10.2 First aid for ingested, inhaled, and absorbed poisons

Poisoning emergencies require quick action and specific treatments. From ingested toxins to inhaled fumes, knowing how to respond can save lives. This section covers key strategies like contacting Poison Control, administering antidotes, and performing decontamination procedures.

First aid for poisons involves a range of techniques tailored to the type and route of exposure. We'll explore supportive care, gastrointestinal decontamination methods, and external decontamination procedures for skin and eye exposures. Understanding these approaches is crucial for effective poison management.

Poison Treatment

Poison Control Center and Supportive Care

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• Poison Control Center provides expert advice on poison treatment and management available 24/7 by calling 1-800-222-1222
• Supportive care focuses on maintaining vital functions (airway, breathing, circulation) until the poison is metabolized or eliminated from the body
• Oxygen therapy administers supplemental oxygen to support breathing and oxygenation in cases of respiratory distress caused by poisoning (carbon monoxide)

Antidotes and Specific Treatments

• Antidotes are substances that counteract or neutralize the effects of a specific poison (naloxone for opioid overdose, atropine for organophosphate pesticides)
• Some poisons have specific treatments that enhance elimination or reduce absorption of the substance
  • Chelation therapy uses chelating agents (EDTA, dimercaprol) to bind and remove heavy metals (lead, mercury) from the body
  • Hemodialysis filters the blood to remove certain poisons (ethylene glycol, lithium) that are not effectively cleared by the kidneys

Gastrointestinal Decontamination

Activated Charcoal

• Activated charcoal is a highly porous substance that binds to many poisons in the gastrointestinal tract, preventing their absorption into the bloodstream
• Typically administered orally as a liquid or powder mixed with water within 1 hour of ingestion for maximum effectiveness
• Not effective for all poisons (acids, alkalis, ethanol, metals) and may interfere with the absorption of oral antidotes

Induced Emesis and Gastric Lavage

• Induced emesis (vomiting) was previously used to remove ingested poisons from the stomach but is no longer recommended due to the risk of aspiration and further injury
• Gastric lavage involves inserting a tube through the mouth into the stomach to flush out its contents with water or saline
  • Reserved for potentially life-threatening ingestions within 1 hour, when activated charcoal is ineffective or contraindicated
  • Risks include aspiration, esophageal or stomach injury, and electrolyte imbalances

External Decontamination

Skin and Eye Decontamination

• Skin decontamination involves removing contaminated clothing and flushing the skin with copious amounts of water for at least 15 minutes to remove or dilute the substance
  • Dry chemicals (lime, phenol) should be brushed off before flushing to avoid activation by water
  • Some chemicals (hydrofluoric acid) require specific decontamination solutions (calcium gluconate gel) to neutralize the substance and prevent further injury
• Eye decontamination requires continuous irrigation with water or saline for at least 15-30 minutes, while holding the eyelids open and rotating the eyes to ensure complete flushing
  • Contact lenses should be removed if present and discarded to prevent trapping the substance against the eye

Decontamination Safety Precautions

• Rescuers should wear appropriate personal protective equipment (gloves, gowns, masks, eye protection) to avoid secondary contamination when handling poisoned patients or their belongings
• Decontamination should be performed in a well-ventilated area or outdoors, if possible, to minimize exposure to toxic fumes or vapors
• Contaminated clothing and materials should be properly bagged and disposed of as hazardous waste to prevent further exposure or environmental contamination