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1、POISONING AND OVERDOSE Poisoning Any substance that can harm the body Types Chemicals Toxins Effects: Destroys the skin Suffocates Systemicdepress or over stimulate CNSdependent upon. Nature of poison Concentration Age, weight, general health Ingested Patient Assessment Substance When exposure occur
2、red How much was ingested Over how long a period Interventions prior to your arrival Weight EffectsActivated Charcoal a form of carbon that has been processed to make it extremely porous and thus to have a very large surface area available for adsorption or chemical reactions. just one gram of activ
3、ated carbon has a surface area of approximately 500 m (or about 2.17 tennis courts) Not an antidote reduces the amount of poison available for the body to absorb Absorbs many poisons but not allContraindications Cannot swallow AMS Ingestion of acids or alkalis Swallowed gasolineCare Identify and tre
4、at life-threats Transport decision Focused Hx. and PE SAMPLE Remove any remnants or pill fragments Baseline VS Take all bottles and labelsConsult Medical Control Repeat and follow directions carefully Pediatric Give weight Estimated amt. of poison ingestedINHALED POISONS CO Chlorine gas Ammonia Agri
5、cultural chemicals and pesticides CO2Scene Safety Protective clothing Self-contained breathing apparatus if trained Many inhaled poisons can be absorbed through the skin If you dont have the proper training or equipment STAY OUT!Assessment Exact name of substance When did exposure occur Period of ex
6、posure Interventions pta Effects of substance and interventionsCare Airway Breathing Move to a safe place non-urgent move urgent move emergency move Treat any immediate life-threats Transport decision Focused Hx. and PE O2 Bottled, containers and labelsCO Most common inhaled poison Car exhaust and f
7、ire supression Odorless, colorless, tastelessSigns and symptoms Headache a band around the head Dizziness Breathing difficulty Nausea Cyanosis AMS Consider a possibility when there are vague flu-like complaints and a group of people. May begin to feel better immediately after being removed from sour
8、ceSmoke Inhalation Difficulty breathing Coughing Breath with smoky or odorous smell Carbon residue in mouth and nose Black residue in sputum Singed nose hairsAbsorbed Poisons Absorption can take place with little or no damage to the skinAssessment Exact name of substance When did exposure occur Peri
9、od of exposure Interventions pta Effects of substance and interventionsCare ABCs and Life-threats Transport decision Remove contaminated clothing be cautions of becoming contaminated Remove the poison: Powders brush off Liquids Irrigate at least 20 minutes Eyes Irrigate for at least 20 minutes Do no
10、t neutralize acids and alkalis Alcohol and Substance Abuse May have underlying trauma from falls May have underlying medical problems diabetes, GI bleed Alcohol and drugs are commonly taken togetherPatient Assessment Scene Safety You may need to obtain SAMPLE from other sourcesSigns and symptoms of
11、alcohol abuse Odor of ETOH on breath or clothing Swaying and unsteadiness Slurred speech, rambling, incoherent Flushed with sweating Scene safe ABCs LOC and GCS Monitor VS and be alert for shock Protect from self-injury and yourselves *restrain If patient refusesSubstance AbusePatient Care BSI Scene
12、 safe ABCs Never touch or taste any suspected illicit drug Treat for shock Talk to your patient to establish rapport and determine LOC and GCS Perform Rapid or Detailed PE carefully assess for head injury Inspect for “tracks” Protect from harm or harming others If pt. creates unsafe scene, GET OUT Transport as soon as possible Contact medical direction Monitor VS Be aware of possible seizures Many drug users may appear calm at first then become violent-be on the alert
