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Physiology of Vomiting

At least after death you're not nauseous. (Woody Allen in Sleeper)

Vomiting is the forceful expulsion of contents of the stomach and often, the proximal
small intestine. It is a manifestation of a large number of conditions, many of which are
not primary disorders of the gastrointestinal tract. Regardless of cause, vomiting can
have serious consequences, including acid-base derangments, volume and electrolyte
depletion, malnutrition and aspiration pneumonia.
The Act of Vomiting
Vomiting is usually experienced as the finale in a series of three events, which everyone
reading this has experienced:

Nausea is an unpleasant and difficult to describe psychic experience in humans


and probably animals. Physiologically, nausea is typically associated with
decreased gastric motility and increased tone in the small intestine. Additionally,
there is often reverse peristalsis in the proximal small intestine.

Retching ("dry heaves") refers to spasmodic respiratory movements conducted


with a closed glottis. While this is occurring, the antrum of the stomach contracts
and the fundus and cardia relax. Studies with cats have shown that during
retching there is repeated herniation of the abdominal esophagus and cardia
into the thoracic cavity due to the negative pressure engendered by inspiratory
efforts with a closed glottis.

Emesis or vomition is when gastric and often small intestinal contents are
propelled up to and out of the mouth. It results from a highly coordinated series
of events that could be described as the following series of steps (don't practice
these in public):
o

A deep breath is taken, the glottis is closed and the larynx is raised to
open the upper esophageal sphincter. Also, the soft palate is elevated to
close off the posterior nares.

The diaphragm is contracted sharply downward to create negative


pressure in the thorax, which facilitates opening of the esophagus and
distal esophageal sphincter.

Simultaneously with downward movement of the diaphragm, the muscles


of the abdominal walls are vigorously contracted, squeezing the stomach
and thus elevating intragastric pressure. With the pylorus closed and the

esophagus relatively open, the route of exit is clear.


The series of events described seems to be typical for humans and many animals, but
is not inevitable. Vomition occasionally occurs abruptly and in the absense of
premonitory signs - this situation is often referred to as projectile vomiting. A common
cause of projectile vomiting is gastric outlet obstruction, often a result of the ingestion of
foreign bodies.
An activity related to but clearly distinct from vomiting is regurgitation, which is the
passive expulsion of ingested material out of the mouth - this often occurs even before
the ingesta has reached the stomach and is usually a result of esophageal disease.
Regurgitation also is a normal component of digestion in ruminants.
There is also considerable variability among species in the propensity for vomition. Rats
reportedly do not vomit. Cattle and horses vomit rarely - this is usually an ominous sign
and most frequently a result of acute gastric distension. Carnivores such as dogs and
cats vomit frequently, often in response to such trivial stimuli as finding themselves on a
clean carpet. Humans fall between these extremes, and interestingly, rare individuals
have been identified that seem to be incapable of vomiting due to congenital
abnormalities in the vomition centers of the brainstem.
Control of Vomition
The complex, almost sterotypical set of activities that culminate in vomiting suggest that
control is central, which indeed has been shown to be true. Within the brainstem are
two anatomically and functionally distinct units that control vomiting:
Bilateral vomition centers in the reticular formation of the medulla integrate signals
from a large number of outlying sources and their excitement is ultimately what triggers
vomition. Electric stimulation of these centers induces vomiting, while destruction of the
vomition centers renders animals very resistant to emetic drugs. The vomition centers
receive afferent signals from at least four major sources:

The chemoreceptor trigger zone (see below)

Visceral afferents from the gastrointestinal tract (vagus or sympathetic


nerves) - these signals inform the brain of such conditions as gastrointestinal
distention (a very potent stimulus for vomition) and mucosal irritation.

Visceral afferents from outside the gastrointestinal tract - this includes


signals from bile ducts, peritoneum, heart and a variety of other organs. These
inputs to the vomition center help explain how, for example, a stone in the
common bile duct can result in vomiting.

Afferents from extramedullary centers in the brain - it is clear that certain


psychic stimuli (odors, fear), vestibular disturbances (motion sickness) and
cerebral trauma can result in vomition.

The chemoreceptor trigger zone is a bilateral set of centers in the brainstem lying
under the floor of the fourth ventricle. Electrical stimulation of these centers does not
induce vomiting, but application of emetic drugs does - if and only if the vomition
centers are intact. The chemoreceptor trigger zones function as emetic chemoreceptors
for the vomition centers - chemical abnormalities in the body (e.g. emetic drugs, uremia,
hypoxia and diabetic ketoacidosis) are sensed by these centers, which then send
excitatory signs to the vomition centers. Many of the antiemetic drugs act at the level of
the chemoreceptor trigger zone.
To summarize, two basic sets of pathways - one neural and one humoral - lead to
activation of centers in the brain that initiate and control vomition. Think of the vomition
centers as commander in chief of vomition, who makes the ultimate decision. This
decision is based on input from a battery of advisors, among whom the chemoreceptor
trigger zone has considerable influence. This straighforward picture is almost certainly
oversimplified and flawed in some details, but helps to explain much of the physiology
and pharmacology of vomition.
Causes and Consequences of Vomiting
The myriad causes of vomiting are left as an exercise - come up with a list based on
personal experience and your understanding of the control of vomition. An important
point, however, is that many cases of vomiting are due to diseases outside of the
gastrointestinal tract.
Simple vomiting rarely causes problems, but on occasion, can lead to such serious
consequences as aspiration pneumonia. Additionally, severe or repetitive vomition
results in disturbances in acid-base balance, dehydration and electrolyte depletion. In
such cases, the goal is to rapidly establish a definitive diagnosis of the underlying
disease so that specific therapy can be instituted. This is often not easy and in many
cases, it is advantageous to administer antiemetic drugs in order to suppress vomition
and reduce its sequelae.

The Pathophysiology of Vomiting

Vomiting is the process by which gastric contents come out of the mouth due to reverse
peristalsis in the small intestine and an organized sequence of muscular activity secondary to a
well-coordinated nervous circuit both of which eventually result in expulsion of the vomitus.

How does vomiting occur?


Vomiting occurs when the vomiting centres (present in the lateral reticular formation of the
medulla) are stimulated. The following areas can stimulate the vomiting centre:

The Chemoreceptor Trigger Zone: This area is located in the floor of the 4 thventricle of
the brain and constitutes the area postrema, a circumventricular organ which is devoid of
the blood brain barrier due to which substances such as drugs and toxins carried in the
blood can directly reach it. This explains why some drugs cause or stop vomiting. This
zone contains dopamine D2, serotonin 5-HT3, opioid, acetylcholine and substance P
receptors whose activations results in different pathways, the end result of all of which
includes substance P.
The Vagus Nerve: This is the 10th cranial nerve and gets activated whenever the pharynx
is activated and the gag reflex results.
The Vestibular System: This system controls balance and sends its input to the CNS via
the vestibular nerve, playing a role in any disturbance of balance (such as motion
sickness), eventually resulting in vomiting. This system has a rich supply of muscarinic
receptors.
Vagal and Enteric Nervous System: The nervous system of the gut, when stimulated,
can induce vomiting via the vagal afferents or its rich sympathetic nervous supply. The
gastrointestinal tract can be irritated by chemotherapy, radiation, certain drugs, severe
distension and infection.
The CNS: When the higher brain centres such as the cerebrum are affected by stress or
certain psychiatric conditions, this can also result in vomiting.

So to sum up, whatever stimulates these five components will stimulate the vomiting centre,
thus causing vomiting.
The Phases of Vomiting:
Vomiting consists of three phases;
1.
2.
3.

Nausea, sweating and salivation


Retching
Expulsion of gastric contents through the mouth

The physiology behind vomiting: Vomiting is mediated by the parasympathetic & sympathetic
nervous system along with the motor system, as described below:

The parasympathetic nervous system causes excessive salivation to protect the tooth
enamel from the acid contents of the stomach when are vomited out.
The sympathetic nervous system causes sweating as well as increase in heart rate.
The motor system causes a deep breath so that the vomitus is not aspirated. In addition,
reverse peristalsis begins from the middle of the small intestine so that its contents are
brought up to the stomach, passing the pyloric sphincter, which lies relaxed at this point
due to the parasympathetic activity. Contrary to popular belief, the oesophagus or
stomach do not contract and there is not negative peristalsis in these organs. Then how is
the vomitus expelled? That happens due to two processes: inspiration against a closed
glottis and contraction of the abdominal musculature. The former lowers the pressure
inside the thoracic cavity and the latter increases abdominal pressure, thus propelling the
contents of the small intestine to move easily from a region of high pressure to a region of
low pressure. The stomach is contracted only at the angular notch whereas the lower

oesophageal sphincter relaxes when the stomach contents have to be propelled out. To
put this in to order, inspiration lowers the thoracic pressure while the lower oesophageal
sphincter is contracted and the abdominal muscles are contracting forcefully, thus building
up pressure within the abdominal cavity. The intestines are undergoing negative
peristalsis and as soon as their contents reach the lower oesophageal sphincter, it opens
and pressure is suddenly released, propelling the gastric contents out of the mouth
through the relaxed oesophagus.
Vomiting: The molecular level:
Vomiting is mediated by neurotransmitters such as histamine, dopamine, serotin, neurokinin and
vasopressin, with the former three being the main controllers. That is why dopamine, serotonin
and histamine antagonists are given for the suppression of vomiting.

PROCEDURE : GASTRIC LAVAGE


P U R P O S E :
Remove unabsorbed poison after ingestion.
Diagnosis and stop gastric haemorrhage.
Clean stomach before diagnostic procedures.
Remove liquid or small particles of material from stomach.
R E Q U I R E M E N T
1)Nasogastric insertion equipments.
2)Lavage fluid Nacl or other prescribed solution.
3)Syringe 20ml for aspiration and 50ml for lavage.
4)Specimen container with lab request form.
5)Kidney dish as receiver.
6)Measuring jug.
7)Protective sheet.
8)Clinical waste.
9)Domestic waste.
S T E P S
1 . Ver i f y D r s o r d e r.
2.Assest patient level of conciousness.
3.Greet patient and explain procedure.
4 . P r o v i d e p r i v a c y.

5.Remove dental appliances and inspect oral cavity for loose teeth.
6.Position patient in Semi-Fowlers.
7.Insert NG tube as per procedure handout.
8.Check placement of tube in stomach ( 3 times check).
9.Aspirate stomach contents before instilling water or antidote.Keep specimen in container for
analysis.
10.Remove 20ml syringe and attach with 50ml syringe to pourlavage solution into NG tube
or attach with 50ml syringe barrel.
11.Pour or inject slowly 20ml solution and wait for 1 minute.
12.Aspirate (if use syringe) or siphon (if use barrel) gastric contentsand discard it in kidney dish.
13.Save samples of first two washings.
14.Record input and output throughout procedures.
15.Repeat step 10-14 until returns are clear. Usually requires a totalvolume of 2 liters.
16.Remove NG tube as per procedure handout.
17.Make patient comfortable.
18.Label specimens and despatch to lab immediately.
19.Clean and clear equipments.
20.Record and report findings.
N U R S I N G R E S P O N S I B I L I T I E S
1.Ensure procedure is carried out on correct client at correct site.
2.Assess patients level of conciousness.
3.Ensure patients comfort is maintained throughout procedure. F o w l e r s p o s i t i o n .
1.Perform procedure in a correct manner. Use appropriate solution.
2.Monitor vital sign for pre, intra and post procedure.
3.Monitor input and output.
4.Send labeled specimens in appropriate container wit lab requestform.
5.Record and report findings

An antidote is a substance that can counteract a form of poisoning. The


term antidote is a Greek word meaning given against. This post will help you
familiarize with the common antidotes that are used in the hospital setting. The
following are antidotes that should be familiarized by the nurse to respond to
this emergency situation quickly.
Antidote

Indication

Mode of Action
Restores

acetylcysteine (Mucomyst)

depleted

Acetaminophen/

glutathione

Tylenol/ Paracetamol

protects

stores

against

and
renal

and hepatic failure.


Non-specific poisons
except cyanide, iron,

Activated charcoal

lithium, caustics and


alcohol.

albuterol inhaler, insulin &


glucose,
kayexalate

NaHCO3,

Potassium

Absorption of drug in the


gastric

and

intestinal

tracts.

Interrupts

the

entero-hepatic cycle with


multiple dose.

anticholinesterase agents
atropine

sulfate

or

pralidoxime

Neuromuscular
blockade (paralytics)
Anticholinesterase

Competitive inhibition of
muscarinic receptors.
Not

known;

partial

protection against acute


Amanita
Benzylpenicillin

phalloides

(Death

cap

mushroom)

hepatic

failure;

may

displace

amatoxin

from

protein-binding

sites

allowing increased renal


excretion;
inhibit

may

also

penetration

of

amatoxin to hepatocytes.
Calcium salts

Fluoride ingestion

Rapidly complexes with


fluoride ion.
Deferoxamine

acts

by

binding free iron in the


deferoxamine

Iron

bloodstream

and

enhancing its elimination


in the urine.
Binds

molecules

of digoxin, making them

digibind
digoxine immune fab

Digoxin

unavailable for binding at


their site of action on
cells in the body.
Chelation of lead ions and

dimercapol,

edetate

calcium, disodium,

Lead

endogenous metals (e.g.,


zinc,

manganese,

iron,

copper).
diphenhydramine (Benadry

Extrapyramidal

l)

symptoms (EPS)

flumazenil

Benzodiazepines

A potent antagonist to
acetylcholine

in

muscarinic receptors.
Reverses

the

effects

ofbenzodiazepines by

competitive inhibition at
the

benzodiazepine

binding

site

on

the

GABAAreceptor.
A competitive inhibitor of
the

enzyme

alcohol

dehydrogenase found in
fomepizole

Ethylene glycol

the

liver.

This

enzyme

plays a key role in the


metabolism of ethylene
glycol and methanol.
Stimulates the formation
of adenyl cyclase causing
Beta
glucagon

blockers

calcium

and

channel

blockers

intracellular
cycling

increase
AMP

in
and

enhanced glycogenolysis
and

elevated

serum

glucose concentration.
Dextrose

(the

monosaccharide glucose)
is used, distributed and
Glucose (Dextrose 50%)

Insulin reaction

stored by body tissues


and

is

metabolized

to

carbon dioxide and water


with

the

release

of

energy.
Heparin

Ergotamine

Reverses
hypercoagulable state by
interacting

with

antithrombin III. Used in


combination

with

vasodilator phentolamine
or

nitroprusside

to

prevent local thrombosis

and ischemia.
Forms cyanocobalamin, a
Hydroxocobalamin

Cyanide

non-toxic metabolite that


is easily excreted through
the kidneys.

Fluorouracil
Protects the healthy cells
from
leucovorin calcium

Methotrexate

the

effects

methotrexate

of

while

allowing methotrexate to
enter

and

kill

cancer

cells.
Magnesium sulfate

mesna

calcium gluconate

Cyclophosphamide

chemoprotectant

drug

that

reduces

the

effects

of

undesired
certain

chemotherapy

drugs.
Chemical producing
severe
Methylene blue

methemoglobinemia
.

Ifosamide-induced

Reduces

methemoglobin

to hemoglobin.

encephalopathy.
Prevents or reverses the
effects
nalmefene or naloxone

Opioid analgesics

of

including

opioids
respiratory

depression, sedation and


hypotension.
naloxone (Narcan)

Narcotics

Naloxone is

believed

to

antagonize opioid effects


by competing for the ,
and

opiate

receptor

sites in the CNS, with the


greatest affinity for the

receptor.
Anticholinesterase which
Neostigmine

causes accumulation of

Anticholinergics

acetylcholine

at

cholinergic receptor sites.


Oxidizes

hemoglobin to

methemoglobin
Nitrite,

sodium

and

glycerytrinitrate

which

binds the free cyanide


Cyanide

and

can

enhance

endothelial

cyanide

detoxification

by

producing vasodilation.
Copper, gold, lead,
Penicillamine

mercury,

zinc,

Chelation of metal ions.

arsenic
Regitine

produces

an

alpha-adrenergic block of
relatively short duration.
It also has direct, but less
phentolamine (Regitine)

Dopamine

marked, positive inotropic


and chronotropic effects
on cardiac muscle and
vasodilator

effects

on

vascular smooth muscle.


A

reversible

anticholinesterase
phyostigmine or NaHCO3

Tricyclic
antidepressants

which

effectively increases the


concentration

of

acetylcholine at the sites


of

cholinergic

transmission.
Phytomenadione
K.)

(Vitamin

Coumadin/Warfarin

Bypasses

inhibition

Vitamin

of

epoxide

reductase enzyme.

Protamine that is strongly


basic

combines

with

acidic heparin forming a


protamine sulfate

Heparin

stable

complex

and

neutralizes

the

anticoagulant activity of
both drugs.

Pyridoxine

Isoniazid,

Reverses

theophylline,

pyridoxine deficiency by

monomethyl

promoting

hydrazine.

synthesis. Promotes the

Adjunctive
in

ethylene

therapy
glycol

poisoning.

acute
GABA

conversion

of

metabolite glycolic acid


to glycine.
Neutralizes
binding

Snake anti-venin

toxic

venom

with

by

circulating

venom components and

Cobra bite

with

locally

deposited

venom by accumulating
at the bite site.
Prevents

Iron
Cardiotoxic

Sodium Bicarbonate

drug
(TCA,

cocaine)

inhalational
poisoning
Sodium thiosulphate

Cyanide

Decreases

affinity

of

cardiotoxic drugs to the


fast sodium channel.
Promotes

Weak acids
Chlorine

of

ferrous to ferric.

affecting fast sodium


channel

convertion

ionization

of

weak acids.
gas

Neutralization

of

hydrochloric acid formed


when chlorine gas reacts
with water in the airways.
Replenishes
thiosulphate

depleted
stores

by

acting

as

sulfur

donor

necessary

for

the

conversion

of

CN-O

to

thiocyanate through the


action

of

transferase

sulfur
enzyme

rhodanese.
Alcohol,
Thiamine

Wernicke-

Korsakoff Syndrome

deficiency

Adjunctive

Enhances

in

ethylene glycol
Chemicals
Vitamin C

Reverses acute thiamine


detoxification

of glyoxylic acid.

causing

methemoglobinemia

Reduces

in

to hemoglobin.

patients

G6PD deficiency

with

methemoglobin

The most common poisons in children


Did you know that even these common household items can poison children?

cosmetics and personal care products

cleaning substances and laundry products

pain medicine

foreign bodies such as toys, coins, thermometers

topical preparations

vitamins

antihistamines

pesticides

plants

antimicrobials
The most common poisons in adults

pain medicine

sedatives, hypnotics, antipsychotics

antidepressants

cardiovascular drugs

cleaning substances (household)

alcohols

pesitcides

bites and envenomations (ticks, spiders, bees, snakes)

anticonvulsants

cosmetics and personal care products

The most dangerous poisons for children


These are especially hazardous household items. Buy small quantities. Discard
unneeded extras. Make sure they are always out of a child's reach.

Medicines: these are OK in the right amount for the right person. They can be
dangerous for children who take the wrong medicine or swallow too much.

Carbon monoxide: This gas is in fact an invisible killer. Take it seriously. Make
sure there's a carbon monoxide alarm in every sleeping area of your home.

Button batteries: Be especially mindful of the 20 mm lithium coin cell. When


swallowed by children, especially those younger than 4 years, it often lodges in the
esophagus causing burns within just 2 hours. A hole in the esophagus may develop
and the burn can extend into the trachea or aorta. More than 40 children have died
from swallowing button batteries.

Iron pills: adult-strength iron pills are very dangerous for children to swallow.
Children can start throwing up blood or having bloody diarrhea in less than an hour.

Cleaning products that cause chemical burns: these can be just as bad as
burns from fire. Products that cause chemical burns include include drain openers,
toilet bowl cleaners, rust removers, and oven cleaners.

Nail glue remover and nail primer: some products used for artificial nails can
be poisonous in surprising ways. Some nail glue removers have caused cyanide
poisoning when swallowed by children. Some nail primers have caused burns to the
skin and mouth of children who tried to drink them.

Hydrocarbons: this is a broad category that includes gasoline, kerosene, lamp


oil, motor oil, lighter fluid, furniture polish, and paint thinner. These liquids are easy
to choke on if someone tries to swallow them. If that happens, they can go down the
wrong way, into the lungs instead of the stomach. If they get into someones lungs,
they make it hard to breathe. They can also cause lung inflammation (like

pneumonia). Hydrocarbons are among the leading causes of poisoning death in


children.
Pesticides: chemicals to kill bugs and other pests must be used carefully to

keep from harming humans. Many pesticides can be absorbed through skin. Many can
also enter the body by breathing in the fumes. Some can affect the nervous system
and can make it hard to breathe.
Windshield washer solution and antifreeze: Small amounts of these liquids

are poisonous to humans and pets. Windshield washer solution can cause blindness
and death if swallowed. Antifreeze can cause kidney failure and death if swallowed.
Wild mushrooms: many types of mushrooms grow in many areas of the

country. Some are deadly to eat. Only experts in mushroom identification can tell the
difference between poisonous mushrooms and safe mushrooms.
Alcohol: when children swallow alcohol, they can have seizures, go into a coma,

or even die. This is true no matter where the alcohol comes from. Mouthwash, facial
cleaners, and hair tonics can have as much alcohol in them as alcoholic beverages.
Drain cleaners and toilet bowl cleaners: These caustics cause devastating

burns to the mouth, throat and stomach. Drain cleaners may be strongly alkaline and
toilet bowl cleaners may be strong acids. If swallowed, they must be diluted
immediately to limit the damage that rapidly occurs.
Topical anesthetics: These medicines can cause seizures or a condition called

methemoglobinemia which keeps the blood from carrying oxygen to the tissues. Be
especially careful with teething gels, hemorrhoid preparations, anti-itch creams, and
sunburn relief agents.
Common Poisons Around The Home

There are many poisons around the home. Below are some of the most common poisons
encountered every day. Be aware of household medicines and chemicals so you can use
and

store

them

properly

and

act

quickly

if

someone

is

poisoned.

If someone has been exposed to any of these substances or any other poison around

the home, contact the National Poison Centre for advice call 0800 POISON (0800 764766),

or

consult

another

medical

professional

without

delay.

Paracetamol
Paracetamol is a common household drug, available in either tablets or a liquid form
and is used to treat mild pain and fever in children and adults. Paracetamol is
relatively safe at the recommended doses, even in young children. However, it is also
one of the most common causes of poisoning, and must be used properly and stored
securely. If someone takes more than the recommended dose of paracetamol, it can
make

them

very

sick,and

even

cause

liver

damage.

Codeine
Used to relieve pain and coughing, codeine is often combined with other drugs such as
paracetamol, aspirin, or ibuprofen. Overdose or accidental exposures can cause
serious problems. Codeine can make a person very drowsy, and slow their breathing
and heart rate. As little as one tablet can be enough to make a small child sick. Even if
you're not sure if a child has ingested any tablets, contact your Poisons Centre. Always
remember

to

keep

all

medications

out

of

reach

and

sight

of

children.

Antibiotics
Antibiotics are used to treat infections. There is a wide range of antibiotics available, so
it is very important to contact your Poisons Centre and bring the container to the
phone. Some people can have life- threatening allergic reactions to antibiotics. If you
suspect someone is experiencing an allergic reaction, get medical assistance
immediately.
Dishwashing Liquid
Generally of low toxicity, however may still make someone ill. They may be irritating to
the mouth or throat and could cause someone to vomit soon after an exposure.
Dishwashing liquids generally irritate the eyes but can cause damage in some cases.
Good first aid is required. Flush eyes with clean running water for at least 15 minutes
if

in

eyes.

If

swallowed,

give

1/4

to

1/2

cup

of

water.

Dishwasher Powder
This product is corrosive and may cause chemical burns if eaten, left on the skin or
splashed into the eyes. If swallowed rinse the mouth to ensure it is clear of any powder
and call the National Poisons Centre immediately. Do not give anything to drink. If any

gets onto the skin or into the eyes, thoroughly flush with water. Eyes should be
flushed for at least 30 minutes. These powders are potentially very dangerous and it is
important

to

immediately

call

your

Poisons

Centre

for

advice.

Bleach
Undiluted bleach can cause chemical burns, and is potentially dangerous if ingested or
splashed into eyes. It is very important not to mix bleach, or products containing
bleach, with any other household cleaners as a chemical reaction can release toxic
gases. Thoroughly flush with water if any gets onto skin or into eyes. Eyes should be
flushed for at least 30 minutes. If swallowed, do not give anything to drink unless
instructed

to

do

so

by

the

Poisons

Centre.

Mushrooms
There are several varieties of poisonous mushrooms in New Zealand. It is very difficult
to accurately identify mushroom species. Symptoms can be delayed for several days or
weeks, and can include an upset stomach, hallucinations, even liver and kidney
damage. All mushroom ingestions need to be treated as potentially serious, even if only
a small amount has been ingested. Call your Poisons Centre for more information.
Alcohol (Ethanol)
Alcohol can be found in many products around the home, including some medicines,
cleaning products, and perfumes. Ingestion may cause drowsiness, inebriation and
slurred speech. Even small amounts of alcohol can be very harmful to children,
causing hypoglycaemia (low blood sugar), which can be very serious if not treated.
Always keep alcoholic drinks and other products containing alcohol out of reach and
sight

of

children.

Weed Killer
There are several different types of weed killer available, with varying degrees of
toxicity. Some may only cause mild symptoms, while even small amounts of others can
cause serious damage to the lungs, heart and kidneys. It is important to accurately
identify the product, and if possible bring the container to the phone when you call
your

Poisons

Centre.

Slug/Snail Bait
As with weed killers, there are several different formulations of slug and snail baits
available. Some of these can be toxic in small doses, especially to small children and
pets. It is extremely important to identify which product has been used when seeking
help; always bring the container to the phone when you call the Poisons Centre.

Remember
children

to
and

animals

away

from

areas

keep
where

bait

has

been

used.

Petrol
Petrol is often stored in inappropriate containers around the home, and can easily be
mistaken for another liquid. If petrol is ingested, or petrol vapours inhaled, it can make
you very sick. When swallowed, it is very easy for petrol to go down the wrong way
which can cause lung problems. Petrol can also damage the eyes if not treated quickly.
If someone has swallowed some petrol, it is ok to give them a small amount of water to
drink. Always store petrol and other fuels in clearly labelled designated containers,
and keep out of reach of children

TOXINS, HOW TO AVOID THE TOP TEN MOST COMMON


Source, by Dr. Joseph Mercola with Rachael Droege.
There are many upsides to living in a modern, high-tech society (like having
access to the Internet and digital cameras and MP3 audio players to name a
few of my favorites.)
But as with most things in life and in nature, whether you call it yin and yang,
balance or the principle that opposites attract, with the upside comes a
significant downside.
For all of the conveniences and advances that we have grown so accustomed
to comes a slew of environmental toxins chemicals and other materials
largely from industry and carelessness that have very much saturated our
water, our food and the very air we breathe.
Many of these toxins are things that you cant see, smell or feel, at least not
right away. One of the major problems with them is just that. We dont realize
that were being affected until we come down with a chronic disease after
years of subtle and often consistent exposure to a combination of these
toxins.
This makes it almost impossible to pinpoint a specific environmental toxin as
the source of illness, yet when you look at the facts the increasing
numbers of cancers, immune system disorders, neurological problems,
chronic fatigue syndrome, multiple chemical sensitivities, allergies and
hormonal disturbances that are facing the nation it is hard NOT to take
notice. Consider these statistics:

Some 77,000 chemicals are produced in North America


Over 3,000 chemicals are added to our food supply
More than 10,000 chemical solvents, emulsifiers and preservatives are
used in food processing
1,000 new chemicals are introduced each year
Where do all of these chemicals end up? They are absorbed into our
groundwater, rivers, lakes and oceans, spewed into our air, and added, quite
intentionally, to our food supply.

The Effects of Toxins on Your Body


A study in last years British Medical Journal estimated that perhaps 75
percent of most cancers are caused by environmental and lifestyle factors,
including exposure to chemicals.
Another report, this one by the Columbia University School of Public Health,
estimated that 95 percent of cancer is caused by diet and environmental
toxicity.
This is really not surprising when you consider that estimates show most
Americans have somewhere between 400 and 800 chemicals stored in their
bodies, typically in fat cells. Some of the short- and long-term effects of
these toxins include:

Neurological disorders (Parkinsons, Alzheimers, depression, attention


deficit disorder, schizophrenia, etc.)
Cancer
Nutritional deficiencies
Hormonal imbalances
Enzyme dysfunction
Altered metabolism
Reproductive disorders
Fatigue
Headaches
Obesity
Muscle and vision problems
Immune system depression
Allergies/Asthma
Endocrine disorders
Chronic viral infections
Less ability to tolerate/handle stress
The 10 Most Common Toxins
The following toxins are among the most prevalent in our air, water and/or
food supply. This list is by no means all-inclusive, as thousands of other
toxins are also circulating in our environment. Keep reading to find out tips to
avoid these toxins and others as much as possible.

1.

PCBs (polychlorinated biphenyls): This industrial chemical has


been banned in the United States for decades, yet is a persistent organic
pollutant thats still present in our environment.
Risks: Cancer, impaired fetal brain development
Major Source: Farm-raised salmon. Most farm-raised salmon, which accounts
for most of the supply in the United States are fed meals of ground-up fish
that have absorbed PCBs in the environment and for this reason should be
avoided.

2.

Pesticides: According to the Environmental Protection Agency (EPA),


60 percent of herbicides, 90 percent of fungicides and 30 percent of
insecticides are known to be carcinogenic. Alarmingly, pesticide residues
have been detected in 50 percent to 95 percent of U.S. foods.
Risks: Cancer, Parkinsons disease, miscarriage, nerve damage, birth defects,
blocking the absorption of food nutrients
Major Sources: Food (fruits, vegetables and commercially raised meats), bug
sprays

3.

Mold and other Fungal Toxins: One in three people have had an
allergic reaction to mold. Mycotoxins (fungal toxins) can cause a range of
health problems with exposure to only a small amount.
Risks: Cancer, heart disease, asthma, multiple sclerosis, diabetes
Major Sources: Contaminated buildings, food like peanuts, wheat, corn and
alcoholic beverages

4.

Phthalates: These chemicals are used to lengthen the life of


fragrances and soften plastics.
Risks: Endocrine system damage (phthalates chemically mimic hormones
and are particularly dangerous to children)
Major Sources: Plastic wrap, plastic bottles, plastic food storage containers.
All of these can leach phthalates into our food.

5.

VOCs (Volatile Organic Compounds): VOCs are a major


contributing factor to ozone, an air pollutant. According to the EPA, VOCs
tend to be even higher (two to five times) in indoor air than outdoor air, likely
because they are present in so many household products.
Risks: Cancer, eye and respiratory tract irritation, headaches, dizziness,
visual disorders, and memory impairment
Major Sources: Drinking water, carpet, paints, deodorants, cleaning fluids,
varnishes, cosmetics, dry cleaned clothing, moth repellants, air fresheners.

6.

Dioxins: Chemical compounds formed as a result of combustion


processes such as commercial or municipal waste incineration and from
burning fuels (like wood, coal or oil).
Risks: Cancer, reproductive and developmental disorders, chloracne (a
severe skin disease with acne-like lesions), skin rashes, skin discoloration,
excessive body hair, mild liver damage
Major Sources: Animal fats: Over 95 percent of exposure comes from eating
commercial animal fats.

7.

Asbestos: This insulating material was widely used from the 1950s to
1970s. Problems arise when the material becomes old and crumbly,
releasing fibers into the air.
Risks: Cancer, scarring of the lung tissue, mesothelioma (a rare form of
cancer)
Major Sources: Insulation on floors, ceilings, water pipes and healing ducts
from the 1950s to 1970s.

8.

Heavy Metals: Metals like arsenic, mercury, lead, aluminum and


cadmium, which are prevalent in many areas of our environment, can
accumulate in soft tissues of the body.
Risks: Cancer, neurological disorders, Alzheimers disease, foggy head,
fatigue, nausea and vomiting, decreased production of red and white blood
cells, abnormal heart rhythm, damage to blood vessels

Major Sources: Drinking water, [some] fish, vaccines, pesticides, preserved


wood, antiperspirant, building materials, dental amalgams, chlorine plants,
etc.
9.

Chloroform: This colorless liquid has a pleasant, nonirritating odor


and a slightly sweet taste, and is used to make other chemicals. Its also
formed when chlorine is added to water.
Risks: Cancer, potential reproductive damage, birth defects, dizziness,
fatigue, headache, liver and kidney damage.
Major Sources: Air, drinking water and food can contain chloroform.

10.
Chlorine: This highly toxic, yellow-green gas is one of the most heavily
used chemical agents.
Risks: Sore throat, coughing, eye and skin irritation, rapid breathing,
narrowing of the bronchi, wheezing, blue coloring of the skin, accumulation
of fluid in the lungs, pain in the lung region, severe eye and skin burns, lung
collapse, reactive airways dysfunction syndrome (RADS) (a type of asthma)
Major Sources: Household cleaners, drinking water (in small amounts), air
when living near an industry (such as a paper plant) that uses chlorine in
industrial processes.