Chapter 16: Poisoning

1
Chapter 16 Poisoning
2
Introduction

• A poison is any substance that can cause injury,
  illness or death when introduced into the body.
• Poisoning is considered a sudden illness.
• Between 1 and 2 million poisonings occur each
  year in the United States.
• More than 90 percent of all poisonings take place
  in the home.

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Poisoning

• Activity
• How Poisons Enter the Body
• Inhalation
• Ingestion
• Absorption
• Injection

4
Checking the Scene

• Often, the scene itself is the best clue that a
  poisoning may have occurred. Factors to notice
  include
• Unusual odors.
• Flames or smoke.
• An open medicine cabinet.
• Open or spilled containers.
• Overturned or damaged plants.
• Drug paraphernalia or empty containers.

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Signals of Poisoning

• The signals of poisoning include
• Nausea or vomiting.
• Diarrhea.
• Chest or abdominal pain.
• Trouble breathing.
• Sweating.
• Changes in consciousness.
• Seizures.
• Headache.

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Signals of Poisoning(continued)

• Dizziness.
• Weakness.
• Irregular pupil size.
• Burning or tearing eyes.
• Abnormal skin color.
• Burn injuries around the lips or tongue.

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Care for Poisoning

• The severity of a poisoning depends on
• The type and amount of poison.
• How and where the poison entered the body.
• The time elapsed since the poisoning.
• The victims size, weight, medical condition and
  age.

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Care for Poisoning(continued)

• General guidelines of care for any poisoning
  emergency
• Check the scene.
• Check for life-threatening conditions. Call 9-1-1
  or the local emergency number if the victim is
  unconscious or is having trouble breathing.
• If the victim is conscious, ask questions.
• What type of poison did the victim ingest,
  inhale, inject or come into contact with?
• How much poison did the victim ingest, inhale,
  inject or come into contact with?
• When did the poisoning take place (approximate
  time)?

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Care for Poisoning(continued)

• Call the National Poison Control Center at
  [phone] or 9-1-1 or the local
  emergency number.
• Give care as directed by poison control center
  personnel or the EMS call taker.

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Inhaled Poisons

• Poisoning by inhalation occurs when a person
  breathes in toxic fumes.
• The danger associated with inhaled poisons makes
  checking the safety of the scene important.
• Notice clues at the scene
• Unusual odors
• Strong smell of fuel
• Hissing sound
• Call 9-1-1 or the local emergency number from a
  different location. NO CELL PHONES FOR GAS
  LEAKS!!!!!

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Inhaled Poisons

• A commonly inhaled poison is carbon monoxide. It
  is a colorless, odorless gas
• Carbon monoxide exposure can cause death.
• Pale or bluish skin color indicates lack of
  oxygen, which may indicate exposure.
• Emitted from gas combustion, heater/furnaces,
  tobacco smoke, defective cooking equipment
• Death can occur after just a few minutes of
  exposure

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Care for Inhaled Poisons

• All victims of inhaled poison need oxygen ASAP.
• Help a conscious victim by getting him or her to
  fresh air.
• Call 9-1-1 or the local emergency number.
• If you find an unconscious victim
• Remove him or her from the scene if it is safe to
  do so.
• Call 9-1-1 or the local emergency number.
• Give care for any other life-threatening
  conditions.
• Call 9-1-1 or the local emergency number if you
  suspect that fumes are present.

13
Ingested Poisons

• The U.S Centers for Disease Control and
  Prevention (CDC) estimates that 76 million people
  suffer food-borne illnesses each year in the
  United States.
• Two of the most common categories of food
  poisoning are
• bacterial food poisoning
• chemical food poisoning.
• Salmonella is the most common type of food
  poisoning.
• Botulism is the most deadly type of food
  poisoning.

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Signals of food poisoning include

• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Fever
• Dehydration

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Care for Ingested Poisons

• In some cases of ingested poisoning, the Poison
  Control Center may instruct you to induce
  vomiting.
• Only induce vomiting if instructed to do so by a
  medical professional.
• Vomiting should not be induced if the victim
• Is unconscious.
• Is having a seizure.
• Is pregnant (in the last trimester).
• Has ingested a corrosive substance (such as drain
  cleaner or oven cleaner) or a petroleum product
  (such as kerosene or gasoline).
• Is known to have heart disease.

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Absorbed Poisons

• An absorbed poison enters the body after it comes
  in contact with the skin.
• Absorbed poisons come from plants such as poison
  ivy, poison oak and poison sumac, as well as from
  fertilizers and pesticides used in lawn and plant
  care.

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Care for Absorbed Poisons

• To care for a victim who has come into contact
  with a poisonous plant
• Immediately rinse the affected area.
• If a rash or weeping lesion (an oozing sore)
  develops, seek advice from a pharmacist or
  physician.
• If a victims condition worsens, seek a
  physician.
• To care for a victim who has come into contact
  with wet or dry chemicals
• Flush the area continuously with water.
• Call 9-1-1 or the local emergency number.
• If running water is not available, carefully
  brush off any dry chemicals with a gloved hand.

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Injected Poisons

• Injected poisons enter the body through the bites
  or stings of certain insects, spiders, ticks,
  marine life, animals and snakes or as drugs or
  misused medications injected with a hypodermic
  needle.
• Insect and animal bites and stings are the most
  common sources of injected poisons.
• Marine life sting ray!
• Care for injected poisons will be discussed
  later.

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Anaphylaxis

• Severe allergic reactions to poisons are rare.
  But when one occurs, it is a life-threatening
  medical emergency. This reaction is called
  anaphylaxis.
• Anaphylaxis is a form of shock.
• Onset of anaphylaxis can be rapid and the signals
  include
• Swelling and redness.
• Hives.
• Rash.
• Itching.
• Burning skin and eyes.
• Weakness.

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Anaphylaxis(continued)

• Nausea.
• Vomiting.
• Restlessness.
• Dizziness.
• Dilated pupils.
• Slurred speech.
• Chest discomfort or pain.
• Weak or rapid pulse.
• Rapid or trouble breathing.
• Coughing or wheezing.

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Care for Anaphylaxis

• Call 9-1-1 or the local emergency number.
• Place victim in a position of comfort for
  breathing.
• Comfort and reassure the victim.
• People who know they are extremely allergic to
  certain substances may carry an anaphylaxis kit.
• The kit contains a dose of epinephrine that can
  be injected into the body to counteract the
  anaphylactic reaction.
• In some cases, you may need to assist the victim
  in using his or her kit.

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Preventing Poisoning

• By following these guidelines you will be able to
  prevent most poisoning emergencies
• Keep the household products and medications out
  of the reach of children.
• Use childproof safety caps on containers of
  medications and other potentially dangerous
  substances.
• Use special latches and clamps to keep children
  from opening cabinets.
• Keep products in their original containers.
• Use poison symbols to identify dangerous
  substances.

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Preventing Poisoning(continued)

• Dispose of outdated medications and household
  products.
• Use chemicals only in well-ventilated areas.
• Wear proper clothing.
• Immediately wash those areas of the body that may
  have come in contact with a poison.

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Closing

• Poisoning can occur in any one of four ways
  inhalation, ingestion, absorption and injection.
• The severity of a poisoning depends on factors
  such as
• The type and amount of poison.
• How and where the poison entered the body.
• The time elapsed since the poisoning.
• The victims size, weight, medical condition and
  age.
• For suspected poisoning call the national number
  of the Poison Control Center or 9-1-1 or the
  local emergency number.
• Follow the directions of poison control center
  personnel or the EMS call taker.

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Chapter 17 Bites and Stings
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Introduction

• Bites and stings are among the most common forms
  of injected poisonings.
• In this lesson you will learn how to recognize,
  care for and prevent some of the most common
  types of bites and stings from
• Insects.
• Ticks.
• Spiders and scorpions.
• Marine life.
• Snakes.
• Domestic and wild animals.
• Humans.

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Signals of Common Bites and Stings

• Specific signals of common bites and stings
  depend on
• The type and location of the bite or sting.
• The amount of poison injected.
• The time elapsed since the poisoning.
• The victims size, weight, medical condition and
  age.

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Signals of Common Bites and Stings(continued)

• Less severe reactions of bites and stings may
  trigger signals
• A bite or sting mark
• A stinger, tentacle or venom sac
• Redness
• Swelling
• Pain or tenderness
• Severe allergic reactions to bites and stings may
  bring on a life-threatening condition, a form of
  shock known as anaphylaxis.

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Insects

• Between .5 to 5 percent of Americans are severely
  allergic to substances in the venom of bees,
  wasps, hornets and yellow jackets.
• When a highly allergic person is stung, call
• 9-1-1 or the local emergency number
  immediately for medical care.
• For most people, insect stings may be painful or
  uncomfortable but are not life threatening.

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Care for Insects Stings

• To give care for an insect sting
• Examine the sting site.
• If the stinger is still present, remove it to
  prevent any further poisoning.
• Wash the area with soap and water and cover the
  site, then apply ice or a cold pack.
• Observe the victim for signals of allergic
  reaction.

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Ticks

• Ticks can contract, carry and transmit disease to
  humans.
• Rocky Mountain Spotted Fever is caused by the
  transmission of microscopic bacteria from the
  wood tick or dog tick host to other warm-blooded
  animals.
• The main signal of Rocky Mountain Spotted Fever
  is a spotted rash.
• Other signals of Rocky Mountain Spotted Fever
  include
• Fever.
• Chills.
• Severe headache.
• Joint and muscle aches.

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Ticks(continued)

• Lyme disease, or Lyme borreliosis, is another
  illness that people can get from the bite of an
  infected tick.
• The first signal of Lyme disease is a rash.
• Other signals of Lyme disease include
• Fever and chills.
• Headache.
• Weakness or fatigue.
• Flu-like joint and muscle aches.

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Ticks(continued)

• In advanced stages, Lyme disease may cause
• Arthritis.
• Numbness.
• Memory loss.
• Vision or hearing problems.
• High fever.
• Stiffness in the neck.

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Protection From Tick Bites

• To protect yourself from tick bites
• Wear repellent and proper clothing.
• Check and clean your clothes thoroughly after
  having been in wooded areas.
• Use precautions when removing a tick.

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Care for Tick Bites

• Remove the embedded tick.
• Do not try to burn the tick off.
• Do not apply petroleum jelly or nail polish to
  the tick.
• Place the tick in a sealable container for
  analysis.
• If you cannot remove the tick or parts remain,
  get medical care.
• Wash the bite area with soap and water.
• Apply antiseptic or antibiotic ointment.
• Wash your hands.

36
Spider Bites

• Few spiders in the United States have venom that
  can cause death.
• Two spiders that can cause illness and
  occasionally death are the
• Black widow spider.
• Brown recluse spider.
• Bites usually occur on the hands or arms.

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Spider Bites(continued)

• A black widow spider bite usually causes a sharp
  pinprick pain followed by a dull pain in the area
  of the bite.
• Other signals of this spider bite include
• Muscular rigidity.
• Restlessness.
• Anxiety.
• Profuse sweating.
• Weakness.
• Drooping eyelids.

38
Scorpion Stings

• Scorpions live in dry regions of the southwestern
  United States and Mexico and are most active at
  night, which is when most stings occur.
• Since it is hard to distinguish poisonous
  scorpions from the non-poisonous scorpions, all
  scorpion stings should be treated as medical
  emergencies.

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Signals of Spider Bites and Scorpion Stings

• Signals of spider bites and scorpion stings may
  include
• A mark indicating a possible bite or sting.
• Severe pain in the area of the bite or sting.
• A blister, lesion or swelling at the entry or
  bite site.
• Nausea and vomiting.
• Trouble breathing or swallowing.
• Sweating or salivating profusely.
• Irregular heart rhythm.
• Muscle cramping or abdominal pain.

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Care for Spider Bites and Scorpion Stings

• If a person is bitten by a spider (i.e., brown
  recluse or black widow) or stung by a scorpion
• Call 9-1-1 or the local emergency number
  immediately.
• Wash the wound.
• Apply ice or a cold pack.

41
Snakes

• Medical personnel are not in general agreement
  about care for snakebites.
• Most deaths from snakebites occur because
• The victim has an allergic reaction.
• The victim is in poor health.
• Too much time passes before the victim receives
  medical care.
• Signals that indicate a poisonous snakebite
  include
• One or two distinct puncture wounds.
• Severe pain and burning at the wound.
• Swelling and discoloration at the wound site.

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Poisonous Vs Non-Poisonous

• Diamond shaped head
• Elliptical eyes/pupils

• Round Head
• Round eyes/pupils

Exception Coral Snake, round head, round eyes
and VERY poisonous Red and yellow, kills a
fellow! Will you be close enough to distinguish
these features? I WONT!!!!!
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Care for Snakebites

• Follow these guidelines to care for someone
  bitten by a snake
• Call 9-1-1 or the local emergency number.
• Wash the wound, if possible.
• Immobilize the affected part.
• Keep the affected area lower than the heart, if
  possible.
• Minimize the victims movement.

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Care for Snakebites(continued)

• Regardless of what you may have otherwise heard
  or read
• Do not apply ice.
• Do not cut the wound.
• Do not apply a tourniquet.
• Do not use electric shock.
• Suction venom out only if you dont expect
  professional care before 30 minutes. Use a snake
  bite kit. NOT your mouth!

45
Marine Life

• Some marine life, such as jellyfish, can inflict
  painful injuries that can make you sick.
• The side effects of marine life stings include
  allergic reactions that can cause
• Trouble breathing.
• Heart problems.
• Paralysis.

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Care for Marine Life Stings

• Remove the victim from the water.
• Call 9-1-1 or the local emergency number if the
  victim
• Does not know what stung him or her.
• Has a history of allergic reactions to marine
  life stings.
• Is stung on the face or neck.
• Develops trouble breathing.

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Care for Marine Life Stings

• For jellyfish, sea anemone or Portuguese
  man-of-war stings
• Soak the injured part in vinegar.
• Do not apply fresh water or ammonia.
• Do not rub the area.
• For sting ray, sea urchin or spiny fish stings
• Flush the wound with tap water or ocean water.
• Immobilize the injured part.
• Soak the body part in hot water.
• Clean the wound.
• Bandage the wound.
• Sting Rays barb is FULL of toxins/poisons. Need
  professional care. Permanent nerve damage can
  occur!

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Domestic and Wild Animals

• The bite of a domestic or wild animal, like a
  human bite, carries the risk of infection as well
  as soft tissue injury.
• The most serious disease that can result from a
  wild or domestic animal bite is rabies.
• Rabies is fatal if not treated. Professional
  medical attention is needed as soon as possible.
• Tetanus is a potentially fatal infection that
  affects the central nervous system.
• It is caused by the transmission of bacteria that
  produce a toxin when someone is bitten by an
  animal or human.

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Domestic and Wild Animals(continued)

• Signals of tetanus include
• Irritability.
• Headache.
• Fever.
• Painful muscular spasms.
• One of the most common signals of tetanus is
  muscular stiffness in the jaw, which is why
  tetanus is sometimes known as lockjaw.

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Care for Domestic and Wild Animal Bites

• If someone is bitten by an animal, try to get the
  person safely away from the animal.
• For a minor wound
• Wash the wound with soap and water.
• Control bleeding.
• Apply a dressing.
• Seek medical care.

51
Care for Domestic and Wild Animal
Bites(continued)

• If the wound is bleeding heavily
• Control the bleeding.
• Seek medical care immediately.
• Contact animal control authorities.

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Humans Bites

• Human bites differ from other bites because they
  may be more contaminated, tend to occur in
  higher-risk areas of the body and often receive
  delayed care.
• Human saliva has been found to contain at least
  42 different kinds of species of bacteria.
• According to the CDC, human bites are not
  considered to carry a risk of transmitting
  hepatitis B or HIV.

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Care for Human Bites

• If the wound is not severe
• Wash the wound thoroughly with soap and water.
• Control the bleeding.
• Apply a dressing.
• Take the victim to a physician or medical
  facility.
• If the bite is severe
• Control the bleeding.
• Call 9-1-1 or the local emergency number.

54
Preventing Bites and Stings

• Preventing bites and stings from insects,
  spiders, ticks, snakes, scorpions and marine life
  is the best protection against the transmission
  of injected poisons.

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Preventing Bites and Stings

• Follow these general guidelines to prevent bites
  and stings
• Apply repellent.
• Wear sturdy boots.
• Wear long-sleeved shirts and long pants.
• Tuck pant legs into socks or boots and tuck shirt
  into pants.
• Wear light-colored clothing.
• Use a rubber band or tape where pants and socks
  meet to prevent ticks or insects from getting
  under clothing.
• Inspect yourself carefully after being outdoors.

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Preventing Bites and Stings
(continued)

• Shower immediately after coming indoors.
• Keep an eye out for and avoid nests.
• Spray pets that go outdoors with repellent.
• Stay in the middle of trails when hiking.
• Avoid walking in areas known to be populated with
  snakes.
• Make noise as you walk.
• If you encounter a snake, walk away on the same
  path you were on.

57
Preventing Bites and Stings

• To prevent stings from marine animals, you might
  consider wearing a wet suit or dry suit or
  protective footwear in the water.
• To prevent dog bites
• Do not run past a dog.
• Avoid eye contact, try to remain motionless.
• Do not approach a strange dog.
• Always let a dog see and sniff you before you pet
  the animal.