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  • 1. Chapter Poisoning and Overdose Emergencies Seventeen
  • 2. Chapter
    • Recognition and management of poisoning and overdose emergencies, including administration of activated charcoal
    Seventeen CORE CONCEPTS
  • 3. Poison K EY TERM Any substance that can harm the body
  • 4. INHALATION INJECTION INGESTION ABSORPTION Drain Cleaners Rat Poison Lye Sprays Cleaning Fluid Drugs Household Cleaners Insecticides Four Routes of Poisoning
  • 5. Patient ASSESSMENT
    • What substance was involved?
    • Get exact name.
    • Bring container, if possible.
    • When did exposure occur?
    • How much was ingested (or involved)?
    • If not known, estimate maximum
    possible amount. Poisoning/Overdose Signs and Symptoms (Continued)
  • 6. Patient ASSESSMENT Poisoning/Overdose Signs and Symptoms
    • Over how long a period did
    • If not known, estimate shortest and
    longest possible times. exposure occur? (Continued)
  • 7. Patient ASSESSMENT
    • Does patient have an altered mental status?
    • Is there abdominal pain?
    • Are there chemical burns around mouth?
    • Is there unusual breath odor?
    • What interventions taken?
    • What is patient’s estimated weight?
    • What effects on patient?
    Poisoning/Overdose Signs and Symptoms
  • 8. I NGESTED POISONS
  • 9. Patient ASSESSMENT
    • History of ingestion
    • Nausea
    • Vomiting
    • Diarrhea
    Ingested Poisons Signs and Symptoms
  • 10. Patient CARE Ingested Poisons Emergency Care Steps
  • 11. Gather information. Remove pills from patient’s mouth carefully. Consult medical direction: Administer activated charcoal?
  • 12. Administer activated charcoal as directed. Position patient for vomiting. Save all vomitus. Have suction equipment ready.
  • 13.
    • Poisoning by mouth
    Activated Charcoal Indication Contraindications
    • Altered mental status
    • Ingestion of acid or alkali
    • Patient unable to swallow
  • 14. Trade Names: SuperChar, InstaChar, LiquiChar
  • 15.
    • Premixed in water,
    Activated Charcoal Medication Form commonly 12.5 grams in plastic bottle
    • Avoid powder form in
    the field
  • 16.
    • Adults and children:
    Activated Charcoal Dosage 1 gram activated charcoal/ kg of body weight
    • Adult: 25-50 grams
    • Pediatric: 12.5-25 grams
  • 17.
    • Consult medical direction.
    • Shake container thoroughly.
    • Have patient drink mixture.
    Activated Charcoal Administration If necessary, use a covered container and a straw.
  • 18. Activated Charcoal
    • If patient does not drink all
    Administration medication right away, shake again to prevent settling. dose, route, and time of administration.
    • Record medication name,
  • 19.
    • Binds to certain poisons;
    Activated Charcoal Actions prevents absorption by body.
    • Binds to certain poisons;
    than others. Consult medical direction about brand.
  • 20.
    • Black stools
    • Some patients vomit.
    Activated Charcoal Side Effects If so, repeat the dose. Reassessment Strategies Be prepared for the patient to vomit or for patient’s condition to deteriorate.
  • 21. Sometimes it is very difficult to convince a patient to drink a premixed solution of activated charcoal. It looks like mud. Giving a covered container and straw to the patient may make it easier to drink. It is important to acknowledge any fear or apprehension your patient is experiencing. Your calm, professional demeanor helps you gain a patient’s trust and respect in your ability to administer medication in the appropriate manner. Remember, too, that activated charcoal may be given to the patient while en route to the receiving facility. P RECEPTOR P EARL
  • 22. I NHALED POISONS
  • 23. Patient ASSESSMENT Inhaled Poisons Signs and Symptoms
    • History of inhalation
    • Difficulty breathing
    • Chest pain
    • Cough
    • Hoarseness
    (Continued)
  • 24. Patient ASSESSMENT Inhaled Poisons Signs and Symptoms
    • Dizziness
    • Headache
    • Confusion
    • Seizures
    • Altered mental status
  • 25. Patient CARE Inhaled Poisons Emergency Care Steps
  • 26. Have patient removed from the hazardous environment. Establish an open airway.
  • 27. Maintain airway and administer oxygen. Remove any contaminated clothing.
  • 28. Consult medical direction. Transport the patient.
  • 29.
    • Very common inhaled poison
    • Colorless, odorless, tasteless gas
    • Results from incomplete combustion
    Carbon Monoxide
    • Causes hypoxia by taking the
    place of oxygen in red blood cells
  • 30. I NJECTED POISONS
  • 31.
    • Headache, dizziness, nausea
    • Difficulty breathing
    • Cyanosis
    • Altered mental status
    • Cherry red lips (very
    Signs and Symptoms Carbon Monoxide uncommon)
  • 32. Patient ASSESSMENT Injected Poisons Signs and Symptoms
    • Weakness
    • Dizziness
    • Chills and fever
    • Nausea and vomiting
  • 33. Patient CARE Injected Poisons Emergency Care Steps
    • Secure airway and administer oxygen.
    • Be alert for vomiting.
    • Transport container/patient.
  • 34. A BSORBED POISONS
  • 35. Patient ASSESSMENT Absorbed Poisons Signs and Symptoms
    • History of exposure
    • Liquid or powder on skin
    • Burns
    • Itching, irritation, redness
  • 36. Patient CARE Absorbed Poisons Emergency Care Steps
  • 37. Brush powders from patient. Remove patient from source without contaminating yourself.
  • 38. Remove contaminated clothing and other articles. Irrigate with clear water for at least 20 minutes.
  • 39. Patient CARE Absorbed Poisons Emergency Care Steps
    • Eye
    • Irrigate with clean water for at least
    20 minutes and continue en route if possible.
  • 40. When treating a poisoned or overdosed patient whose airway is patent, be prepared for deterioration and the need to secure airway. Airway Management in Poisoning Emergencies
  • 41. 1. What are the ways patients can be poisoned? 2. What is the most common inhaled poison, and how is it treated? 3. What are the indications for, contraindications for, and manner of administering activated charcoal? R EVIEW QUESTIONS