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Flashcards in EAC Poisons and Substance Abuse Deck (22):
1

define:
Poison

A poison is any substance which, when taken into the body in sufficient quantity, may either endanger life or seriously impair body functions

can be: Intentional, accidental and non-accidental

2

4 routes of poisons entry

Inhalation - gases or fumes

Ingestion - liquids or solids

Injection - needles or bites

Absorption - through eyes or skin (mucosa)

3

define:
Dependency

The physical and/or psychological effects produced by the habitual taking of certain drugs, characterised by a compulsion to continue taking the drug.

4

define:
Addiction

Addiction is a state characterized by compulsive engagement in rewarding stimuli, despite adverse consequences.

5

define:
Tolerance

the reduction or loss of the normal response to a substance that usually provokes a reaction in the body

6

poisons are classified as

corrosive/irritant

non-corrosive - neurotoxic poisons (drugs), poisonous gases (CO), paraquat poisoning

7

signs and symptoms of:
corrosive/irritant substances

lips and mouth show signs of corrosion (burning) and/or staining

Severe pain and swelling in the mouth and throat

Wretching, followed by vomiting

Abdominal cramps and diarrhoea

Difficult speech due to swelling of the mucosa

Odours on breath

8

signs and symptoms of:
Non-Corrosive substances

Pinpoint pupils

Slow and shallow breathing (depressed respiration)

Lethargy and reduction in activity

Vomiting and diarrhoea

Loss of consciousness

9

time critical elements associated with poisoning and overdose

LOC
Respiratory depression/arrest
Cardiac arrest
Compromised airway
Heat stroke

10

commonly abused drugs

Stimulants: amphetamines, ecstacy, cocaine

Depressants: cannabis, alcohol, opiates (heroin, morphine, codeine, opium), tranquilisers (diazepam, valium)

Hallucinogenic: LSD, magic mushrooms, PCP

Solvents: adhesives, aerosols, solvents, gases, cleaning agents

11

effects of:
Stimulants

Excitability and euphoria
Hypertension
Tachycardia
Dilated pupils
Sweating/hyperpyrexia
Convulsions/unconsciousness

12

effects of:
Depressants

Anti depressants
Shallow respirations
Cool, clammy skin
Dilated pupils (except in opiates - pinpoint)
Decreasing LoC

13

effects of:
Hallucinogens

Vivid visual hallucinations
Delusions
Rapid mood swings
Fear, panic and potentially violent
Hypertension and tachycardia
Effects may last up to 12 hours
possibility of seizures

14

considerations when dealing with:
Solvents

Irritation to skin around nose and mouth
Apparent intoxication
Hallucinations
Coma
Asphyxia
Rapid irregular pulse
Cardiac arrest
Damage to lungs and alveoli
Pulmonary oedema
Suffocation
Toxic effect on heart, lungs, kidneys and brain
Accidental death form falls

15

considerations when dealing with:
Alcohol Intoxication

Has the potential to mask serious injuries and illnesses
Risk of vomiting and aspiration
Often they don't think they need to go to hospital

16

correct procedure when dealing with poisoning/overdose

Contact CHUB to use toxbase
information required:
Substance taken
Quantities and strength
When
With what
Vomited?
Weight or build
Gender
Age

17

management of:
Corrosive/Irritant substances

DRABCDE
Time critical if A/B problems
O2 (not for paraquat poisoning)
full obs
Never induce vomiting, although you may not be able to prevent it
Ascertaining what poison has been taken together with the time and quantity
Not giving anything by mouth unless directed by information on a container
For swallowed caustics and petroleum products dilute by giving milk on scene where possible
Collecting and retaining samples of substance taken for identification
Transporting to hospital as a matter of urgency
Retaining any vomit for analysis
Taking a relative to the hospital with the patient
Placing in recovery position if unconscious
Be prepared to use suction, assist ventilations or start CPR

18

management of:
Neurotoxic poisons

DRABCDE
Time critical if A/B problems
O2
Assisting ventilation if req.
Be prepared for CPR
Never induce vomiting
Providing copious amounts of water or milk to dilute and delay absorption
If the poison is not known; don't delay unnecessarily to identify it
Placing in recovery position if unconscious
Keep patient still and quiet to reduce pulse rate
Not allowing patient to walk
full obs
consider Narcan for opiate overdose

19

management of:
Poisonous Gases

DRABCDE
Approaching the scene with care
Removing the patient form poison source
Ensuring an open airway
Administering high concentrations of O2
Being prepared to perform CPR
Loosening and removing contaminated clothing
Identifying what type of gas was inhaled
Informing the receiving hospital if possible
Transporting to hospital

20

management of:
Paraquat Poisoning

DRABCDE
Ensuring an open airway
NOT administering oxygen, this will increase toxicity
ONLY USE BVM not mouth to mouth/nose
DO NOT encourage to vomit

In addition to usual clinical signs there may be evidence of burning around the mouth

21

management of:
Pesticide and Herbicide Poisoning

DRABCDE
Remove patient from source of poison if possible
Ensuring open airway
Assisting ventilation if required
O2
Encourage vomiting as a matter of priority if the patient has swallowed any of the substance; do not use a salt solution to do this
Removing all contaminated clothing taking care to avoid contamination yourself
Washing contaminated skin thoroughly with soap and water
Irrigating the eyes copiously with clean water and then covering with a soft pad, gauze or cotton wool secured by a bandage if contaminated
Taking to hospital for examination purposes if available:
-the container
-a sample of the substance
-any vomit for analysis

In addition to usual clinical signs there may be evidence of burning or staining around the mouth, tongue, lips

22

Poison management checklist

safety steps: 1,2,3 patients
Treat what you find
Consider CASMEET/blue call
Handover
PRF
Avoid contaminating yourself
Act quickly, speed is essential
Ensure open airway
Assist ventilation if necessary
Treat asphyxia first
If pt unconscious do not induce vomiting and place in recovery position
If the patient vomits spontaneously keep a sample for analysis by the hospital
Continually assess the patient for sudden deterioration
Keep the patient still and quiet, do not let them walk
Constantly re-assure the patient
Collect samples of the poison, bottles and other containers