Poisoning and Overdoses

1
Poisoning and Overdoses

• Thomas Vaden

2
Objectives

• Recognize the signs/symptoms associated with
  poisoning.
• Discuss the emergency medical care for the
  patient with a possible overdose.
• Discuss the 6 ways that poisons enter the body,
  and recognize examples.

3
Objectives

• Explain the rational for administering activated
  charcoal
• Categorize alcohol as a drug and describe its
  effects on the body in combination with
  hypothermia
• Recognize the need for medical direction in
  caring for the patient with poisoning or overdose

4
Poison Control Center

• What is the number for the poison control center
  in Alaska
• 1-800-478-3193

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Poisoning

• The adverse effects of plants, foods, chemicals
  or pharmaceutical agents on the body

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Overdose

• Poisoning by excessive dose

7
Two Peak Age Groups

• The first group is toddler to preschool age
  when children are exploring there environment
• The second group is young adult age group, when
  ingestion is a form or suicidal behavior

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Hypothermia and Alcohol

• Ingested.
• Alcohol is a vasodilator.
• Body temp is lowered.
• At around 94 degrees shivering stops .
• Blood is shunted to core organs.

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Hypothermia and Alcohol (cont.)

• Person is hypothermic continues to consume
  alcohol.
• Alcohol sits in stomach is not absorbed.
• Person goes inside.
• Body has external heat source.
• Alcohol dump.

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Routes of Absorption

• Ingestion
• Absorption
• Dermal exposure
• Ocular exposure
• Injection
• Inhalation

11
Scene Survey and Assessment

• Scene survey
• Is the world safe for you to be there?
• Scene information
• Unusual odors,
• Specific medication
• Specific chemicals

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Scene information

• Do not transport materials that may be a risk.
• Vomit.
• Stool samples.
• Digital Cameras may be of assistance.

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General Assessment

• Management of poisoning is primarily supportive
• Basic Life Support (BLS)
• Level Of Consciousness (LOC)

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What do we do

• Initial Assessment
• General impression of Patient
• Determines Level of Consciousness (AVPU)
• Airway
• Breathing
• Circulation
• Pulse
• Hemorrhage

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Assess Skin

• Skin color
• Skin temperature
• Skin Condition
• Redness
• Blisters

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• Identifies priority Patients and makes transport
  decision.
• Selects and performs appropriate assessment

17
Focused History and Physical Exam

• Assess illness and condition based on chief
  complaint (c/c)
• Inspects and palpates areas based on chief
  complaint (c/c)

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Specific Medical Questions

• Poisoning Overdose
• Substance
• When exposed/ingested
• Amount

19
Specific Medical Questions

• Poisoning Overdose
• Time Period
• Interventions
• Estimated weight

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Obtains SAMPLE History

• S Signs and symptoms
• A Allergies
• M Medication
• P Pertinent medical history
• L Last oral intake
• E Events

21
Obtains baseline vitals

• Blood Pressure
• Pulse
• Respirations

22
Transport

• Properly packages and transports as needed.

23
Rapid Assessment

• Performs a rapid assessment if indicated by
  findings

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Continuing exam

• Moves to detailed exam, ongoing exam as
  indicated.
• Usually performed while transporting.

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Ongoing Assessment

• Repeats initial assessment
• LOC
• Airway
• Breathing
• Circulation

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Ongoing Assessment

• Reassess Vital signs
• Blood pressure,
• Pulse
• Respirations

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Ongoing Assessment

• Reassess all interventions

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Management

• Inhalation
• Absorption
• Injection
• Ingestion

29
Management

• Reports
• Medical Direction
• Poison Control Center
• Emergency Department

30
Summary

• Recognize the signs/symptoms associated with
  poisoning.
• Discuss the emergency medical care for the
  patient with a possible overdose.
• Discuss the 6 ways that poisons enter the body,
  and recognize examples.

31
Summary

• Explain the rational for administering activated
  charcoal
• Categorize alcohol as a drug and describe its
  effects on the body in combination with
  hypothermia
• Recognize the need for medical direction in
  caring for caring for the patient with poisoning
  or overdose