Lesson Outlines
Chapter 18
Lesson 18: Poisoning
Lesson Objectives
After completing this lesson, participants should be able to:
 Describe how to care for ingested poison.
 Describe how to care for a victim with possible alcohol intoxication.
 Describe how to care for a sympathomimetic user.
 Describe how to care for hallucinogen use.
 Describe how to care for a marijuana overdose.
 Describe how to care for an opiate overdose.
 Describe how to care for a depressant overdose.
 Describe how to care for someone who has abused an inhalant.
 Describe how to care for carbon monoxide poisoning.
 Describe how to care for plant-induced dermatitis.
 Describe how to care for a stinging nettle poisoning.
Points
Types of Poisons
 Ingested (swallowed)
o Through the mouth
 Inhaled (breathed)
o Through the lungs
 Absorbed (contact)
o Through the skin
 Injected
o Through needlelike device
Ingested (Swallowed) Poisons
 Poisoning from ingestion occurs when a victim swallows a toxic substance.
 Most ingested poisons have low toxicity or are swallowed in small amounts.
 Poisoning from ingestion is common among children.
 Some ingested substances can block the airway.
 Analgesics are the most common poisoning from ingestion.
 Most exposures to plants are minor.
Recognizing Ingested Poisoning
 Abdominal pain, cramping
 Nausea or vomiting
 Diarrhea
 Burns, odors, or stains around or in mouth
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Drowsiness or unresponsiveness
Poison container nearby
Care for Ingested Poisons
 Determine the age and size of the victim, what and how much poison was
ingested, and when it was taken.
 If corrosive or caustic, have the victim sip cold water or milk.
 Call the poison control center at 800-222-1222 if the person is responsive.
o They can advise if medical care is needed.
 For unresponsive victim, call 9-1-1.
 Place victim in recovery position
 Do not induce vomiting.
 Give activated charcoal (neutralizer) if available and if instructed to do so by
poison control.
o Activated charcoal is a black, tasteless, odorless, insoluble, inert powder
that binds to poison, but it does not absorb all drugs well.
 Save poison containers, plants, or victim’s vomit to help identify the substance.
Alcohol Intoxication
 Alcohol is a depressant, not a stimulant.
o It affects a person’s judgment, vision, reaction time, and coordination.
 It is the most commonly used and abused drug in the United States.
 It is one of the most lethal and is implicated as cofactor in drownings, traffic
deaths, homicides, and suicides.
 Helping the intoxicated person is often difficult because the person can be
belligerent or combative.
 Take the condition seriously.
o It can be life-threatening.
Recognizing Alcohol Intoxication
 Odor of alcohol
 Unsteadiness, staggering
 Confusion
 Slurred speech
 Nausea and vomiting
 Flushed face
 Seizures can also result.
Care for Alcohol Intoxication
 Look for any injuries.
 Monitor breathing.
 Place in recovery position.
 Call poison control for advice (1-800-222-1222).
 If victim becomes violent, leave the area and await police.
 Provide emotional support.
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If victim is unresponsive, await EMS.
Suspect hypothermia.
Move the person to a warm place.
Drug Emergencies
 Drug classifications:
o Uppers (stimulants)—amphetamines, cocaine, caffeine
o Downers (sedative-hypnotic)—barbiturates, tranquilizers, marijuana,
narcotics
o Hallucinogens—LSD, mescaline, peyote, PCP
o Volatile chemicals—glue, cement, paint solvent, gasoline, spray paint, nail
polish remover
Sympathomimetics
 Stimulants (“uppers”)
 Produce excitement
 Amphetamines, methamphetamines
 Taken by mouth or injected
 Cocaine
o One of most addictive substances known
 Crack
o Pure cocaine, smoked
Recognizing Sympathomimetic Use
 Disorganized behavior
 Hyperactivity
 Restlessness
 Anxiety or great fear
 Paranoia
 Delusions
Care for Sympathomimetic Use
 Check breathing.
 Call poison center or 9-1-1.
 Check for injuries.
 Place in the recovery position.
 Give reassurance and emotional support.
 If violent, seek safety until police arrive.
 Seek medical care.
Hallucinogens
 Produce changes in mood, sensory awareness
 Hear colors, see sounds
 Cause hallucinations, bizarre behavior
 Protect user from hurting self
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Recognizing Hallucinogen Use
 Visual hallucinations
 Intensity of vision and hearing
Care for Hallucinogen Use
 Check breathing.
 Call poison center or 9-1-1.
 Check for injuries.
 Place in the recovery position.
 Give reassurance and emotional support.
 If violent, seek safety until police arrive.
 Seek medical care.
Marijuana
 Flowering hemp plant
 Estimated 20 million people use marijuana daily in US
Recognizing Marijuana Overdose
 Euphoria, relaxation, drowsiness
 Short-term memory loss
 Impaired capacity for complex thinking and work
 Depression, confusion
 Altered perception of time
 Anxiety, panic
 Hallucinations
Care for Marijuana Overdose
 Check breathing.
 Call poison center or 9-1-1.
 Check for injuries.
 Place in the recovery position.
 Give reassurance and emotional support.
 If violent, seek safety until police arrive.
 Seek medical care.
Depressants
 Often prescribed as part of legitimate medicine
 People may solicit prescriptions from several physicians.
 Includes:
o Opiates (narcotics)
o Sedative hypnotics (barbiturates and tranquilizers)
Recognizing Sedative-Hypnotic Drug Use
 Drowsiness, sleepiness
 Slurred speech
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Slow breathing rate
Opiates
 Pain relievers named for opium
 Heroin, codeine, morphine
 Frequently abused
 Addicts may start with appropriate prescription
Recognizing Opiate Overdose
 Reduced breathing rate
 Pinpoint pupils
 Sedated condition, unresponsiveness
Care for Depressant Overdose
 Check breathing.
 Call poison center or 9-1-1.
 Check for injuries.
 Place in the recovery position.
 Give reassurance and emotional support.
 If violent, seek safety until police arrive.
 Seek medical care.
Abused Inhalants
 Glue, gasoline, lighter fluid, nail polish
 Similar effects to alcohol
 Can die of suffocation
 Can change heart rhythm
 Can cause permanent brain damage
Recognizing Abused Inhalant
 Mild drowsiness, unresponsiveness
 Slurred speech, clumsiness
 Seizures
 Slow breathing rate
 Smell of solvents
Care for Abused Inhalant
 Check breathing.
 Call poison center or 9-1-1.
 Check for injuries.
 Place in the recovery position.
 Give reassurance and emotional support.
 If violent, seek safety until police arrive.
 Seek medical care.
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Carbon Monoxide Poisoning
 Carbon monoxide is an invisible, tasteless, odorless, colorless, nonirritating gas,
so victims are often unaware of its presence.
 It is the leading cause of poisoning death in the United States each year.
 Carbon monoxide poisoning can be unintentional or a method of suicide.
 People who ride long distances in older, poorly maintained cars are at increased
risk.
 Many deaths involve people sleeping inside a running car, often after alcohol
consumption.
 Dangerous sources of carbon monoxide include faulty furnaces, water heaters,
and kerosene heaters.
 Carbon monoxide causes hypoxia.
o Hemoglobin binds to it and the carbon monoxide does not allow cells to
use oxygen.
Recognizing Carbon Monoxide Poisoning
 Headache
 Ringing in ears
 Chest pain
 Muscle weakness
 Nausea and vomiting
 Dizziness and visual changes
 Unresponsiveness
 Respiratory and cardiac arrest
 Symptoms come and go
 Symptoms worsen and improve in certain places and at certain times
 Nearby people have similar complaints
 Pets seem ill.
Care for Carbon Monoxide Poisoning
 Get the victim out of the toxic environment.
 Call 9-1-1.
 EMS can give 100% oxygen for 30 or 40 minutes to reverse CO poisoning.
 Monitor breathing.
 Place an unresponsive, breathing victim in the recovery position.
 Seek medical care.
Plant-Induced Dermatitis
 Poison ivy, poison oak, poison sumac
 15-25% of exposed people will have incapacitating swelling and blisters.
 Oil oozes out from the plant when it is brushed.
 The oil is not visible on human skin.
 It is spread by direct contact and can stay active for months or years on objects.
 Smoke from burning plants can cause severe dermatitis.
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Most people cannot identify these irritating plants.
o The leaves grow in groups of three.
Recognizing Plant-Induced Dermatitis
 Rash
 Itching
 Redness
 Blisters
 Swelling
 The greater the amount of skin affected, the greater the need for medical care.
 Onset usually occurs 1-2 days after contact.
Care for Plant-Induced Dermatitis
 Wash affected area with soap and cold water as soon as possible
 Apply rubbing alcohol liberally, then remove the alcohol with water.
 For a mild reaction, have the victim soak in a lukewarm bath with 1 to 2 cups of
colloidal oatmeal.
 Or, apply one of the following:
o Wet compresses with aluminum acetate
o Calamine lotion or baking soda paste
o For a mild to moderate reaction, use a corticosteroid ointment.
o For a severe reaction, use a physician-prescribed oral corticosteroid
Stinging Nettle
 Plant with stinging hairs on stem and leaves
 Stinging hair is touched
 Fine needlepoint penetrates skin
 Injects chemical irritant
Recognizing Stinging Nettle Poisoning
 Can affect anyone
 Effects limited to exposed area
 Immediate response
 Redness
 Rapid, intense burning
 Itching
 Reaction lasts hours, not days
Care for Stinging Nettle Poisoning
 Wash exposed area with soap and water.
 Apply:
o Cold, wet pack
o Colloidal oatmeal, hydrocortisone cream, or calamine lotion
o Over-the-counter antihistamine
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