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Poisoning I . De f in i t i on A poison is any substance ( s o l i d , l i q u i d , or gas) that tends to impair health or cause death when introduced in to the body. Poi- soning may occur w i th excessive amounts of medications or other sub- stances not o rd i na r i l y considered poisons. I I . Causes Small ch i ldren are especia l ly l i k e l y to become poisoning vict ims since they tend to put nearly everything they pick up in to t h e i r mouths. However, poisoning is a common problem in adu l ts , as w e l l . A. Frequent causes o f poisoning are: 1. Medicines l e f t w i th in reach of ch i ld ren . Aspir in is a common cause of poisoning in ch i ld ren. 2. Improper storage or disposal o f poisonous sub- stances. For example, poisons transferred from or ig ina l containers to ja rs or so f t dr ink bot t les are p a r t i c u l a r l y hazardous, since they may be i n - gested by accident. 3. Poisonous substances l e f t around, even fo r " j u s t a minute," are p a r t i c u l a r l y hazardous where chi ldren
can get at them. 4. Improper handling of spray equipment, inc luding the mixing of pes t ic ides , insec t i c ides , and weed k i l l e r s , 5. Poisonous v o l a t i l e substances used in enclosed or poorly vent i la ted areas. 6. Poisonous substances stored in medicine cabinets or food cabinets, where they may be taken by mistake. 7. Overdoses of medications taken accidenta l ly or wi th su ic ida l i n t en t . 8. Combination of medications, pa r t i cu l a r l y t r a n q u i l i z - ers or sedatives, wi th a lcohol . B. Poisonous substances are extremely common in the home. A few typ ica l household poisons are l i s t e d below: 1. Cosmetics, ha i r preparat ions. 2. Gasoline, kerosene, other petroleum products. 3. Paint , turpent ine. 4. Strong detergents. 5. Bleaches. 6. Cleaning so lu t ions. 7. Lye, drain cleaners. 8. Glue. 9. Ant i f reeze, 10. Ammonia
11. Acids. 12. Poisonous p lan ts , such as mountain l a u r e l , rhododen- dron, oleander, a var ie ty o f w i ld cher r ies , n igh t - shade, foxglove, non-edible mushrooms. C. Poisonous substances may enter the body through: 1 . Swallowing. 2. Absorption through sk in , eyes, and l in ings of the mouth, nose, anal canal , and geni ta l organs. 3. Inha la t ion. 4. I n j ec t i on . I I I . Prevention A. Keep medications and household products locked up and out o f the reach of ch i ld ren . B. Ask fo r and use safety l i d s or closures on containers of medications and other po ten t ia l l y dangerous products. C. Keep products in t he i r o r ig ina l containers and well labeled. Use the poison symbol to i den t i f y hazardous substances. D. When taking medications, make sure there is s u f f i c i e n t l i g h t to read the labe ls . E. Shelve and otherwise locate medications away from food- s t u f f s . F. Parents should always ca l l "medicine" j u s t t h a t , and not candy.
- 4 - G. Potent ia l l y dangerous v o l a t i l e substances should only be used in wel l vent i la ted areas. IV. Poisoning by Mouth A. Signs and Symptoms of Poisoning by Mouth The symptoms of poisoning vary g rea t ly . Suspicion that a person has swallowed a poisonous substance may be based on: 1 . Information from the v ic t im or from an observer. 2. Presence of a container known to contain a po i - sonous substance. 3. Sudden onset of pain or i l l n e s s . 4. Burns around the l i p s or mouth. 5. Chemical odor on the breath. 6. Pupils of the eyes contracted to pinpoint or un- usually d i l a t e d . B. F i r s t Aid fo r Poisoning by Mouth 1 . Conscious v i c t im . a. Di lu te the poison by having the v ic t im drink a glass of water or m i l k , i f the v ic t im is conscious and not having convulsions. b. Save the label or container of the suspected poison fo r i d e n t i f i c a t i o n . I f the v ic t im vomits, a sample o f the vomited material should be saved fo r analys is .
c. Seek medical assistance by ca l l i ng the poison control center or physic ian. (The poison con- t r o l center number fo r your region should be posted on your phone. I f you do not have the number, d ia l 0 or 911.) d. I f the v ic t im becomes unconscious, keep his a i r - way open. A r t i f i c i a l ven t i l a t i on or Cardiopulmonary Resuscitation (CPR) should be given, i f ind icated. An emergency squad should be cal led as soon as possible. 2. Unconscious v i c t im . a. Maintain an open airway. b. Call f o r an emergency squad as soon as possible. c. Administer a r t i f i c i a l ven t i l a t i on and CPR, i f ind icated. d. Save container of a suspected poison. e. I f pat ient vomited, save a sample of the vomited mater ia l . f . Do not give f l u i ds to an unconscious person. g. Do not induce vomiting in an unconscious person. I f the person is vomit ing, pos i t ion the person and turn the head so that the material drains out of the mouth.
3. Vict im having convulsions. a. Call fo r an emergency squad as soon as possible. b. Do not attempt to res t ra in the v i c t im , but po- s i t i o n him in such a manner that he w i l l not in ju re himself by knocking against f u rn i t u re or other objects . c. Loosen t i g h t c lo th ing at the v i c t im 's neck and waist . d. Watch fo r an obstruct ion of the airway and a t - tempt to correct i t by head pos i t ion ing , i f necessary. Give a r t i f i c i a l resp i ra t ion and CPR, i f ind icated. e. Do not force a hard object or f inger between the v i c t im 's tee th . f . Do not give any f l u i d s . g. Do not induce vomit ing. I f the v i c t im is vomit- i ng , pos i t ion him so that material drains from the mouth. h. A f te r the convulsion, turn the v i c t im on his s ide , or place him in a prone pos i t ion wi th head turned to allow f l u i ds to drain from the mouth.
NOTES 1 . A l l households should have on hand Syrup of Ipecac, Act ivated Charcoal, and Epsom Salts fo r deal ing w i th incidents of poisoning by mouth. Syrup of Ipecac is used to induce vomit ing; act ivated charcoal to bind the poisonous substances; and epsom sal ts work as a l a x a t i v e . * These products should be used only upon the advice and ins t ruc t ion of the poison control center or phys ic ian** When Syrup of Ipecac is not ava i l ab le , vomiting may be induced by t i c k l i n g the back of the throat wi th a f inger or the blunt end of a spoon, fork or kn i f e . 2. No attempt should be made to neut ra l i ze swallowed po i - sons w i th vinegar or lemon j u i c e . This may cause fu r ther harm to the v i c t i m . Do not give o l i ve o i l or other o i l s . They are o f no proven value in the treatment of poisoning by mouth and may cause harm i f inhaled in to the lungs. 3. I t may be inadvisable to induce vomiting in v ict ims who have swallowed a strong ac id , strong a l k a l i or petroleum product^*** * Recommended dosages are: Syrup of Ipecac - one tab!espoonful f o r ch i ld ren and two tablespoonsful fo r adu l t s ; Act ivated Charcoal - one to two tablespoonsful mixed in a glass of water; Epsom Salts - one tablespoonful mixed in a glass of sweet l i q u i d fo r adults and smaller doses fo r ch i l d ren . * * See footnote nej<t page * * * Many l i q u i d t o i l e t bowl cleaners are strong ac ids. Draino Con- centrated Crystal Drain Opener, Draino L i q u i d , Easy Off Oven Cleaner, Liquid Plum'r and Lewis Lye are examples o f strong a l - k a l i s . Gasoline and Kerosene are examples o f petroleum products.
Burns around the v i c t im 's l i p s or mouth, or a charac te r i s t i c odor of kerosene or gasoline are of value in determining whether such pro- ducts have been swallowed. Vomiting should only be induced upon the advice o f a poison control center or phys ic ian . * 4 . Certain petroleum products contain heavy metals, p e s t i - c ides, or chlor inated solvents that are very tox ic i f absorbed in to the blood stream. When such products are swallowed, a phy- s ic ian may suggest the induct ion of vomiting i f the v i c t im has a good gag r e f l e x , no central nervous system depression, and is breathing normally. Petroleum products such as mineral o i l or petroleum j e l l y general ly contain no such tox ic components. 5. There is s t i l l controversy among au tho r i t i es regarding the value of d i l u t i ng ,by having the v i c t im dr ink water or m i l k , when l i q u i d caust ics , p a r t i c u l a r l y strong a l k a l i s , have been swallowed. I t is f e l t by some that since the damage is immediate (wi th in 30 seconds) and progressive, that d i l u t i o n is of no real value and that d i l u t i o n may st imulate the v ic t im to vomit and thereby cause more damage. 6. The ins t ruc t ions on product labels fo r the spec i f i c treatment of poisoning caused by the product may be wrong. Spe- c i f i c ant idotes should only be administered on the advice of the poison control center or physic ian. * I f the poisoning inc ident occurs in a s i t ua t i on where a phone i s = not ava i lab le ( e . g . , camping) or i f , fo r some other reason, a po i - son contro l center or physician cannot be reached, then vomiting should be induced only i f 1) the v i c t im has ingested an overdose of drugs or medications; or 2) i t is cer ta in that a non-corrosive agent O - G . , nei ther a strong acid nor a l k a l i ) has been ingested. In such s i t ua t i ons , the v i c t im should be taken to a medical f a - c i l i t y as soon as possib le.
7. Eye Exposure Many substances which come in contact wi th the surface of the eye can cause chemical burns, a l l e r g i c react ions, inf lammation, or be absorbed through the eyes. Any substance splashed in to the eye should be flushed out immediately wi th water. Lukewarm water should be poured gently in to the eye from a container held two to three inches above the eye, fo r about 15 minutes. Adults may use a shower to wash out the eyes. The poison center or a physician should be ca l led fo r addi t ional advice. 8. Skin Exposure I f a chemical or tox ic substance is sp i l l ed on the sk i n , i t may cause chemical burns, an a l l e r g i c reac t ion , inf lammation, or be absorbed through the sk in . Clothing should be removed and the area of the skin washed wi th large amounts o f water. The poison control center or a physician should be cal led fo r addit ional ad- v i c e . * * The fo l lowing is recommended for carbol ic acid s p i l l s on the sk in . Copious amounts of running water, or o l i ve o i l or cas- to r o i l should be used to wash the af fected area. I t i s not recommended that rubbing alcohol be used as a f i n a l r inse fo r carbol ic acid burns of the sk in . (This spec i f i c recommenda- t ion is made because the American National Red Cross asked that advice on th i s matter found on page 142 in the current Advanced F i r s t Aid and Emergency Care manual be examined.)
