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POISONING
PRESENTED BY: -
Mr. OM VERMA
ASSOCIATE PROFESSOR
Poisonings are either accident or
intentional accidental . poisoning occur
more common in the emotional or
unintentional event and also in the age of
unintentional event and also in the age of
pediatric age group, where as intentional
poisoning are more frequent in the
adolescence and adult population.
Poisoning can also occur from injected
venom such as snake or insect bites.
According to Philliph –
“A poison is a chemical
agent capable of producing harmful effects of
the biological system .”
the biological system .”
According to the AND –
“ A substance that
causes injuries , illness, or death , especially
by chemical means.”
Poisoning is injury or death due to
swallowing, inhaling, touching or injecting
various drugs, chemicals, venoms or
gases. Many substances — such as drugs
gases. Many substances — such as drugs
and carbon monoxide — are poisonous
only in higher concentrations or dosages.
ACCORDING TO LIPPEN COTT
A poison is any substance that is
harmful to Human body.The effects
of poisoning range from short-term
of poisoning range from short-term
illness to brain damage, coma, and
resulting death
ACCORDING LUCKMANS
ETIOLOGY:
Medications are the most common cause of poisoning
and are responsible for more than half of all cases.
The medications most commonly linked to poisoning are:
Paracetamol
Aspirin
Tricyclic antidepressants
Tricyclic antidepressants
Selective serotonin reuptake inhibitors
Beta-blockers
Calcium-channel blockers
Benzodiazepines
Opioids
However, all medications have the potential to be harmful
if taken at too high a dose or taken by someone who has
not been prescribed them, such as a child.
Food can sometimes cause poisoning if:
It becomes contaminated with bacteria
from raw meat
from raw meat
It has not been prepared or cooked
properly
Unhygienic food intake
Illness caused by food contaminated with
bacteria, viruses, parasites or toxins.
Infectious organisms or their toxins are the most
common causes of food poisoning.
common causes of food poisoning.
Food poisoning symptoms may include cramping,
nausea, vomiting or diarrhea.
occurs when a person breathes in high
concentrations of CO2 gas. Normally,
CO2 is found in the air at very low
concentrations, at around 0.04%.This
2
concentrations, at around 0.04%.This
concentration of CO2 is typically harmless
to the body. However, certain situations
may increase exposure to CO2
CMP is a chemical produced from the incomplete
burning of natural gas or other products containing
carbon.This includes exhaust, faulty heaters, fires,
and factory emissions. Anything that burns coal,
gasoline, kerosene, oil, resulting Breathing
problems, including no breathing, shortness of
gasoline, kerosene, oil, resulting Breathing
problems, including no breathing, shortness of
breath, or rapid breathing Coma Confusion
Convulsions Dizziness Carbon monoxide is an
odorless gas that causes thousands of deaths each
year
Exposure to a substance can occur by inhalation,
ingestion or direct contact. Inhalation
(breathing) of gases, vapors, dusts or mists is a
common route of exposure. Chemicals can enter
common route of exposure. Chemicals can enter
and irritate the nose, air passages and lungs.
Excess expose chemical lead the death .
TYPES
OF
OF
POISONING
poisoning by ingestion refers
to oral intake of a harmful
substance which even in small
substance which even in small
amounts can damage tissue
disturb body function and
causes possible death.
Lead poisoning result from
consumption of lead in some from
lead poisoning is common in
lead poisoning is common in
children living in area , where they
are work shop for repair or old
automobiles, lead storage and
batteries .
Food poisoning mainly occur on
consumption of food that is
contaminated with
contaminated with
microorganisms, toxins , or
chemical causes for food
poisoning.
PATHOPHYSIOLOGY
-
-
DueToAny Etiological Factors (Carbon Monoxide
Poisoning May Occur As A Result Of Industrial Or
Household IncidentsOr Attempted Suicide).
Carbon Monoxide BindTo Circulating HemoglobinAnd
Carbon Monoxide BindTo Circulating HemoglobinAnd
Thereby ReducingThe Oxygen-Carrying Capacity Of
The Blood.
Carbon Monoxide – Bound Hemoglobin, Called
Carboxyhemoglobin, .Decrease Transport Oxygen.
ReducesOxygenationToVital Organs
lung CNS CVS G.I
.
.
Respiratory Confusion
failure Dizziness Weakness Altered G.I
headache
DEATH
Vomiting
Abdominal pain
Headache
Sign of shock
Difficulty inbreathing
Difficulty inbreathing
Loss of consciousness
Some poisons enlarge the pupil ,
Some result in excessive drooling , while
other dry the mouth and skin.
Increased heart rate
Usual odor in breath.
Burn around the mouth
CLINICAL MANIFESTATION:
A person suffering from carbon monoxide poisoning
appears intoxicated (from cerebral hypoxia).
Other symptoms include:
Headache.
Headache.
Muscular weakness.
Palpitation.
Dizziness.
Mental confusion which can progress rapidly to coma.
Skin color range from pink or cherry red to cyanotic
and pale.
ASSESSMENT
INTERVETION
INTERVETION
MANAGEMENT
Ingested poison may be corrosive which include
acids & alkaline.
Acids-toilet cleaners,rust remover
alkaline.,bleach,drain cleaner
Clinical manifestation
Clinical manifestation
Abdominal pain cramping
Nausea ,vomiting& diarrhea
Drowsiness or unconsciousness
Burns, dour or stain around & in mouth
 Assess airway ,breathing,circulation
 Identify the poison
 Obtain blood urine samples for toxicology
screening
screening
 Monitor vital signs and neurologic status
 Monitor fluid & electrolyte imbalance
Supportive care:
 Large-bore IV access& administer o2
 Prevent aspiration by positioning
 Insert an indwelling catheter
b)Minimize absorption:
Administer activated charcoal with
b)Minimize absorption:
 Administer activated charcoal with
cathartic ( laxative) which is a substance
that eases defecation, usually by
softening feces.
 To induce emesis the action or process
of vomiting.
A large tube is inserted through the mouth or nose
into the stomach. Gastric lavage is a
gastrointestinal decontamination technique that
aims to empty the stomach of toxic substances by
aims to empty the stomach of toxic substances by
the sequential administration and aspiration of
small volumes of fluid via an orogastric tube.
Toxicants are removed by flushing saline solutions
into the stomach, followed by suction of gastric
contents.
It is the inhalation of the products of
incomplete hydrocarbon combustion.
Clinical manifestation :
Clinical manifestation :
Headache,dizziness&visual changes
Nausea ,vomiting&muscle weakness
Unconsciousness
Chest pain,respiratory&cardiac arrest
 Assess airway&breathing
 Assess level of consciousness
 Assess vital signs
 Assess vital signs
 Assess complaints of headache, muscular
weakness, dizziness
 Obtain blood samples for
carboxyhemoglobin levels
 Inspect skin
 Continuous ECG monitoring
 Correct acid-base & electrolyte abnormalities
 Monitor vital signs.
 Provide 100% oxygen by mask
 Provide 100% oxygen by mask
 Intubate if necessary to protect the airway
 Oxygen is antidotal for carbon monoxide
poisoning and will also help enhance elimination.
Continue oxygen until signs resolve or
carboxyhemoglobin levels are less than 4%.
Insects stings or bites are injected poisons that can
produce either local or systemic reactions
Clinical manifestations:
Pain,erythema ( presenting as a rash ) & edema
Pain,erythema ( presenting as a rash ) & edema
at site.
Anaphylactic reactions may produce
unconsciousness, laryngeal edema &
cardiovascular collapse.
 Assess airway ,breathing,&circulation
 Obtain history of insect sting, previous exposure
& allergies
 Inspect skin for local reaction
 Monitor blood pressure &respiratory status
Interventions
Interventions
 administer bronchodilator& oral anti-histamine.
 Apply ice packs to site & elevate the extremity.
 Administer tetanus prophylaxis.
 Clean the wound
Toxic effects occurs when a drug is taken in a larger
dose than normal dose.
Assessment
 Assess respiration
 Assess level of consciousness
 Assess level of consciousness
 Assess vital signs & perform neurologic survey.
 Do physical examination.
Intervention
 Attain control over airway,ventilation &
oxygenation.
 Administer IV fluids & O2
 Give drug antagonist &50%dextrose
IV
 Administer activated charcoal
 Induce vomiting
 Induce vomiting
 Do gastric lavage if unconscious
 Take rectal temperature
 Catheterize the patient.
 Anticipate the complications
Clinical manifestation
▪ Slow pulse& shallow or irregular breathing
▪ Slow pulse& shallow or irregular breathing
▪Confusion,weakness& exhaustion
▪Nausea,vomiting&diarrhea
▪Headache,cold sweating
▪ Unconsciousness
 Maintain airway ,breathing circulation
 Administer atropine as antidote
 Administer activated charcoal
 Do gastric lavage
 Do gastric lavage
 Do Suctioning
 Administer IV fluids ,O 2
 Catheterize the patient.
Assessment
f)Food poisoning
Assessment
 Obtain history from patient or family
 Collect food, gastric content, vomits, serum for
examination
 Assess patient’s vital signs
 Assess fluid & electrolyte imbalance
 Monitor vital signs
 Maintain fluid& electrolyte balance
 Administer anti emetic medication
 Institute measures to support respiratory
 Institute measures to support respiratory
system
 food poisoning, which include replacing lost
fluids and electrolytes and some medicines.
The plan of management is to provide
supportive care, prevention of poison
absorption, use of antidote wherever is
indicated, and enhancement of elimination
indicated, and enhancement of elimination
techniques.
To check the ABCDE
Poisoning can cause short-term effects,
like a skin rash or brief illness. In serious
cases, it can cause brain damage, a
cases, it can cause brain damage, a
coma, or death.
POISIONING JUN 2023

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POISIONING JUN 2023

  • 1. POISONING PRESENTED BY: - Mr. OM VERMA ASSOCIATE PROFESSOR
  • 2. Poisonings are either accident or intentional accidental . poisoning occur more common in the emotional or unintentional event and also in the age of unintentional event and also in the age of pediatric age group, where as intentional poisoning are more frequent in the adolescence and adult population. Poisoning can also occur from injected venom such as snake or insect bites.
  • 3. According to Philliph – “A poison is a chemical agent capable of producing harmful effects of the biological system .” the biological system .” According to the AND – “ A substance that causes injuries , illness, or death , especially by chemical means.”
  • 4. Poisoning is injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases. Many substances — such as drugs gases. Many substances — such as drugs and carbon monoxide — are poisonous only in higher concentrations or dosages. ACCORDING TO LIPPEN COTT
  • 5. A poison is any substance that is harmful to Human body.The effects of poisoning range from short-term of poisoning range from short-term illness to brain damage, coma, and resulting death ACCORDING LUCKMANS
  • 7. Medications are the most common cause of poisoning and are responsible for more than half of all cases. The medications most commonly linked to poisoning are: Paracetamol Aspirin Tricyclic antidepressants Tricyclic antidepressants Selective serotonin reuptake inhibitors Beta-blockers Calcium-channel blockers Benzodiazepines Opioids However, all medications have the potential to be harmful if taken at too high a dose or taken by someone who has not been prescribed them, such as a child.
  • 8. Food can sometimes cause poisoning if: It becomes contaminated with bacteria from raw meat from raw meat It has not been prepared or cooked properly Unhygienic food intake
  • 9. Illness caused by food contaminated with bacteria, viruses, parasites or toxins. Infectious organisms or their toxins are the most common causes of food poisoning. common causes of food poisoning. Food poisoning symptoms may include cramping, nausea, vomiting or diarrhea.
  • 10. occurs when a person breathes in high concentrations of CO2 gas. Normally, CO2 is found in the air at very low concentrations, at around 0.04%.This 2 concentrations, at around 0.04%.This concentration of CO2 is typically harmless to the body. However, certain situations may increase exposure to CO2
  • 11. CMP is a chemical produced from the incomplete burning of natural gas or other products containing carbon.This includes exhaust, faulty heaters, fires, and factory emissions. Anything that burns coal, gasoline, kerosene, oil, resulting Breathing problems, including no breathing, shortness of gasoline, kerosene, oil, resulting Breathing problems, including no breathing, shortness of breath, or rapid breathing Coma Confusion Convulsions Dizziness Carbon monoxide is an odorless gas that causes thousands of deaths each year
  • 12. Exposure to a substance can occur by inhalation, ingestion or direct contact. Inhalation (breathing) of gases, vapors, dusts or mists is a common route of exposure. Chemicals can enter common route of exposure. Chemicals can enter and irritate the nose, air passages and lungs. Excess expose chemical lead the death .
  • 14.
  • 15. poisoning by ingestion refers to oral intake of a harmful substance which even in small substance which even in small amounts can damage tissue disturb body function and causes possible death.
  • 16. Lead poisoning result from consumption of lead in some from lead poisoning is common in lead poisoning is common in children living in area , where they are work shop for repair or old automobiles, lead storage and batteries .
  • 17. Food poisoning mainly occur on consumption of food that is contaminated with contaminated with microorganisms, toxins , or chemical causes for food poisoning.
  • 19. DueToAny Etiological Factors (Carbon Monoxide Poisoning May Occur As A Result Of Industrial Or Household IncidentsOr Attempted Suicide). Carbon Monoxide BindTo Circulating HemoglobinAnd Carbon Monoxide BindTo Circulating HemoglobinAnd Thereby ReducingThe Oxygen-Carrying Capacity Of The Blood. Carbon Monoxide – Bound Hemoglobin, Called Carboxyhemoglobin, .Decrease Transport Oxygen. ReducesOxygenationToVital Organs
  • 20. lung CNS CVS G.I . . Respiratory Confusion failure Dizziness Weakness Altered G.I headache DEATH
  • 21. Vomiting Abdominal pain Headache Sign of shock Difficulty inbreathing Difficulty inbreathing Loss of consciousness Some poisons enlarge the pupil , Some result in excessive drooling , while other dry the mouth and skin. Increased heart rate Usual odor in breath. Burn around the mouth
  • 22. CLINICAL MANIFESTATION: A person suffering from carbon monoxide poisoning appears intoxicated (from cerebral hypoxia). Other symptoms include: Headache. Headache. Muscular weakness. Palpitation. Dizziness. Mental confusion which can progress rapidly to coma. Skin color range from pink or cherry red to cyanotic and pale.
  • 24. Ingested poison may be corrosive which include acids & alkaline. Acids-toilet cleaners,rust remover alkaline.,bleach,drain cleaner Clinical manifestation Clinical manifestation Abdominal pain cramping Nausea ,vomiting& diarrhea Drowsiness or unconsciousness Burns, dour or stain around & in mouth
  • 25.  Assess airway ,breathing,circulation  Identify the poison  Obtain blood urine samples for toxicology screening screening  Monitor vital signs and neurologic status  Monitor fluid & electrolyte imbalance
  • 26. Supportive care:  Large-bore IV access& administer o2  Prevent aspiration by positioning  Insert an indwelling catheter b)Minimize absorption: Administer activated charcoal with b)Minimize absorption:  Administer activated charcoal with cathartic ( laxative) which is a substance that eases defecation, usually by softening feces.  To induce emesis the action or process of vomiting.
  • 27. A large tube is inserted through the mouth or nose into the stomach. Gastric lavage is a gastrointestinal decontamination technique that aims to empty the stomach of toxic substances by aims to empty the stomach of toxic substances by the sequential administration and aspiration of small volumes of fluid via an orogastric tube. Toxicants are removed by flushing saline solutions into the stomach, followed by suction of gastric contents.
  • 28. It is the inhalation of the products of incomplete hydrocarbon combustion. Clinical manifestation : Clinical manifestation : Headache,dizziness&visual changes Nausea ,vomiting&muscle weakness Unconsciousness Chest pain,respiratory&cardiac arrest
  • 29.  Assess airway&breathing  Assess level of consciousness  Assess vital signs  Assess vital signs  Assess complaints of headache, muscular weakness, dizziness  Obtain blood samples for carboxyhemoglobin levels  Inspect skin
  • 30.  Continuous ECG monitoring  Correct acid-base & electrolyte abnormalities  Monitor vital signs.  Provide 100% oxygen by mask  Provide 100% oxygen by mask  Intubate if necessary to protect the airway  Oxygen is antidotal for carbon monoxide poisoning and will also help enhance elimination. Continue oxygen until signs resolve or carboxyhemoglobin levels are less than 4%.
  • 31. Insects stings or bites are injected poisons that can produce either local or systemic reactions Clinical manifestations: Pain,erythema ( presenting as a rash ) & edema Pain,erythema ( presenting as a rash ) & edema at site. Anaphylactic reactions may produce unconsciousness, laryngeal edema & cardiovascular collapse.
  • 32.  Assess airway ,breathing,&circulation  Obtain history of insect sting, previous exposure & allergies  Inspect skin for local reaction  Monitor blood pressure &respiratory status Interventions Interventions  administer bronchodilator& oral anti-histamine.  Apply ice packs to site & elevate the extremity.  Administer tetanus prophylaxis.  Clean the wound
  • 33. Toxic effects occurs when a drug is taken in a larger dose than normal dose. Assessment  Assess respiration  Assess level of consciousness  Assess level of consciousness  Assess vital signs & perform neurologic survey.  Do physical examination. Intervention  Attain control over airway,ventilation & oxygenation.
  • 34.  Administer IV fluids & O2  Give drug antagonist &50%dextrose IV  Administer activated charcoal  Induce vomiting  Induce vomiting  Do gastric lavage if unconscious  Take rectal temperature  Catheterize the patient.  Anticipate the complications
  • 35. Clinical manifestation ▪ Slow pulse& shallow or irregular breathing ▪ Slow pulse& shallow or irregular breathing ▪Confusion,weakness& exhaustion ▪Nausea,vomiting&diarrhea ▪Headache,cold sweating ▪ Unconsciousness
  • 36.  Maintain airway ,breathing circulation  Administer atropine as antidote  Administer activated charcoal  Do gastric lavage  Do gastric lavage  Do Suctioning  Administer IV fluids ,O 2  Catheterize the patient.
  • 37. Assessment f)Food poisoning Assessment  Obtain history from patient or family  Collect food, gastric content, vomits, serum for examination  Assess patient’s vital signs  Assess fluid & electrolyte imbalance
  • 38.  Monitor vital signs  Maintain fluid& electrolyte balance  Administer anti emetic medication  Institute measures to support respiratory  Institute measures to support respiratory system  food poisoning, which include replacing lost fluids and electrolytes and some medicines.
  • 39. The plan of management is to provide supportive care, prevention of poison absorption, use of antidote wherever is indicated, and enhancement of elimination indicated, and enhancement of elimination techniques. To check the ABCDE
  • 40. Poisoning can cause short-term effects, like a skin rash or brief illness. In serious cases, it can cause brain damage, a cases, it can cause brain damage, a coma, or death.