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WELCOME TO
FIRST AID PART 4
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Homeobook.com
POISONING……….
• Poising any harmful substance introduced into the
body by
• ingestion,
• inhalation,
• injection
• or excessive intake of drugs
– It ranges from mere food poisoning or house hold
poisoning
– Suicidal , Homicidal or accidental intake
– grave industrial poisoning
– from insect bite to fatal snake bite
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• Ipecac is often found in larger household first
aid kits or can be purchased in drug stores. It
is not meant to be used regularly and can
cause long term damage to the heart if
deliberately abused .
• You may be asked to follow the Ipecac with 1-
2 glasses of water.
• If you don't have Ipecac, another way to
induce vomiting is to mix table salt with water,
and then drink the solution.
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• If vomiting does not occur, you can follow with a glass
of room temperature soda or other carbonated
beverage.
• If syrup of Ipecac isn't available ……. mix a combination
of Luke warm water and hydrogen peroxide.
• When vomiting begins, have the victim vomit into a
plastic bag or basin. Avoid vomiting into a toilet.
• Note that activated charcoal may interfere with the
effectiveness of Ipecac.
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• Important point:
• Distinguish the poisons which are corrosive from others
– Look at mouth for any grayish discoloration, numbness, or
burning
INSTANCES WHEN VOMITING SHOULD NOT BE INDUCED
• If unresponsive.
• Cannot maintain an airway open.
• Has ingested an acid, a corrosive lye, or a petroleum
product such as gasoline or furniture polish , Instead gastric
lavage to be done
• Corrosive poisons ingestion
• Has a medical condition that could be complicated by
vomiting, such as heart attack, seizures and pregnancy.
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• To summarize :
– the action plan in case of any poisoning
• Intension of the “ Attempt”
• Nature of Poison
• Vital Parameters
• Effect of poison
• Collection of material for hospital
• Inform if need, to legal authorities
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• Kerosene, Petrol poisoning…..
• Patho physiology of Hydrocarbon Toxicity
– Hydrocarbons is directly related to their physical
properties.
– Viscosity ---as the viscosity increases, the
aspiration potential decreases.
– Volatility ----more likely to be inhaled or aspirated
into the respiratory system , causing pneumonia ,
and CNS and cardiac poisoning.
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• Aliphatic hydrocarbons Fuels
• Solvents
• Furniture polish and paints
• Aromatic hydrocarbons
• Plastics Solvents
• Glues
• Halogenated hydrocarbons
• Refrigerants
• Propellants
• Cleaning products
• Paint strippers
• Solvents
• Wood distillates
• Turpentine
• Pine oil
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FIRST AID…
• Remove the clothing.
• With a dry cloth, blot the poison from the
skin.
• If the poison is a dry powder, brush it off.
• Flood the area with copious amount of water.
• Continually monitor the patient's vital signs.
• Collect suspected materials such as bottles,
packets etc. And should be sent to hospital
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• IRON TONIC “ Poisoning”
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• BEE STING TREATMENT
• The first step removal of the stinger
• The stinger should be removed as quickly as
possible without regard to method
• Once the stinger is removed, pain and swelling
should be reduced with a cold compress.
• Many traditional remedies have been
suggested
17
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• Bee venom is acidic as it contains the highly acidic
• And the amount of venom injected is typically very
small (between 5 and 50 micrograms of fluid)
• And placing large amounts of alkali near the sting site
is unlikely to produce a perfectly neutral pH to stop
the pain.
• Many people do claim benefit from these home
remedies. The effect is probably related to rubbing
the area or the mind perceiving benefit.
• For about 2 percent of people, anaphylactic shock
from certain proteins in the venom can be life-
threatening and requires emergency treatment.
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• WASP BITE
• Ice: Place an ice cube or ice pack on sting and press on
wound for about 20 minutes, will help reduce pain.
• Ice can also be used to help reduce the swelling that
will occur.
• Make sure to protect the skin by covering ice with a
thin cotton towel or paper towel first.
• Baking Soda: Make a thick paste with water and apply
to sting.
• Salt: Make a thick paste with water and apply to sting.
• Apple Cider Vinegar: Soak a small cotton pad with
apple cider vinegar and hold on wound until pain
disappears (the acid content neutralizes the venom).
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• Vinegar: Same treatment as apple cider
vinegar, can also drizzle a few drops directly
onto skin (the acid content neutralizes the
venom).
• Lemon Juice: (the acid content neutralizes the
venom).
• Lemon:
• Garlic: Crush a fresh clove of garlic and apply
to stung area, cover with a band aid.
• Onion: Slice an onion and press in place over
the stung area until pain disappears.
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• Marigolds: Rub the flower head of a marigold
over the stung area (must be a freshly picked
marigold and not dried).
• Aloe Vera: Split open a leaf and apply the aloe
gel directly to the bite area
• Plantain: Chop roughly and mix with a bit of
warm water then apply to wound. You can
also chew a leaf or two then apply to bite.
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SNAKE BITES
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MALABAR PIT VIPER
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KRAIT
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KING COBRA
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INDO CHINESE RAT SNAKE
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YELLOW RAT SNAKE
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INDIAN KRAIT
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The first antivenom was developed in 1895 by French
physician ALBERT CALMETTE for the treatment of Indian
cobra bites 36
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• Try and get a good look at the snake.
• Get away from the snake and try to calm the
victim .
• Make the victim lie down on a bed or mattress.
• If fang marks are visible, the snake was probably
of the poisonous variety.
37
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• The victim should move as little as possible.
The more the victim moves, the quicker the
venom will spread through the body.
• Keep the bitten limb below the level of the
heart. This slows down the spread of the
poison to the heart.
38
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• Some advise that you should wash the bite with
soap and water, and then apply an antiseptic,
while others advise that it is better not to wash
the bite. The doctor will be able to treat the
victim much better if he has traces of the venom.
• It is a good idea to wipe the area clean with an
antiseptic and retain the wipe for venom traces.
• Don't apply ice to the bite.
39
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• Tie a band or cloth about two inches away
from the wound. If there has been swelling,
tie the band about two inches from the
swelling.
• The band should be at least an inch thick, and
it should be tied within 20 minutes of the bite,
if it is to have any effect.
• The band should be firm and tight, but not so
tight that it completely blocks blood flow. A
good rule of thumb is that the bandage should
be loose enough for a finger to slip through.
40
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• As far as possible, DO NOT LET THE VICTIM WALK.
Remember, the limb should be moved as little as possible.
• Do not give the patient anything to eat or drink.
• It is important that consumption of alcohol, a known
vasodilator which will speed up the absorption of venom.
• Do not administer stimulants or pain medications to the
victim.
• Remove any items or clothing which may constrict the
bitten limb if it swells (rings, bracelets, watches, footwear,
etc.)
• Do not incise the bitten site.
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ALCOHOL POISONING
42
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• How To Tell If Someone has Alcohol Poisoning:
• If the person is breathing less than twelve
times per minute or stops breathing for
periods of ten seconds or more . If one finds
empty bottle or cans of alcohol beverages near the
casualty.
• If the person is asleep and you are unable to wake them up
• Look at the person's skin. If it is cold, clammy, pale, bluish in
colour
43
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MANAGEMENT OF ALCOHOLIC POISONING
• Put the person in the recovery position
• Make sure they're breathing and that their mouth
is empty
• Clear any vomit, away from their mouth
• Stay with a person who is vomiting. Try to keep
the person sitting up. If they must lie down, keep
them on the recovery position.
• Watch for choking; if the person begins to choke,
get help immediately
• If they stop breathing, start CPR (mouth to mouth
resuscitation)
• Loosen any tight clothing that might restrict their
breathing 44
Homeobook.com
• Keep them warm - use blankets or a coat (but not
too warm)
• Call an ambulance as soon as possible. Explain to
the ambulance crew what has happened and
what you have done
• Don't Ignore someone who is unconscious or
vomiting
• Give someone fluids (even water) if you think
they're in shock or unconscious
45
Homeobook.com
Dehydration
Dehydration can result in:Cramps in the leg,
back and arms
• Failure to sweat
• Headaches and dizziness
• Vomiting
• Suddenly feeling very tired
46
Homeobook.com
• Feeling like urinating, but not doing so when
you go
• Fainting
Prevent and treat dehydration by : Drinking
water, fruit juice or a sports drink and avoiding
alcohol
• Eating something that keeps the salt levels in
the body up. Salty snacks, fruit juice, and
sports drinks will all help to keep the body
provided with the minerals it needs
47
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• Never ignore someone who is having a bad time or is sick.
• Don't give the person a cold shower; the shock of the
cold could cause unconsciousness.
• Don't give the semiconscious person food or fluids (not
even water) It could cause vomiting, choking or aspiration.
• Don't panic. Even if things aren't going to plan, try to
stay calm.
DON’TS
48
Homeobook.com
METHYL ALCOHOL POISONING
• Early manifestations such as nausea, vomiting, headache, vertigo
and gastritis are primarily caused by Methanol itself. High serum
levels of Methanol (>40 mg/dl) is associated with convulsions and
coma.
• Late manifestations such as visual disturbances, severe metabolic
acidosis, seizures, coma and death are common after 30 hours after
ingestion.
• Severe poisoning leads to myocardial depression, bradycardia and
shock.
• Administration of Ethanol to saturate alcohol dehydrogenase in the
liver, preventing the formation of toxic metabolite, formaldehyde.
Folic acid to form carbon dioxide and water
49
Homeobook.com
End of Part 4
50
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Poisioning forensic medicine ,part one .pdf

  • 1. WELCOME TO FIRST AID PART 4 1 Homeobook.com
  • 2. POISONING………. • Poising any harmful substance introduced into the body by • ingestion, • inhalation, • injection • or excessive intake of drugs – It ranges from mere food poisoning or house hold poisoning – Suicidal , Homicidal or accidental intake – grave industrial poisoning – from insect bite to fatal snake bite 2 Homeobook.com
  • 3. • Ipecac is often found in larger household first aid kits or can be purchased in drug stores. It is not meant to be used regularly and can cause long term damage to the heart if deliberately abused . • You may be asked to follow the Ipecac with 1- 2 glasses of water. • If you don't have Ipecac, another way to induce vomiting is to mix table salt with water, and then drink the solution. 3 Homeobook.com
  • 4. • If vomiting does not occur, you can follow with a glass of room temperature soda or other carbonated beverage. • If syrup of Ipecac isn't available ……. mix a combination of Luke warm water and hydrogen peroxide. • When vomiting begins, have the victim vomit into a plastic bag or basin. Avoid vomiting into a toilet. • Note that activated charcoal may interfere with the effectiveness of Ipecac. 4 Homeobook.com
  • 5. • Important point: • Distinguish the poisons which are corrosive from others – Look at mouth for any grayish discoloration, numbness, or burning INSTANCES WHEN VOMITING SHOULD NOT BE INDUCED • If unresponsive. • Cannot maintain an airway open. • Has ingested an acid, a corrosive lye, or a petroleum product such as gasoline or furniture polish , Instead gastric lavage to be done • Corrosive poisons ingestion • Has a medical condition that could be complicated by vomiting, such as heart attack, seizures and pregnancy. 5 Homeobook.com
  • 6. • To summarize : – the action plan in case of any poisoning • Intension of the “ Attempt” • Nature of Poison • Vital Parameters • Effect of poison • Collection of material for hospital • Inform if need, to legal authorities 6 Homeobook.com
  • 7. • Kerosene, Petrol poisoning….. • Patho physiology of Hydrocarbon Toxicity – Hydrocarbons is directly related to their physical properties. – Viscosity ---as the viscosity increases, the aspiration potential decreases. – Volatility ----more likely to be inhaled or aspirated into the respiratory system , causing pneumonia , and CNS and cardiac poisoning. 7 Homeobook.com
  • 8. • Aliphatic hydrocarbons Fuels • Solvents • Furniture polish and paints • Aromatic hydrocarbons • Plastics Solvents • Glues • Halogenated hydrocarbons • Refrigerants • Propellants • Cleaning products • Paint strippers • Solvents • Wood distillates • Turpentine • Pine oil 8 Homeobook.com
  • 9. FIRST AID… • Remove the clothing. • With a dry cloth, blot the poison from the skin. • If the poison is a dry powder, brush it off. • Flood the area with copious amount of water. • Continually monitor the patient's vital signs. • Collect suspected materials such as bottles, packets etc. And should be sent to hospital 9 Homeobook.com
  • 10. • IRON TONIC “ Poisoning” 10 Homeobook.com
  • 17. • BEE STING TREATMENT • The first step removal of the stinger • The stinger should be removed as quickly as possible without regard to method • Once the stinger is removed, pain and swelling should be reduced with a cold compress. • Many traditional remedies have been suggested 17 Homeobook.com
  • 18. • Bee venom is acidic as it contains the highly acidic • And the amount of venom injected is typically very small (between 5 and 50 micrograms of fluid) • And placing large amounts of alkali near the sting site is unlikely to produce a perfectly neutral pH to stop the pain. • Many people do claim benefit from these home remedies. The effect is probably related to rubbing the area or the mind perceiving benefit. • For about 2 percent of people, anaphylactic shock from certain proteins in the venom can be life- threatening and requires emergency treatment. 18 Homeobook.com
  • 19. • WASP BITE • Ice: Place an ice cube or ice pack on sting and press on wound for about 20 minutes, will help reduce pain. • Ice can also be used to help reduce the swelling that will occur. • Make sure to protect the skin by covering ice with a thin cotton towel or paper towel first. • Baking Soda: Make a thick paste with water and apply to sting. • Salt: Make a thick paste with water and apply to sting. • Apple Cider Vinegar: Soak a small cotton pad with apple cider vinegar and hold on wound until pain disappears (the acid content neutralizes the venom). 19 Homeobook.com
  • 20. • Vinegar: Same treatment as apple cider vinegar, can also drizzle a few drops directly onto skin (the acid content neutralizes the venom). • Lemon Juice: (the acid content neutralizes the venom). • Lemon: • Garlic: Crush a fresh clove of garlic and apply to stung area, cover with a band aid. • Onion: Slice an onion and press in place over the stung area until pain disappears. 20 Homeobook.com
  • 21. • Marigolds: Rub the flower head of a marigold over the stung area (must be a freshly picked marigold and not dried). • Aloe Vera: Split open a leaf and apply the aloe gel directly to the bite area • Plantain: Chop roughly and mix with a bit of warm water then apply to wound. You can also chew a leaf or two then apply to bite. 21 Homeobook.com
  • 26. INDO CHINESE RAT SNAKE 26 Homeobook.com
  • 36. The first antivenom was developed in 1895 by French physician ALBERT CALMETTE for the treatment of Indian cobra bites 36 Homeobook.com
  • 37. • Try and get a good look at the snake. • Get away from the snake and try to calm the victim . • Make the victim lie down on a bed or mattress. • If fang marks are visible, the snake was probably of the poisonous variety. 37 Homeobook.com
  • 38. • The victim should move as little as possible. The more the victim moves, the quicker the venom will spread through the body. • Keep the bitten limb below the level of the heart. This slows down the spread of the poison to the heart. 38 Homeobook.com
  • 39. • Some advise that you should wash the bite with soap and water, and then apply an antiseptic, while others advise that it is better not to wash the bite. The doctor will be able to treat the victim much better if he has traces of the venom. • It is a good idea to wipe the area clean with an antiseptic and retain the wipe for venom traces. • Don't apply ice to the bite. 39 Homeobook.com
  • 40. • Tie a band or cloth about two inches away from the wound. If there has been swelling, tie the band about two inches from the swelling. • The band should be at least an inch thick, and it should be tied within 20 minutes of the bite, if it is to have any effect. • The band should be firm and tight, but not so tight that it completely blocks blood flow. A good rule of thumb is that the bandage should be loose enough for a finger to slip through. 40 Homeobook.com
  • 41. • As far as possible, DO NOT LET THE VICTIM WALK. Remember, the limb should be moved as little as possible. • Do not give the patient anything to eat or drink. • It is important that consumption of alcohol, a known vasodilator which will speed up the absorption of venom. • Do not administer stimulants or pain medications to the victim. • Remove any items or clothing which may constrict the bitten limb if it swells (rings, bracelets, watches, footwear, etc.) • Do not incise the bitten site. 41 Homeobook.com
  • 43. • How To Tell If Someone has Alcohol Poisoning: • If the person is breathing less than twelve times per minute or stops breathing for periods of ten seconds or more . If one finds empty bottle or cans of alcohol beverages near the casualty. • If the person is asleep and you are unable to wake them up • Look at the person's skin. If it is cold, clammy, pale, bluish in colour 43 Homeobook.com
  • 44. MANAGEMENT OF ALCOHOLIC POISONING • Put the person in the recovery position • Make sure they're breathing and that their mouth is empty • Clear any vomit, away from their mouth • Stay with a person who is vomiting. Try to keep the person sitting up. If they must lie down, keep them on the recovery position. • Watch for choking; if the person begins to choke, get help immediately • If they stop breathing, start CPR (mouth to mouth resuscitation) • Loosen any tight clothing that might restrict their breathing 44 Homeobook.com
  • 45. • Keep them warm - use blankets or a coat (but not too warm) • Call an ambulance as soon as possible. Explain to the ambulance crew what has happened and what you have done • Don't Ignore someone who is unconscious or vomiting • Give someone fluids (even water) if you think they're in shock or unconscious 45 Homeobook.com
  • 46. Dehydration Dehydration can result in:Cramps in the leg, back and arms • Failure to sweat • Headaches and dizziness • Vomiting • Suddenly feeling very tired 46 Homeobook.com
  • 47. • Feeling like urinating, but not doing so when you go • Fainting Prevent and treat dehydration by : Drinking water, fruit juice or a sports drink and avoiding alcohol • Eating something that keeps the salt levels in the body up. Salty snacks, fruit juice, and sports drinks will all help to keep the body provided with the minerals it needs 47 Homeobook.com
  • 48. • Never ignore someone who is having a bad time or is sick. • Don't give the person a cold shower; the shock of the cold could cause unconsciousness. • Don't give the semiconscious person food or fluids (not even water) It could cause vomiting, choking or aspiration. • Don't panic. Even if things aren't going to plan, try to stay calm. DON’TS 48 Homeobook.com
  • 49. METHYL ALCOHOL POISONING • Early manifestations such as nausea, vomiting, headache, vertigo and gastritis are primarily caused by Methanol itself. High serum levels of Methanol (>40 mg/dl) is associated with convulsions and coma. • Late manifestations such as visual disturbances, severe metabolic acidosis, seizures, coma and death are common after 30 hours after ingestion. • Severe poisoning leads to myocardial depression, bradycardia and shock. • Administration of Ethanol to saturate alcohol dehydrogenase in the liver, preventing the formation of toxic metabolite, formaldehyde. Folic acid to form carbon dioxide and water 49 Homeobook.com
  • 50. End of Part 4 50 Homeobook.com