This document provides information about poisoning, including the different ways poisons can enter the body, general signs and symptoms of poisoning, and pre-hospital treatment steps. It discusses ingested, inhaled, absorbed, and injected poisons specifically. Snake bites and their treatment are covered, as well as information on alcohol and drug abuse. The document also outlines the process for making antivenom.

1. POISONING
LEC BY- INSP VIJAY KUMAR
NDRF ACADEMY, NAGPUR
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2. OBJECTIVES
Upon completion of this topic you will be able to know
about:
 Poison and its Signs and symptoms and Pre hospital
treatment.
 Four specific signs and symptoms of Ingested poison
 Four specific signs and symptoms of Inhaled poison
 Four specific signs and symptoms of Absorbedpoison
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3. OBJECTIVES
• The Signs & Symptoms Of Injected poison, Including Snake
Bites And Steps For Pre hospital treatment
• Signs & symptoms for Alcohol abuse and steps for Pre hospital
treatment
• Signs & symptoms for Drug abuse & steps for Pre hospital
treatment
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4. POISON
A poison, is any substance that is harmful to our body.
• Any substance can be poisonous if too much is taken.
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5. POISON CAN ENTER IN BODY
BY FOUR WAYS:
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6. General Signs & Symptoms Of Poisoning
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7. 7IVKG3 May 2019

8. Ingested Poison
An ingested poison is that which is introduced into the
digestive tract by means of the mouth.
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9. Signs And Symptoms Of Ingested
Poisons
• Diaphoresis (excessive sweating)
• Burns, swelling around the mouth
• Excessive salivation or foaming from the mouth
• Abnormal breathing
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10.  Give the patient one or two glasses of water to dilute the
poison.
 Induced vomiting is contraindicated in poisoning with
hydrocarbons, strong acids and alkalis.
 As per local protocol, give the patient activated charcoal
– 2 or 3 spoonful's in eight ounces of water.
(1 ounce = 28.35 grams)
PHT For Ingested Poisons
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11.  Bring the suspected source; container, labels, or
other evidence of the poison to the hospital.
 Treat for shock.
 Continually monitor the patient.
 Transport the patient.
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12. Inhaled Poisons
“Though it is important to give care immediately,
do not enter the scene unless you are sure, it is
safe”
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13. About Inhaled Poisons
• Caused by fumes and vapours.
• The body absorbs inhaled poisons very rapidly.
• You may need to use special masks to gain access to the
patient in a hazardous environment.
• Additional expert help may be required.
• Signs and symptoms of inhaled poisoning is more related
to the respiratory system 13IVKG3 May 2019

14. Signs and symptoms for Inhaled Poisons
- Fever
- Cough
- Nausea/vomiting
- Joint pain
- Headache
- Chest pain
- Shortness of breath
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15. Absorbed Poisons
• An absorbed poison is one that enters the body through contact with
the skin.
• Examples of natural sources include poison ivy, poison sumac and
poison oak.
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16. • Man-made sources include corrosives, insecticides,
herbicides and cleaning agents.
herbicides insecticides 16IVKG3 May 2019

17. Signs And Symptoms Of Absorbed Poisons
• History of exposures
• Liquid or residue on the skin
• Itching or irritation
• Rash or blisters
• Signs and symptoms of absorbed poisons
are more related to skin involvement. 17IVKG3 May 2019

18. Pre Hospital Treatment For
Poisoning
• Use universal precaution.
• Remove patient’s clothing
• Blot the poison from the skin with a dry
cloth. If the poison is a dry powder, brush it
off.
• Flood the affected area with copious
amounts of water until EMS arrives. 18IVKG3 May 2019

19. • Maintain open airway. Administer oxygen if
needed as per local protocol.
• Perform initial assessment. Do not perform
mouth to mouth ventilation in ingested or
inhaled poison cases. Use the BVM.
• Call your local poison control centre, if
available.
• Perform physical exam. 19IVKG3 May 2019

20. Injected Poisons
• An injected poison enters the body through a
break in the skin.
• The break can be caused by a needle (drugs), an
insect bite or sting. 20IVKG3 May 2019

21. Signs And Symptoms Of Injected Poisons
• Needle tracks
• Pain, swelling, or redness at the injection site
• History of bites or stings
• Bite mark or stinger embedded in the skin
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22. Pre-hospital treatment for injected
poisons
Use universal precautions and secure the scene.
1. Maintain open airway.
2. Administer oxygen, if needed. Be alert for possible
vomiting.
3. Protect yourself and the patient from repeated injections.
Cut off patient’s clothing to protect from possible
repeated insect stings or bites. 22IVKG3 May 2019

23. 4. For BEE stings:
• Remove the stinger together with the poison sac.
• Use a plastic card and scrape the skin’s surface to keep
the sac from breaking inside the patient’s skin.
• Place a bag of ice or cold pack on the sting.
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24. 5. Bring all containers, labels, or other evidence of poisoning to
the hospital.
6. Conduct a physical exam.
7. Treat for shock.
8. Continually monitor the patient during transport.
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25. Snake Bites
• These are quite common in certain areas. Signs
and symptoms may delay several hours before
presenting.
• Death can occur quickly if the patient has an
allergic reaction to the venom.
“Treat all snake bites as poisonous”
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26. Signs And Symptoms Of Poisonous
Snake Bites
• Nausea and vomiting
• Weakness, paralysis
• Seizures, decreased level of consciousness
• Puncture wound
• Pain or burning sensation around the bite mark
• Blood oozing from the bite mark
• Discoloration and swelling 26IVKG3 May 2019

27. Pre-hospital Treatment For Snake
Bites:
1. Use universal precautions and secure the scene.
2. Move the patient to a safe place.
3. Calm the patient and try to place him/her in a comfortable
position.
4. Locate the bite marks and stabilise.
5. Remove rings, bracelets and any restrictive garments from
the affected extremity.
6. Do not apply tourniquets, do not make incisions around the
bite marks, and do not suction the venom from the wound.
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28. 7. Treat for shock and provide basic life support as
needed.
8. Do not give the patient any food or drink.
9. If possible, capture the snake for species
identification.
10. Administer oxygen per local protocol.
11. Continually monitor the patient during transport.28IVKG3 May 2019

29. ANTIVENOM
• Making antivenom is a painstaking, resource-intensive,
time-consuming process. In the 1890s Albert Calmette,
was living in Vietnam when a flood forced enter into a
village near Saigon, and monocled cobras comes out to
their places, they bite at least 40 people and killed four.
• The first antivenom for snakes (called an anti-ophidic
serum) was developed by Albert Calmette a French
scientist of the Pasteur Institute working at
its Indochine branch in 1895, against the Indian
Cobra (Naja naja).
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30. • By 1896 Calmette had discovered the process of
injecting horses with venom until they produced
antibodies, taking the serum out of their blood and
injecting it into snake-bitten humans as antivenom.
• In 1901, Vital Brazil working at the Instituto
Butantan in São Paulo, Brazil, developed the first
monovalent(when they are effective against a single
species' venom) and polyvalent(when they are effective
against a range of species, or several different species
at the same time) antivenoms for Central and South
American Crotalus and Bothrops snakes, as well as for
certain species of venomous spiders, scorpions,
and frogs.
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31. • In Australia, the Common wealth Serum
Laboratories (CSL) began antivenom research in the
1920s. CSL has developed antivenoms for the
redback spider, funnel-web spiders and all deadly
Australian snakes.
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32. How to Differentiate Between
Poisonous Snakes and Non
Poisonous Snakes• Look at the head. Most venomous snakes usually have
triangular shaped heads.
• Observe the colors. Some venomous snakes have
bright colors.
• Many people will try to judge if a snake is venomous
by looking into its eyes. Some of the most venomous
snakes in the world have round pupils, but many
infamous snakes such as rattlesnakes have the classic
slitted (weird rectangular) pupil. 32IVKG3 May 2019

33. • Look for a pit between the snake's eyes and
nostrils. A venomous snake normally has a heat-
sensitive pit there to locate warm-blooded prey.
Non-venomous snakes lack such pits.
• See if there is a rattle. A snake with a rattle on its
tail must be a rattlesnake, which is venomous. The
Florida Pygmy Rattlesnake often only has one
segment of rattle and thus cannot make a warning
noise.
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34. • Notice the underside scales on the tip of the
tail. Most venomous snakes have one row of scales
there while non-venomous snakes usually have two
rows.
• Check the bottom of the tail if you can. The bottom
of the tail (behind the anus) of venomous snakes
looks the same as the rest of the belly. If the snake
has a cross pattern (like a diamond shape) it is non-
venomous. However, this may not be easy to find
out, unless the snake is dead.
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35. • Watch water snakes swim. Only venomous water
snakes swim with their entire bodies visible on the
water.
• Examine the bite marks in case of a snake
attack. Two close-set puncture marks would
indicate that the snake has fangs and is venomous.
By contrast, a ragged bite mark means the snake
lacks fangs which is a characteristic only of non
venomous snakes.
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36. STEPS FOR MAKING ANTIVENOM
Step 1: Milking The Venom
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37. Step 2: Cooling Down and Labeling
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38. Step 3: Choosing an Animal for Immunization
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39. Step 4: Immunizing
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40. Step 5: Purifying
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41. Step 6: Human Use
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42. • Alcohol is a drug with wide social acceptance when
ingested everyday.
• Abuse of this drug leads to alcoholism and serious
chronic intoxication with great physical and mental
decay.
• A patient under the influence of alcohol can be
dangerous to him/herself and to others.
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43. Signs And Symptoms Of Alcohol Abuse
• Smell of alcohol on the breath and/or clothes.
• Staggering(walk or move unsteadly, as if about to fall)
• Slurred speech
• Nausea and vomiting
• Redness of the face
• Altered behaviour 43IVKG3 May 2019

44. Pre-hospital treatment for alcohol abuse
• Use universal precautions and secure the scene. Persons
with alcohol poisoning can hurt others or themselves.
• Verify whether it is strictly a case of alcohol abuse.
• Per local protocol, allow EMS decide if police intervention
is required. 44IVKG3 May 2019

45. • Monitor vital signs and stay alert for breathing problems.
• Be alert for vomiting and take steps to prevent aspiration.
• Protect the patient from injury without using restrictive
means.
• Give oxygen per local protocol.
• Transport the patient. 45IVKG3 May 2019

46. Drug Abuse
• It is not necessary for the rescuer to know the specific names and the effects
of each one of the drugs, but the medical first responder should have the
ability to identify a possible case of drug abuse.
The five types of frequently abused drugs are:
1. Stimulants: These stimulate the central nervous system, causing the
user to become excited.
• This group of drugs includes amphetamine, cocaine, caffeine, asthmatic
drugs. 46IVKG3 May 2019

47. Stimulants:
These stimulate the central nervous system, causing
the user to become excited.
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48. 2. Depressant:
Any of a class of a drugs that act as depressants of
the central nervous system and are used as sedatives
or hypnotics. Organic compound having powerful
effect; overdose can be fatal.
As diazepam, bromazepam, methaqualone and anti
convulsants.
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49. 3. Analgesic narcotics (opium-derivatives):
Their use produces an intense state of relaxation.
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50. • Some are easily obtainable, such as codeine found in
cough syrups. Morphine, heroin belong to this
group of drugs.
• These drugs reduce body temperature, slow the
pulse and breathing, relax the muscles, and cause
pupil dilation, drowsiness, and sluggishness. 50IVKG3 May 2019

51. 4. Hallucinogens:
These drugs alter personality and distort perception.
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52. • Marijuana also has some hallucinogenic properties.
• Patients often imagine hearing unusual sounds and
seeing strange colours.
• Persons using hallucinogens can become aggressive
and pose a threat to you, others, and themselves.
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53. 5.Volatile chemicals:
The vapours of certain chemical substances cause
excitement, euphoria or the sensation of flying.
• In general these chemicals are solvents, cleaning
fluids, glues and gasoline.
• The effects are temporary loss of reality, loss of the
sense of smell, accelerated pulse and breathing. 53IVKG3 May 2019

54. Signs And Symptoms Of Drug Abuse
• Excitability
• Drowsiness and slow reflexes
• Reduced pulse and breathing
• Accelerated pulse and breathing
• Relaxed muscles
• Constricted or dilated pupils
• Aggressive behaviour
• Euphoria 54IVKG3 May 2019

55. Pre-hospital treatment for drug abuse
• Use universal precautions and secure the scene. When
speaking with the patient, be tactful and ask directly if
he/she is taking any “Medication”.
• Provide Basic Life Support.
• Induce vomiting if the patient is conscious and if the
overdose was taken orally within the last 30 minutes.
• If the patient is hyperactive, apply restraints to prevent self-
injury and injury to others.
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56. • Speak with the patient to win his/her trust and to
monitor level of consciousness.
• Monitor the patient’s breathing carefully because
sedatives can cause slow breathing and lead to
possible respiratory arrest.
• Comfort the patient and provide emotional support.
• Watch for allergic reactions. 56IVKG3 May 2019

57. • Keep all evidence of drug abuse.
• Call your local poison control centre, if available.
• Administer oxygen per local protocol.
• Transport the patient.
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60. EVALUATION
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