POISONING-BASIC LIFE SUPPORT-MUKESH SUNDARARAJAN

1. Poisoning
&
Management
MUKESH SUNDARARAJAN

2. Content
• Poisoning
- Definition & Description
- Causes
- Classification
- Symptoms
- Diagnosis
• Primary Management
• References

3. Definition & Description
• Poisoning occurs when any substance interferes
with normal body functions after it is swallowed,
inhaled, injected, or absorbed. The branch of
medicine that deals with the detection and
treatment of poisons is known as toxicology.
• Poisonings are a common occurrence. In 80% of
the cases of poisoning, the victim is a child
under the age of five.

4. • Curiosity, inability to read warning labels, a
desire to imitate adults, and inadequate
supervision lead to childhood poisonings.
• The elderly are the second most likely group to
be poisoned. Mental confusion, poor eyesight,
and the use of multiple drugs are the leading
reasons why this group has a high rate of
accidental poisoning.

5. • A substantial number of poisonings also occur
as suicide attempts or drug overdoses.
• Poisons are common in the home and
•
workplace, yet there are basically two major
types.
One group consists of products that were never
meant to be ingested or inhaled, such as
shampoo, paint thinner, pesticides, houseplant
leaves, and carbon monoxide.

6. • The other group contains products that can be
ingested in small quantities, but which are
harmful if taken in large amounts, such as
pharmaceuticals, medicinal herbs, or alcohol.
• Other types of poisons include the bacterial
toxins that cause food poisoning, such as
Escherichia coli; heavy metals, such as the lead
found in the paint on older houses; and the
venom found in the bites and stings of some
animals and insects.

7. Causes
• The effects of poisons are as varied as the
poisons themselves; however, the exact
mechanisms of only a few are understood.
• Some poisons interfere with the metabolism.
• Others destroy the liver or kidneys, such as
heavy metals and some pain relief medications,
including acetaminophen and nonsteroidal anti-
inflammatory drugs (Ibuprofen).

8. • A poison may severely depress the central
nervous system, leading to coma and eventual
respiratory and circulatory failure.
• Some poisons directly affect the respiratory and
circulatory system. Carbon monoxide causes
death by binding with hemoglobin that would
normally transport oxygen throughout the body.
• Cyanide interferes with respiration at the cellular
level.

9. • The type of poison, the amount and time
of exposure, and the age, size, and health
of the victim are all factors which
determine the severity of symptoms and
the chances for recovery.

10. Classification
• Mainly categorized in five broad classes :
1) Plant poisoning
2) Food & household chemicals
3) Pharmaceuticals
4) Venom poisoning
5) Other

11. 1) Plant poisoning
Most parts of the
tree are toxic,
except the bright red
aril surrounding the
seed.
The major toxin
within the yew is
the alkaloid
taxine.
The leaves are
more toxic than the
seed.
Taxus baccata

12. • One hundred milligrams (mg) of moist, crushed
apricot seeds can produce 217 mg of cyanide.
(Beers, Mark H., MD, and Robert Berkow, MD., editors. "Poisoning." In The
Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck
Research Laboratories, 2004.)

13. 2) Food & Household
chemicals
Food
• Food poisoning is a common, yet distressing
and sometimes life-threatening problem in the
world.
• Depending on the type of infection, people can
even die as a result of food poisoning.
• More than 250 different diseases can cause
food poisoning. Some of the most common
diseases are infections caused by bacteria, such
as Campylobacter, Salmonella & E. coli.

14. Household Product:
• Many products used daily in the home are
poisonous if swallowed. These products often
contain strong acids or strong bases (alkalis).
• Toxic household cleaning products include
dishwashing liquids, floor waxes and furniture
polishes, laundry detergents, spot cleaners, and
fabric softeners, toilet bowl cleaners.

15. • Personal care products found in the home can
also be poisonous. These include:
Deodorant
Hairspray
Hair straighteners
Nail polish and polish remover
Perfume & Shampoo

16. 3) Pharmaceutical
• Both over-the-counter and prescription
medicines can help the body heal if taken as
directed.
• However, when taken in large quantities, or with
other drugs where there may be an adverse
interaction, they can act as poisons.
• Drug overdoses, both accidental and intentional,
are the leading cause of poisoning in adults.

17. • Medicinal herbs should be treated like
pharmaceuticals and taken only in designated
quantities under the supervision of a
knowledgeable person.
• Herbs that have healing qualities when taken in
small doses can be toxic in larger doses, or may
interact with prescription medications in
unpredictable ways.

18. • More than 4000 mg of acetaminophen a day
causes poisoning.
• Taking more than 150mg/kg of aspirin can have
serious and even deadly results if untreated
• Barbituate overdose occurs when someone
accidentally or intentionally takes more than the
normal or recommended amount of this
medication. This is life threatening.

19. • Large overdose of morphine can cause
breathing to stop and death if the person does
not get medical attention or an antidote right
away.

20. 4) Venom Poisoning
• Venom is the general term referring to any
variety of toxins used by certain types of animals
that inject it into their victims by the means of a
bite, sting or other sharp body feature.
• Different venomous animal and insects may
inject venom in human during their attack. Such
venom as toxic chemical agent shows the
poisonous effect.

21. 5) Other causes of
poisonings
 People can be poisoned by fumes
they inhale. Carbon monoxide is the
most common form of inhaled poison.
 Other toxic substances that can be
inhaled include farm and garden
insecticides and herbicides, gasoline
fumes, insect
repellent, paint thinner fumes and
many other chemical agent.

22. Symptoms

23. • Aspirin poisoning symptoms: Upset stomach
and stomach pain, Nausea & Vomiting. Chronic
overdose may include Tiredness, Slight fever,
Confusion ,Collapse, Rapid heart beat.
• Barbiturate intoxication and overdose include:
Altered level of consciousness, Difficulty in
thinking, sleepiness or coma, Faulty judgment,
In coordination, Shallow breathing, Slowness of
speech

24. • Morphine poisoning symptoms: Gastrointestinal
system constipation, Nausea, Vomiting, Low
blood pressure, Weak pulse, Difficulty breathing.

25. Diagnosis
is suspected if the victim
• Initially, poisoning
shows changes in behavior and signs or
symptoms previously described. Hallucination or
other psychiatric symptoms may indicate
poisoning by a hallucinogenic plant.
• Evidence of an empty container or information
from the victim are helpful in determining exactly
what substance has caused the poisoning.
• The vomit may be tested to determine the exact
composition of the poison.

26. Primary Management of
Poisoning

27. Primary Management
• Seek immediate medical help.
• Try and identify the poison if possible .
• Check for signs like burns around mouth,
breathing difficulty or vomiting.
• Induce vomiting if poison swallowed.
• In case of convulsions, protect the person from
self injury.

28. • If the vomit falls on the skin, wash it thoroughly
• Position the victim on the left till medical help
arrives.
1) For inhalation poisoning
• Seek immediate emergency help.
• Get help before you attempt to rescue others.
• Hold a wet cloth to cover your nose and mouth
• Open all the doors and windows.

29. • Take deep breaths before you begin the rescue.
• Avoid lighting a match.
• Check the patient's breathing.
• Do a CPR, if necessary.
• If the patient vomits, take steps to prevent.

30. Charcoal/ Ipecac
• Primary detoxication by ipecac-induced emesis
or gastric lavage
incomplete.
• In mild to moderate
(cleansing or rinsing) is
poisoning administration of
alone without gastric
activated charcoal
emptying is often more effective, because it
binds toxins promptly.

31. • In-vitro and in-vivo studies of many substances
charcoal (e.g. digitalis, beta-blocking
have shown good adsorption to activated
agents,
phenobarbitone, carbamazepine, theophylline).
2) Venom Poisoning:
• Lie down immediately after the bite.
• Call an ambulance.
• Don’t move, particularly the bitten part.

32. • In the first second after the bite it is possible to
press out the poison. Do it if possible.
• Clean the wound with antiseptic solution and
bandage the wound (not tightly).
• Drink a lot of fluid, it will dilute the poison.
• If possible catch the snake or at least remember
the look of animal or insect.

33. Research based…
 Syrup of ipecac should no longer
be used routinely as a poison
treatment intervention in the home.
 Current research does not support
the routine administration of activated
charcoal in the home as efficacy
and safety have not been
demonstrated.

34. References
1) FARLEX, http://medical-dictionary.thefreedictionary.com/Poisoning
2) St John Ambulance, http://www.sja.org.uk/sja/first-aid-
advice/poisoning/drug-poisoning.aspx
3) Pediatrics,
http://pediatrics.aappublications.org/content/112/5/1182.full
4) US National Library Of Medicine,
http://www.ncbi.nlm.nih.gov/pubmed/8145456
5) MD INDIA,
http://www.medindia.net/patients/Firstaid_Poisoning.htm