Toxicology: General Nursing

Management of Poisoning
Emergencies
Presented by
Shaimaa El Hadary
Lecturer of Nursing
2012

3/22/2012

Objectives:
After completing this lecture, each student should
be able to:

Mention what a poison is

Identify factors determining the severity of
poisoning
Identify different types of poisoning
Discuss the first aid for different types of
poisoning

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 What a poison is
Factors determining the severity of
poisoning
How poisons enter the body
First aid of poisoning
Conclusion
Questions

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What a poison is?

A poison is a substance
that causes illness or
death when introduced
into the body by altering

cell structure or function.

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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.

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Check the scene

Flames or
smoke.

open
medicine
cabinet

spilled
containers

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Unusual
odors.

damaged
plants

How Poisons Enter the Body:

Ingestion
Inhalation
Absorption
Injection

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(1) Ingested poisons

A poison enter the body through mouth
it can include many common household, industrial,
chemical, medications, petroleum ,agricultural
products made to control insects.

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S&S for Ingested Poisoning

Unusual breath odors
Discoloration or burning around
the mouth

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Ingested Poisons
Patient Assessment

What substance was involved?

When did the exposure occur?
How much was ingested?
Over how long a period did the ingestion occur?
What interventions has the patient , family taken?
What is the patients estimated weight?

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Ingested Poisons Emergency Nursing

Management
Cases of poisoning by non-corrosive poison for conscious person
can be treated by 3 general means

Dilution

Activated
charcoal
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Vomiting

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Ingested Poisons Emergency Nursing

Management

Cases of poisoning by corrosive poison

(strong acid/alkali)
1.
2.
3.

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Do not induce vomiting.

Give milk or water (2glasses for adults)
Handle him gently; keep him from being
chilled.

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Emergency care of a patient who has ingested

poison includes the following:
1- Detect & treat immediately life threatening
problems in the initial assessment.
2- perform a focused history & physical
examination including SAMPLE history. Use
gloved hands to carefully remove any pills ,
tables, or fragments from the patients mouth.

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 3- Assess baseline vital signs.

4- Consult medical direction. As administer
activated charcoal to adsorb the poison.
5-Transport the patient with all containers ,
bottles,& labels from substance.
6- Perform ongoing assessment.

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Activated Charcoal
Indication: poisoning by mouth
Contraindication:
Altered mental status / inability to swallow.
Action: adsorbs ( binds) certain poisons &
prevent them from being absorbed into the
body.
Medication form: premixed in water
Dosage: 1gram / kg of body wt.
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 Side effect: black stools. some pts may vomit ,

particulty those who have ingested poisons
that cause nausea. If patients vomits, repeat
the dose once.

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Inhaled poisons
substances that are breathed in, it can be
gases, vapors, sprays. Such poisons include
carbon monoxide ( from car exhaust, wood
burning stoves), ammonia , chlorine, insect
sprays.

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S&S for inhaled Poisoning

Respiratory distress
Cough
Hoarseness
Chest pain
Dizziness
Headache
Confusion

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Inhaled poisons Emergency Nursing

Management

1.
2.
3.
4.

Remove the victim from the source.

Ventilate the victim
Elevate the head
If unconscious, check the pulse rate ,airway, and
breathing and begin cardiopulmonary
resuscitation (CPR), if necessary.
5. Loosen any tight clothing.
6. Cover with blanket
7. Seek medical aid urgently.
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Absorbed poisons
substances taken into the body through
unbroken skin. May or may not damage the
skin. Many are corrosives or irritants that will
injure the skin & then be slowly absorbed into
body tissues & the bloodstream possibly
causing widespread.

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Absorbed Poison
Patient Assessment
What substance was involved?
When did the exposure occur?
How much of substance was the pt. exposed to?
How large an area of skin was the substance on?
Over how long a period did the exposure occur?
What interventions has the patient , family
taken?
What effects is the patient experiencing from
exposure?

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S&S for absorbed Poisoning

Traces of powder or liquid on the skin

Inflammation or redness of the skin
Blisters
Swelling or burns
Skin rash
Itching

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Absorbed Poisoning Emergency Nursing

Management

1. Remove clothing that has been in contact with the

poison
2. Flush the affected area thoroughly with cool water.
3. Wash the area with soap and water
4. If there is poison in the eye, rinse it for 20 minutes.
5. Keep a sample.

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Injected poisons

poisons that inserted through the skin, for

example by needle , snake or insect stinger.

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S&S for injected Poisoning

S&S of animal/insect bite or sting

Hypodermic needle marks
Localized swelling
Localized redness
Localized pain
itching

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Questions

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