chapter 16

Some of the signs and symptoms of injected poisonings include:

- A bite or sting mark at the point of entry. - A stinger, tentacle or venom sac in or near the entry site. - Redness, pain, tenderness or swelling around the entry site. - Signs and symptoms of allergic reaction, including localized itching, hives or rash. - Signs and symptoms of a severe allergic reaction (anaphylaxis), including weakness, nausea, dizziness, shock, swelling of the throat or tongue, constricted airway or trouble breathing.

Common causes of unintentional poisonings at home include:

- Alcohol (found in many products, including hand sanitizer, mouthwash, perfume, cologne, aftershave and vanilla extract). - Medications (over-the-counter and prescription) and vitamins. - Cleaning products (detergent "pods" are especially attractive to children). - Glues and paints. - Insect and weed killers. - Car maintenance products (e.g., antifreeze, windshield washer fluid). - Plants (both houseplants and outdoor plants). - Oils, lubricants and polishes. - Personal care products. - Tobacco. - Heavy metals, such as lead (often found in old, peeling paint).

common causes of poisoning in the age group 6 to 19

- Analgesic medications - Bites and stings - Cleaning substances - Cosmetics - Cough and cold remedies - Food products and food poisoning - Plants - Stimulants and street drugs

common causes of poisoning in the age group younger than 6

- Analgesic medications ("painkillers") - Cleaning substances - Cosmetics and personal care products - Cough and cold remedies - Gastrointestinal medications - Insecticides - Plants - Topical medications - Vitamins

You think the person may have been exposed to an allergen.

- Any TWO of the following: - Any skin reaction - Swelling of the face, neck, tongue or lips - Trouble breathing - Signs and symptoms of shock - Nausea, vomiting, cramping or diarrhea

You do not know if the person has been exposed to an allergen.

- Any skin reaction (such as hives, itchiness or flushing) OR - Swelling of the face, neck, tongue or lips PLUS - Trouble breathing OR - Signs and symptoms of shock

After conducting a scene size-up, checking the person, and having someone call 9-1-1 or the designated emergency number, check the auto-injector:

- Remove the auto-injector from the carrier tube or package, if necessary. - If applicable, confirm it is prescribed for the person. - Check the expiration date of the auto-injector. If it has expired, do not use the auto-injector. - If the medication is visible, confirm that the liquid is clear and not cloudy. If it is cloudy, do not use it.

. The severity of a poisoning depends on three factors:

- The type and amount of the substance - The time that has elapsed since the poison entered the body - The person's age, size (build), weight and medical conditions

Preventing food poisoning: clean

- Wash hands thoroughly (for 20 seconds) with soap and running water before and after preparing or handling food; between handling raw and cooked foods; and whenever handling food preparation surfaces, dishes and utensils. - Wash all surfaces and utensils after each use. - Wash fruits and vegetables, but not meat, poultry or eggs

examples of absorbed poisons

- poison ivy - poison oak - poison sumac

. Other signs and symptoms of inhaled poisonings include:

-Trouble breathing or a breathing rate that is faster or slower than normal. - Chest pain or tightness. - Burning in the nose or eyes. - Nausea and vomiting. - Cyanosis. - Headaches, dizziness and confusion. - Coughing, possibly with excessive secretions. - Seizures. - Altered mental status with possible unresponsiveness.

symptoms of food poisoning can begin between

1 and 48 hours after eating

_______ calls about poisoning each year

2 million

What if... A person has ingested a poison and I have a bottle of syrup of ipecac? Should I give it to the person? That's what my mother used to keep on hand for such an emergency.

Although keeping a bottle of syrup of ipecac at home used to be widely recommended, that has changed and it is no longer recommended. In fact, these days there is no situation in which syrup of ipecac should be given for an ingested poison as there is a possibility of significant harm. Ipecac can cause serious complications and excessive and difficult-to-control vomiting, as well as delay care given later in an advanced medical facility if needed. More generally, as taught in this chapter, you should never administer anything by mouth for any poison, or induce vomiting, unless advised to do so by PCC or EMS personnel.

poison

Any substance that causes injury, illness, or death when it enters the body, especially by chemical means

carbon monoxide poisoning

Carbon monoxide is a gas that is produced whenever a fuel such as gas, oil, kerosene, diesel, wood or charcoal is burned. When equipment that burns these fuels is ventilated properly, carbon monoxide is not a problem. But if the equipment or ventilation system is faulty, or if equipment that is only supposed to be run outdoors is run inside an enclosed area, toxic levels of carbon monoxide can build up quickly, leading to carbon monoxide poisoning. Carbon monoxide poisoning is often called a "silent killer" because the gas has no smell and you cannot see it. Signs and symptoms of carbon monoxide poisoning include drowsiness, confusion, headache, dizziness, weakness, and nausea or vomiting. A person with signs or symptoms of carbon monoxide poisoning needs fresh air and medical attention immediately. Remove the person from the area if you can do so without endangering yourself, and call 9-1-1 or the designated emergency number.

What if... I suspect a person has food poisoning? Should I call 9-1-1 for that?

Maybe. It depends on the severity of the person's condition. The great majority of foodborne illnesses are mild and cause symptoms for only a day or two. More severe cases tend to occur in the very old, the very young, those who have an illness already that reduces their immune system function and healthy people exposed to a very high dose of an organism. If a person with food poisoning is unresponsive, not breathing or has changes in their level of consciousness, always call 9-1-1 or the designated emergency number. Otherwise contact a local healthcare provider and/or the board or department of health.

What if... A person has poison ivy? Can they spread it to me while I'm helping care for it?

Poison ivy causes a rash when a person who is allergic comes into contact with the plant's urushiol, an oily resin produced by the plant that is responsible for irritating the skin. Urushiol does not dry easily and attaches to one's skin, clothing, tools, equipment or pet's fur. So, yes, if there is still urushiol on a person or anything else you touch, it can spread poison ivy to you even if you do not have direct contact with the plant itself. As with the person you are helping, if you do come into contact with the urushiol, immediately wash the skin with soap and lukewarm water and wash all clothing and everything else that may have the oil on it.

inhaled poisons

poisons that are breathed into the lungs

common causes of poisoning in the older than 19

- Analgesic medications - Antidepressant drugs - Bites and stings - Cardiovascular drugs - Chemicals - Cleaning substances - Food products and food poisoning - Fumes and vapors - Insecticides - Sedatives and hallucinogenic drugs

After administering the injection, ensure 9-1-1 or the designated emergency number has been called if this has not already been done, and monitor the person's response as follows:

- Continue to reassure the person. - Ask the person how they feel. - Check the person's breathing.

In general, call 9-1-1 or the designated emergency number instead of the PCC if a person:

- Is unresponsive, confused or responsive but not fully awake. - Has trouble breathing. - Has persistent chest pain or pressure. - Has pressure or pain in the abdomen that does not go away. - Is vomiting blood or passing blood in their stool or urine. - Exhibits signs of shock such as pale, ashen or grayish, cool, moist skin. - Has a seizure, severe headache or slurred speech. - Acts aggressively or violently.

The PCC or a medical professional will advise you exactly how to induce vomiting. In most instances, vomiting should not be induced. This includes when the person:

- Is unresponsive. - Is having a seizure. - Is pregnant (in the last trimester). - Has ingested a corrosive substance (such as drain or oven cleaner) or a petroleum product (such as kerosene or gasoline). Vomiting these corrosives could burn the esophagus, throat and mouth. - Is known to have heart disease.

If your household contains members who are at high risk for unintentional poisoning, these are simple steps you can take to help keep them safe:

- Keep all medications and household products well out of reach (preferably up, away and out of sight) of children or older adults with medical conditions that are associated with confusion (e.g., dementia). - Store potentially poisonous substances in locked cabinets. - Be aware that purses and bags may contain potential poisons (such as medications or hand sanitizer). Avoid putting bags or purses down where they are within reach of curious children or confused older adults. - Closely supervise children and confused older adults, especially in areas where potential poisons are commonly stored (such as kitchens, bathrooms and garages). - Keep medications and products in their original containers with their original labels in place. - Use poison symbols to identify potentially poisonous substances, and teach children the meaning of the symbols. - Be aware that a child or confused older adult may try to consume products that feature fruit on the label (e.g., cleaning products), so take care when storing these. - Never call a medicine "candy" to entice a child to take it, even if the medicine has a pleasant candy-like flavor. - Use child-resistant safety caps on containers of medication and other potentially dangerous products, but do not assume that children cannot open them. (There is no such thing as "childproof.") - Dispose of medications and other potentially poisonous substances properly. Check with your local government for procedures for the safe disposal of unused and expired medications and other hazardous materials.

Signs and symptoms of ingested poisonings include:

- Nausea, vomiting or diarrhea. - Chest or abdominal pain. - Trouble breathing. - Sweating. - Changes in level of consciousness. - Seizures. - Headache or dizziness. - Weakness. - Irregular pupil size. - Double vision. - Abnormal skin color. - Burn injuries around the lips or tongue or on the skin around the mouth.

Preventing food poisoning: chill

- Refrigerate perishable foods within 2 hours. - Make sure your refrigerator and freezer are at the right temperature: between 40° F (4° C) and 32° F (0° C) and at 0° F (−18° C) or below, respectively. - Never thaw or marinate foods on the counter. - Know when to throw food out.

After you have checked the scene and determined that there has been a poisoning, you should follow these general care guidelines:

- Remove the person from the source of poison if the scene is dangerous. Do this only if you are able to do so without endangering yourself or bystanders. - Check the person's level of consciousness and breathing: - If the person is awake, ask questions to get more information about the current situation. - Look for any containers and/or packaging and take them with you to the telephone. - Call the 24-hour national Poison Help line at 800-222-1222 and follow any directions the call taker gives.

You also may suspect a poisoning based on information from or about the person. If you suspect someone has swallowed a poison, try to find out:

- The type of poison. - The quantity taken. - When it was taken. - How much the person weighs

Some of the signs and symptoms of absorbed poisonings include:

- Traces of the liquid, powder or chemical on the person's skin. - Skin that looks burned, irritated, red or swollen. - Blisters that may ooze fluid, or a rash. - Itchy skin.

A person who is having a severe, life-threatening allergic reaction (anaphylaxis) may develop one or more of the following signs and symptoms within seconds or minutes of coming into contact with the allergen:

- Trouble breathing (Figure 16-4) - Swelling of the face, neck, tongue or lips - A feeling of tightness in the chest or throat - Skin reactions (such as hives, itchiness or flushing) - Stomach cramps, nausea, vomiting or diarrhea - Dizziness - Loss of consciousness - Signs and symptoms of shock (such as excessive thirst; skin that feels cool or moist and looks pale or grayish; an altered level of consciousness; and a rapid, weak heartbeat)

You know that the person has been exposed to an allergen

- Trouble breathing OR - Signs and symptoms of shock

Preventing food poisoning: Cook

- Use a food thermometer to make sure food is cooked to the proper temperature (see www. foodsafety.gov for more details). Clean the thermometer after each use. - Keep food hot after cooking, at a temperature of at least 140° F (60° C). - Follow microwave directions to cook food thoroughly (to 165° F, or 74° C). If the instructions say to let food sit after microwaving, do so as it allows the food to cook more completely.

Preventing food poisoning: Separate

- Use separate cutting boards—one for produce and one for raw meat, poultry, seafood and eggs—as well as separate plates and utensils for cooked and raw foods. - Keep meat, poultry, seafood and eggs separate from other food in your grocery cart, when bagging and later at home in the refrigerator

_____ people contract foodborne illnesses each year in the United States.

48 million

what are the way of preventing food poisoning

By following the steps Clean, Separate, Cook and Chill, you can reduce the likelihood of foodborne illnesses from occurring

Epinephrine Auto-Injector

If a person is known to have an allergy that could lead to anaphylaxis, they may carry an epinephrine auto-injector (a syringe system, available by prescription only, that contains a single dose of epinephrine

a few of the many common plants that can be highly toxic and even lethal if ingested

Lily-of-the-valley, mistletoe, philodendron, oleander, hyacinth, foxglove, mountain laurel and hemlock

Two of the most common causes of food poisoning are

Salmonella bacteria (most often found in poultry and raw eggs) Escherichia coli (E. coli) (most often found in raw meats and unpasteurized milk and juices).

anaphylaxis

Severe allergic reactions to poisons are rare, but when one occurs, it is truly a life-threatening medical emergency

absorbed poison

a poison that enters the body through the skin

ingested poison

a poison that is swallowed

Poison control center (PPC)

a specialized health center that provides information on poisons or suspected poisoning emergencies

Two of the most common categories of food poisoning are

bacterial (growth on food) and chemical (high acidity) food poisoning

When caring for injected poisons

check the person for life-threatening conditions and care for any found. If there are no life-threatening conditions, applying a cold pack can reduce pain and swelling in the affected area.

what are the 4 ways a poison can enter the body

ingestion inhalation absorption injection

epinephrine

is a drug that slows or stops the effects of anaphylaxis

antihistamine

is a medication that counteracts the effects of histamine, a chemical released by the body during an allergic reaction. released by the body during an allergic reaction

anaphylaxis

of distributive shock caused by an often sudden severe allergic reaction, in which air passages may swell and restrict breathing; also referred to as anaphylactic shock.

injected poisons

poison that enters the body through a bite, sting or syringe

how do you activate the auto-injector device

pushing into leg and it should be used on the muscular area of the persons mid outer thigh

if you care for someone who has been in contact with a poisonous plant

rinse with water and soap cant hurt