Objectives

 
After 15 minutes of teaching, my students will be able:

1. To define the word Poisoning

2. To discuss the symptoms of Poisoning
3. To distinguish different types of Poisoning
4. To deliver emergency care if poisoning is present in
patient
5. To discuss ways to prevent Poisoning
6. To identify common agents that cause poisoning
7. To identify substances that are potential poisons
 POISONING
 Poisoning occurs when any substance
interferes with normal body functions after
it is swallowed, inhaled, injected, or
absorbed.
 In 80% of the cases, the victim is a child
under the age of five. About 50 children
die each year from poisonings. Curiosity,
inability to read warning labels, a desire to
imitate adults, and inadequate supervision
lead to childhood poisonings.
 COMMON AGENTS:
 Soaps
 Cosmetics
 Detergents or cleaners
 Plants
 OTC drugs or
prescription drugs
 Poisonous plants
Flowers: House Ground Trees: Shrubs: Vines: Other:
plants: plants:

Azalea Dumb Baneberry Black locust Castor Goldenchai Jimsonwee

Daffodil bulbs cane Belladonna Buckeye bean n d (weed
Delphinium Caladium Caladium Cherry Daphne Moonseed found in
False hellebore Caper spurge Chinaberry Duranta Philodendr gardens)
Foxglove Death camas Goldenchai Holly on Various
Hyacinth Nightshade n Jessamine Rubber mushroom
Hydrangea Poison Holly Lantana vine s
Larkspur hemlock Mountain Mistletoe Rhubarb
Lily of the valley Pokeweed laurel Mountain leaves
Lupine Water Sandbox laurel
Monkshood hemlock Tung Privet
Oleander White Pyracantha
Rhododendron snakeroot (firethorn)
Tansy Rosary pea
Wisteria Yew
Emergency management at home:
 No longer advised to give syrup of ipecac

instead call local poison control center

 Information to give:
– Name, number, address, weight, age and what
the child swallowed
– How long ago the poisoning occurred

– Route of poisoning (oral, inhaled, sprayed on

skin)
– How much did the child take

– What was swallowed

– Child’s present condition

 FIRST AID:
 Do not be poisoned
 toxic gas exposure should be removed from
the source quickly, preferably out into fresh
air
 rescue attempts should be done by
professionals
 If the person appears very sick, call
emergency medical assistance (e.g. 611)
 perform cardiopulmonary resuscitation
(CPR) if needed
 Save containers of the
poisons and all drugs that
might have been possibly
taken by the poisoned
person (including
nonprescription products)
 give the poisoned person
activated charcoal; may
recommend giving syrup of
ipecac to induce vomiting
ACETAMINOPHEN POISONING
 Acetaminoplhen (Tylenol) if taken in large doses =
hepatotoxicity
 Common occurrence because of poor storage and
increased availability
s/sx:
 Anorexia Nausea
 Vomiting Liver tenderness
 Serum aspartate transaminase and alanine
transferase elevates
 CAUSTIC POISONING
 Ingestion of strong alkali (found in toilet bowl cleaners, or
hair care products, may cause burns and tissue necrosis in
the mouth, esophagus, and stomach)
 Important that vomiting is not induced because this can only
cause further burning

S/sx:
 Immediate pain in mouth, throat
 saliva drooling (due to oral edema and an inability to

swallow)
 mouth first turns white from the burn then brown as edema

and ulceration occur

 vomiting of blood, mucus and necrotic tissue
dx test:
 Chest radiograph (to determine whether pulmonary

involvement has occurred secondary to aspiration

 Esophagoscopy (to check for esophageal perforation)

 Barium swallow (to check extent of burns)

Therapeutic management:
 Because of risk of airway obstruction from edema the

child should be immediately be brought to the health

care facility
 Intubation – if with pharyngeal edema to provide a

patent airway
 Iron poisoning
Iron when ingested is corrosive to the gastric
mucosa and leads to gastric irritation
s/sx:
 Nausea and vomiting Diarrhea
 Abdominal pain Melena
 Hematemesis Lethargy, coma
 Cyanosis Vasomotor collapse

NTBI- non-transferrin bound iron

Therapeutic management:
 Stomach lavage – to remove any pills not yet

absorbed
 Cathartic agents (purgative) – to help pass out

enteric coated tablets

 Chelating agent (deferoxamine) – binds with

iron, then excreted; turns urine orange

 Lead poisoning (Plumbism)
 Lead interferes with RBC function by blocking iron
 Usual sources: paint chips, paint dust, pottery, fumes from
burning or swallowed batteries
Dx tests:
 Serum ferritin – blood lead determination

s/sx:
 Asymptomatic Anorexia
 Abdominal pain
 Signs of encephalopathy: lethargy impulsiveness,
learning difficulties, seizures
 THERAPEUTIC MANAGEMENT:

 Removal of child from environment or removal of

source of lead
 Chelation therapy (dimercaprol BAL) (edentate
calcium disodium CaEDTA) – remove lead from
soft tissue and bone then excreted through urine

calcium ethylenediaminetetraacetate (CaEDTA) / British anti-Lewisite (BAL)

 Poisonous Substances
Common houseplants outdoor plants Toxic household cleaning Personal care Poisonous fumes
products products
bird of paradise
aloe flower
ammonia deodorant Carbon
amaryllis buttercup bleach hairspray monoxide
castor bean
cyclamen dishwashing liquids hair farm and garden
chinaberry tree
Philodendron daffodil drain openers straighteners insecticides and
English ivy
dumb cane floor waxes and nail polish and herbicides
eucalyptus
(also called foxglove furniture polishes polish gasoline fumes
Dieffenbachia) holly
laundry detergents, remover insect repellent
horse chestnut
iris spot cleaners, and perfume paint thinner
jack-in-the-pulpit fabric softeners shampoo fumes
jimsonweed (also
called thornapple) mildew removers
larkspur oven cleaners
lily-of-the-valley
morning glory toilet bowl cleaners
nightshade (several
varieties)
oleander
potato
rhododendron
rhubarb
sweet pea
tomato
wisteria
yew