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IV. What do you do? Emergency Intervention Initial treatment includes emergency resuscitation, support patients ABCs and prevention of further poison absorption. Secondary treatment consists of continuing supportive or symptomatic care and when possible, administration of specific antidote If victim exhibits altered LOC routinely receives oxygen, glucose and naloxone (Narcan). Enter IV
-refers to inhalation, ingestion, and injection of or skin contamination from any harmful substance. Its a common environmental emergency.
Ingested poisons I. What causes the emergency? Children Accidental poisoning due to curiosity and ignorance (ingestion of aspirin, cleaning agents, insecticides, paints, cosmetics and plants. Employees in companies that uses chemicals ( chlorine, carbon dioxide, hydrogen sulfide, nitrogen dioxide and ammonia) and ignores safety standards Improper cooking, canning, storage of foods Ingestion of or skin contamination from plants Accidental or intentional drug overdose or chemical ingestion Control of airway, ventilations and oxygenation Stabilize cardiovascular and other body functions Monitor ECG, v/s and neurologic status Monitor renal function Obtain blood specimen Determine what substance, amount, time ingested, signs and symptoms, age and weight Activated charcoal is effective in eliminating many toxic substances. Gastric lavage
Adults
Inhaled poison Immediately carry pt. fresh air Loosen all tight clothing Initiate CPR if required, administer oxygen Prevent chilling Keep pt quiet as possible Do not give alcohol in any form
II. How does emergency progress? The pathophysiology of poisons depends on the substance thats inhaled or ingested. The extent of damage depends on pH of the substance, amount ingested, its form (solid or liquid) and length of exposure to it. Substances with Alkaline pH cause tissue damage by liquefaction necrosis, which softens the tissue. Acids produce coagulation necrosis. Coagulation necrosis denatures (changes the molecular composition of) proteins when the substance contacts tissues. The limits the extent of the injury by preventing penetration of the acid into the tissue. The mechanism of action for inhalants is unknown, but theyre believed to act on the CNS similarly to a very potent anesthetic. Hydrocarbons sensitize the myocardial tissue and allow it to be sensitive to catecholamine, resulting in arrhythmias. III. What are your assessments?
Skin poisoning Drenched immediately with running water Determine the identity and characteristics of the chemical agent
Food Poisoning Determine the source and type of poisoning Food should be brought to the medical facility and obtain patient history Assess for patients signs and symptoms of fluid and electrolyte imbalances
V. What are potential complications? Inhaled (carbon monoxide) poisoning Diarrhea, nausea and vomiting Agitation, delirium Coma Constricted/ dilated pupils Diaphoresis Dry mouth Extrapyramidal tremor Hematemesis Kussmauls respiration Partial or total blindness Pink skin Seizures Cardiac arrest Brain damage Respiratory failure