Poisoning/ Medical emergency/ Antidote/Nursing management

Poisoning - A medical emergency Srividhya.N Introduction Poisoning is one of most common medical emergency in all countries. As per WHO 193,460 people died worldwide from unintentional poisoning In india around 26,173 people died of poisoning in year 2015 Majority of the poisoning occur due to acute pesticide.
Definition Poison: A poison is any substance that when ingested,inhaled ,absorbed,applied to the skin or produced within body in relatively small amounts,,injures the body by its chemical action Poisoning: Poisoning represents the harmful effects on the human body of accidental and intentional exposure to toxic amounts of any substance Toxicology: Branch of medicine that deals with detection and treatment of poison is called toxicology
Causes of poisoning: Chemicals Household cleaning items Industrial chemicals Pesticides (Organophosphate) Therapeutic drug over dose Toxic plants Bites of toxic animals ,insects….
Types of poisoning Ingestion Inhalation Injection Absorbtion Ingested poisons(Swallowed poison) Swallowed poisons are mostly corrosive. It includes alkaline and acidic agents that can cause tissue distruction after coming in contact with mucus membrane.
Types of ingested poisoning Alkaline products Lye Drain cleaners Toilet bowl cleaners Bleach Non phosphate detergents Oven cleaners Button batteries Drug overdose Acid products Battery Acid Toilet cleaners Rust cleaners Metal cleaners Petroleum distillates Kerosene Turpentine
Food poisoning : Signs and symptoms Fever Vomiting Diarrhea Dehydration Jaundice Changes in breathing rate and rhythm Changes in pulse rate and rhythm Skin lesion Abdominal pain Change skin pupil size Seizure Decreased urine output
Treatment - Goals Maintain vital signs Decontaminate the site of exposure Prevent and reduce absorption Enhance elimination Relieve symptoms Prevent further organ damage
Non pharmacological management Ensure patient airways Remove contaminated clothing If its chemical poisoning wash chemicals from skin with soap and water If needed nasogastric aspiration Gastric lavage ( Contraindicated in corrosive poisoning) within 1 hour Keep on observation and continuous monitoring Assess neurological status
Antidote: Antidote is defined as a therapeutic substance used to counteract the toxic action of any substance Supportive therapy and correct antidote will increase patient survival rate.
Basic physical antidotes Give water and milk for dilution of strong acid and alkaline poison Administer activated charcoal to decrease the absorption of poison Mixture of egg and milk will coat and protect the gastric mucosa Inhalational poison : The very common inhalational poison is carbon monoxide poisoning It may occur as a result of industrial or household incidents or attempted suicide
Pathophysiology: The inhaled carbon monoxide gets binds with haemoglobin and so the absorbtion of oxygen decreases The haemoglobin absorbs CMO 200 times more than oxygen to form carboxyhemoglobin Signs of carbon monoxide poisoning Treatment of CO2 poisoning Carry the patient to fresh air immediately, Open all doors and windows Loosen all tight clothing Initiate CPR if required; Administer 100% O2. Prevent chilling; wrap the patient in blanket. Keep the patient as quiet as possible. Do not give alcohol in any form or permit the patient to smoke.
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