Toxicology: General Nursing

Management of Poisoning

EmergenciesEmergencies

Presented by

Shaimaa El Hadary

Lecturer of Nursing

2012

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Objectives:

After completing this lecture, each student should be able to:

Mention what a poison is Mention what a poison is

Identify factors determining the severity of poisoning

Identify different types of poisoning

Discuss the first aid for different types of poisoning

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What a poison is

Factors determining the severity of

poisoning

How poisons enter the body

First aid of poisoning

Conclusion

Questions

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What a poison is?

A poison is a substance

that causes illness or ?death when introduced into the body by altering

cell structure or function.

?

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*The type and amount of poison.

*How and where the poison entered the

body.

*The time elapsed since the poisoning.

The severity of a poisoning depends

on factors such as

*The time elapsed since the poisoning.

*The victims size, weight, medical

condition and age.

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Check the scene

Flames or

smoke.

Unusual

odors.

open

medicine

cabinetodors.

damaged

plants

spilled

containers

medicine

cabinet

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How Poisons Enter the Body:

Ingestion

Inhalation

Absorption

Injection

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(1) Ingested poisons

A poison enter the body through mouth

it can include many common household, industrial,

chemical, medications, petroleum ,agricultural

products made to control insects.products made to control insects.

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S&S for Ingested Poisoning

Unusual breath odors

Discoloration or burning around

the mouth

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Ingested Poisons

Patient Assessment

What substance was involved?

When did the exposure occur? When did the exposure occur?

How much was ingested?

Over how long a period did the ingestion occur?

What interventions has the patient , family taken?

What is the patients estimated weight?

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Ingested Poisons Emergency Nursing

Management

Cases of poisoning by non-corrosive poison for conscious person

can be treated by 3 general means

Dilution

VomitingActivated charcoal

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Cases of poisoning by corrosive poison

(strong acid/alkali)1. Do not induce vomiting.

Ingested Poisons Emergency Nursing Management

1. Do not induce vomiting.

2. Give milk or water (2glasses for adults)

3. Handle him gently; keep him from being

chilled.

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Emergency care of a patient who has ingested

poison includes the following:

1- Detect & treat immediately life threatening

problems in the initial assessment.

2- perform a focused history & physical2- perform a focused history & physical

examination including SAMPLE history. Use

gloved hands to carefully remove any pills ,

tables, or fragments from the patients mouth.

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3- Assess baseline vital signs.

4- Consult medical direction. As administer

activated charcoal to adsorb the poison.

5-Transport the patient with all containers , 5-Transport the patient with all containers ,

bottles,& labels from substance.

6- Perform ongoing assessment.

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Activated Charcoal

Indication: poisoning by mouth

Contraindication:

Altered mental status / inability to swallow.

Action: adsorbs ( binds) certain poisons &Action: adsorbs ( binds) certain poisons &

prevent them from being absorbed into the

body.

Medication form: premixed in water

Dosage: 1gram / kg of body wt.

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Side effect: black stools. some pts may vomit ,

particulty those who have ingested poisons

that cause nausea. If patients vomits, repeat

the dose once.the dose once.

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Inhaled poisons

substances that are breathed in, it can be

gases, vapors, sprays. Such poisons include

carbon monoxide ( from car exhaust, wood

burning stoves), ammonia , chlorine, insectburning stoves), ammonia , chlorine, insect

sprays.

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Respiratory distress

Cough

Hoarseness

Chest pain

S&S for inhaled Poisoning

Chest pain

Dizziness

Headache

Confusion

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1. Remove the victim from the source.

2. Ventilate the victim

3. Elevate the head

4. If unconscious, check the pulse rate ,airway, and

Inhaled poisons Emergency Nursing

Management

4. If unconscious, check the pulse rate ,airway, and breathing and begin cardiopulmonary resuscitation (CPR), if necessary.

5. Loosen any tight clothing.

6. Cover with blanket

7. Seek medical aid urgently.

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Absorbed poisons

substances taken into the body through

unbroken skin. May or may not damage the

skin. Many are corrosives or irritants that will

injure the skin & then be slowly absorbed intoinjure the skin & then be slowly absorbed into

body tissues & the bloodstream possibly

causing widespread.

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Absorbed Poison

Patient Assessment

What substance was involved?

When did the exposure occur?

How much of substance was the pt. exposed to?

How large an area of skin was the substance on? How large an area of skin was the substance on?

Over how long a period did the exposure occur?

What interventions has the patient , familytaken?

What effects is the patient experiencing fromexposure?

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S&S for absorbed Poisoning

Traces of powder or liquid on the skin

Inflammation or redness of the skin

Blisters

Swelling or burns Swelling or burns

Skin rash

Itching

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1. Remove clothing that has been in contact with the poison

2. Flush the affected area thoroughly with cool water.

Absorbed Poisoning Emergency Nursing

Management

2. Flush the affected area thoroughly with cool water.

3. Wash the area with soap and water

4. If there is poison in the eye, rinse it for 20 minutes.

5. Keep a sample.

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Injected poisons

poisons that inserted through the skin, for

example by needle , snake or insect stinger.

poisons that inserted through the skin, for

example by needle , snake or insect stinger.

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S&S of animal/insect bite or sting

Hypodermic needle marks

Localized swelling

Localized redness

S&S for injected Poisoning

Localized redness

Localized pain

itching

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Questions

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