination
• Antidotes
IV and supportive treatment: if there is no specific antidote, we treat the patient’s symptoms.
 NON-PHARMACOLOGICAL MANAGEMENT

Ensure airway are patent

Remove contaminated clothing, if necessary
Wash chemical away from skin with soap and a lot of water
If necessary perform nasogastric aspiration of airway is protected
Carry out gastric lavage or aspiration within the first 1 hour after the event or later if involves slow reverse
or highly toxic substances

Detain the patient in the hospital for close monitoring an continuous observation, re-evaluation, and
supportive and symptomatic treatment
 PHARMACOLOGICAL TREATMENT
Initial management

• For hypoglycemia
Glucose, IV 25-50 ml of 50% over 1-3 minutes
• For opioid overdose
Naloxone, v
Adult- 0.4-2 mg , repeat 2-3 minutes (maximum of 10 mg)
Children- 10 micrograms /kg stat, subsequent dose of 100 microgram/kg if no response to initial dose then,

Naloxone, subq or mi, only if IV route is not feasible.