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Management of Medical Emergency-Poisoning!

MEDICAL EMERGENCY- POISONING


  • Management of the poisoned patient involves procedures designed to prevent the absorption, minimize the toxicity, and hasten the elimination to the suspected toxin. The prompt employment of appropriate emergency management procedures often can prevent unnecessary morbidity and mortality.
  • A Regional Poison Center is a practitioner's best source of definitive treatment information and should be consulted in all poisonings, regardless of the apparent simplicity of the case.
  • In all cases, every attempt should be made to accurately identify the toxin, estimate the quantity involved, and determine the time that has passed since the exposure.
  • These data, plus patient-specific parameters such as age, weight, sex, and underlying medical condition or drug-use will assist the person and the Regional Poison Center in designing an appropriate therapeutic plan for the patient.



POISONING BY TOPICAL EXPOSURES:

  1. Immediately irrigate affected areas with a copious amount of water, use soap only if a stubborn, oily substance is the contaminant. Skin should be gently washed, not scrubbed and special attention should be given to the hairs, skin folds, umbilicus, and other areas where the contaminant might be trapped.
  2. If the patients' clothes have been contaminated, remove them during the irrigation and clean them before they are worn again or destroy them.
  3. Do not attempt to "neutralize" the contaminant with another chemical (e.g: acids and alkalis). Attempts at neutralization waste valuable time, are of no benefit, and might be harmful.
  4. Do not cover the affected area with emollients. These can trap unremoved contaminant against the skin. Severely damaged skin may be temporarily covered with a light, dry dressing.
  5. Protect yourself from contamination. Gloves, Aprons, or a change of clothes might be necessary.
  6. After the irrigation is complete, contact a Regional Poison Center for definitive treatment information.


POISONING BY EYE EXPOSURES:

  1. Immediately irrigate the eye; damage can occur within seconds. The stream of water from the tap or a pitcher should strike the patient on the forehead, temple, or bridge of the nose and then flow into the eye.
  2. The eyelids should be open, with frequent blinking during the irrigation.
  3. The irrigation should continue for at least 15 minutes (by clock) to ensure adequate removal of the contaminant and normalization of the conjunctival pH. Body temperature water or saline may be substituted for tap water as the irrigation proceeds, but only if these can be obtained without interrupting the irrigation.
  4. After the irrigation is complete, contact a Regional Poison Center for definitive-treatment information.


POISONING BY INHALATION EXPOSURES:

  1. Remove the patient from the suspected contaminated area, regardless of its apparent safety. Carbon monoxide, a common inhaled toxin, cannot be detected by sight, smell or taste.
  2. Institute artificial ventilation, if necessary, and provide supplementary humidified oxygen, if available and needed.
  3. Protect yourself from contamination at all times.
  4. Contact a Regional Poison Center for definitive treatment information.



POISONING BY INGESTIONS:

  1. Remove any remaining contaminant from inside and around the mouth of the patient.
  2. Give a small amount of water to clear the mouth and esophagus.
  3. Contact a Regional Poison Center for definitive treatment information.
  4. In many cases, it will not be necessary to take additional steps. The following information can be used if additional care is recommended by the Regional Poison Center.
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