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Poison
Any substance that impairs health or causes death by its chemical action.
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Toxicology
The study of toxins, antidotes, and the effects of toxins in the body.
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Overdose
Is commonly used to describe a poisoning in which the patient has been exposed to an excessive dose of a drug.
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Four routes by which a poison can enter one's body
- Ingestion
- Inhalation
- Injection
- Absorption
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Toxins
Drugs or substances that are poisonous to humans.
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Antidote
A substance that neutralizes the effects of a poison or a toxic substance.
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Secondary Assessment for Ingested Poison
- Was any substance ingested?
- Was any alcohol ingested with the substance?
- When did the patient ingest(come in contact with) the poison?
- Over what time period?
- How much of the substance was taken?
- Has anyone attempted to treat the poisoning ?
- Any psychiatric history that might suggest a suicide attempt?
- Any underlying chronic illness, allergy, drug use, addiction?
- How much does the patient weigh?
- What medications are available in the house?
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Emergency Care for ingested Poison
- 1. Maintain the airway
- 2. Provide O2 or assist ventilations
- 3. Prevent further injury (do not flush the mouth of an unresponsive patient)
- 4. During transport, consult medical direction for destination
- 5. Bring suspected poisons to the receiving facility.
- 6. Reassess every 5min
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Activated Charcoal
- A distilled charcoal in powder form that can absorb many times its weight in contaminants; no longer commonly administered in the emergency care of poisoning patients.
- Contraindications: AMS, has swallowed acids or alkalis, unable to swallow, overdose on cyanide
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Huffers
- People who inhale vapors to "get high"
- Can damage aveoli and lead to hypoxia
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Secondary Assessment for Inhaled Poison
- Does the patient have a history that suggests a possible suicide attempt?
- Did the exposure occur in an open or confined space?
- How long was the patient exposed?
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Emergency Care for Inhaled Poison
- 1. Protect yourself
- 2. Quickly get the patient out of the toxic environment
- 3. Place the patient supine or position of comfort
- 4. Ensure an open airway
- 5. Start PPV with O2
- 6. Administer O2 at 15lpm regardless of SpO2 reading
- 7. Bring all containers, bottles, labels, or other clues about the poisoning to the receiving facility.
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Second Assessment for Injected Poison
- Does the patient have a history of drug use?
- Does the patient have a history of allergic reaction to bites or stings?
- What was the time lapse between the injection and the onset of signs and symptoms?
- What type of animal or insect was the patient bitten by?
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Emergency Care for Injected Poison
- 1. Maintain the patient's airway
- 2. Begin PPv and O2 administration
- 3. Be alert for vomiting
- 4. In the case of bite or sting, protect yourself and protect your patient from further injury
- 5. Bring all containers, bottles, labels, or other evidence of poisonous sunstances to the receiving facility.
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Emergency Care for Absorbed Poison
- 1. Protect hands with gloves, move the patient from source of poisoning, and remove contaminated clothing and jewelry
- 2. Carefully monitor airway and respiration status
- 3. Begin PPV with supplementary O2
- 4. Brush any dry chemicals or solid toxins from the patient's skin
- 5. If the poison is liquid, irrigate all parts of the body with clean water for at least 20min
- 6. If the poison entered the eye, irrigate the affected area with clean water for at least 20min
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Food Poisoning
- Some foodborne illnesses include
- -Salmonella-from contaminated food or water
- -Campylobacter-common poisoning from contaminated poultry, milk and water
- -E. coli-severe gastrointestinal poisoning from numerous contaminated food
- -Staphylococcus aureus-food poisoning from unhygienic food preparation
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Emergency Care for CO Poison
- Evacuate everyone else
- Stay at least 150 feet from source
- Always administer O2
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Cyanide
- 1. Remove patient from toxic environment
- 2. Removed contaminated clothing
- 3. Maintain airway
- 4. Assess breathing status, always 15lpm O2
- 5. ALS
- 6. Rapid transport
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Acids and Alkali
- 1. Ensure PPE on every rescuer
- 2. Remove any contaminant and decontaminate patient
- 3. Airway-call ALS if needed
- 4. Rapid transport
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Drug Abuse
Self-administration of drugs (or a single drug) in a manner that is not in accord with approved medical or social patterns
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Withdrawal
A syndrome that occurs after a period of abstinence from the alcohol or drugs to which aperson's body has become accustomed.
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Stimulants and appetite depressents
- Amphetamines
- Caffeine
- Cocaine
- Ephedrine
- Methlyphenidate
- Nicotine
- OTC and prescription drugs
- Methamphetamine
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Cannabis Products
- Hashish
- Marijuana
- THC (tetrahydrocannabinol)
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Depressants-Narcotics and opiates/opioids
- Codeine
- Heroin
- Methadone
- Morphine
- Fentanyl
- Oxycodone
- Hydrocodone
- Hydromorphone
- Buprenorphine
- Opium
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Depressants-sedatives and tranquilizers
- Alcohol
- Antihistamines
- Barbiturates
- Chloral hydrates
- Other nonbarbiturate, nonbenzodiazepine sedatives
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Hallucinogens
- DET
- DMT
- LSD
- Mescaline MDA
- PCP
- STP
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Inhalents
- Aerosol Propellants
- Gasoline and kerosene
- Glues and organic cements
- Propane
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High Priority Patients
- Unresponsiveness
- Inadequate breathing
- Fever
- Abnormal heart rate
- Vomiting with AMS
- Seizures
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Pharming
Raiding others' medicine supplies or using faked prescriptions to obtain drugs.
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CNS stimulants and depressants
Substances that either increase or decrease CNS functions
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Narcotics
CNS depressants that are derived from opiates or opioids.
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Hallucinagens
Substances that cause hallucinations, or false perceptions
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Volatile Inhalents
Substances that are easily vaporized and inhalable.
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The Talk Down Technique
- 1. Make the patient feel welcome
- 2. Identify yourself clearly
- 3. Reassure the patient that his condition is caused by the drug and will not last forever
- 4. Help the patient verbalize what is happening to him
- 5. Reiterate simple on concrete statements
- 6. Forewarn the patient about what will happen as the drug begins to wear off
- 7. Once the patient has been calmed, transport
Never talk down a patient known using PCP
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