I think about accidental poisoning cases every once in a while. As I mentioned last week, my husband ate Drano as a toddler. My great-grandfather’s sister, according to oral tradition, ate potato bug poison. After threatening her mother with a knife, she ended up in a mental institution and died shortly thereafter. Was she crazy and then ate the poison, or did the poison cause insanity?
In a collapsed society where food is lacking, I fear that hungry children will ingest poisons that haven’t been locked away. I fear overworked adults may become distracted and leave poisons within a child’s reach. Or perhaps a poison gets stored in a food or medicine container, always a bad idea.
The following general information comes from the Ship’s Medicine Chest and Medical Aid at Sea.
INTRODUCTION
Poisoning usually occurs as a result of inhaled or swallowed poisons. Certain chemicals, particularly insecticides, can be absorbed by the skin and cause poisoning. The treatment of inhaled noxious gases (as carbon monoxide) is discussed in Chapter IV, p 127+. Many organic solvents found in paint thinners and cleaning solvents may cause poisoning by inhalation. These should be used in well-ventilated areas. Persons overcome by fumes of solvents should be removed to fresh air. The treatment of poisoning by insecticides that can be absorbed by the skin is discussed on p. 114.
Often poisons are swallowed accidentally. Never store poisonous substances with foods or medicines. Never store poisons in discarded food or medicine containers. Poisons in mislabeled containers have been confused with food substances and used in cooking with lethal results.
Poisoning may be confused with other medical emergencies. Poisoning should be suspected in sudden, severe illness associated with violent vomiting, diarrhea, severe abdominal pain, and physical collapse with subsequent unconsciousness. Prolonged, deep sleep from which the individual cannot be aroused, may indicate poisoning. The patient should be examined for stained or burned areas on the lips and on the inside of the mouth. The breath may help to diagnose a poisoning, as well as identify the poison through its characteristic odor. A careful check of the individual’s room, or place where he was found, may reveal a container from which a poison was taken.
GENERAL PRINCIPLES OF TREATMENT
Too much antidote,[1] sedative, or stimulant often does more damage than the poison itself. It is important that good judgment plus a calm attitude should prevail when drugs or therapeutic measures are administered.
See p. 108 for a ready reference chart entitled, Emergency Aid for Poisonings. [This posted last week.]
Give symptomatic treatment, first aid (as artificial respiration, CPR) and, as indicated, diazepam, 5 to 10 mg injection for excitement or convulsions.
Give supportive treatment, such as keeping the patient warm and comfortable, and administering oxygen if indicated.
In all cases, seek medical advice by radio.
Identify the poison as soon as possible. The label on the container may give the ingredients and may list specific antidotes.
If the poison was taken by mouth, quickly remove the unabsorbed poison from the stomach. Many poisons are emetics and cause vomiting. If this does not occur spontaneously, vomiting should be induced provided there are no special circumstances that make it unadvisable. Do not induce vomiting if the patient has taken a corrosive (acid or alkali), strychnine, and petroleum distillates; or if the patient is unconscious or convulsing.
Vomiting may be induced by giving the patient syrup of ipecac in a dose of two tablespoonfuls (30 ml) followed by one or two glasses of water. If vomiting has not occurred in 20 to 30 minutes, this dose should be repeated.
Do not give syrup of ipecac at the same time that activated charcoal (a general antidote) is given because the activated charcoal will render the ipecac ineffective. The activated charcoal may be given after the patient has vomited, or 20-30 minutes after the last dose of syrup of ipecac. If vomiting does not occur after administering syrup of ipecac, gastric lavage should be started at once. (See p. 110 for instructions.)
GENERAL ANTIDOTE
If ipecac s not to be used, or if it has failed to work, give two to four tablespoonfuls of activated charcoal (a general antidote) mixed into a glass of water. Activated charcoal is safe to use, and will bind a large number of poisons, preventing them from being absorbed into the body. Do not use the Universal Antidote.[2]
[More next week.]
References:
The Ship’s Medicine Chest and Medical Aid at Sea, 1978, 109.
Links to related posts:
[1] An antidote is a substance which neutralizes (counteracts) the effects of a poison or prevents its absorption.
[2] The Universal Antidote, a mixture of tannic acid, charcoal, and magnesium oxide, formerly considered a general antidote, should not be used because it is not effective.
