TOX 2- II. Decontamination

Question 1

PURPOSE OF Decontamination

Answer 1

PREVENTION OF FURTHER POISON ABSORPTION

Question 2

Types of decontamination

Answer 2

1. Gastrointestinal decontamination
2. Eye decontamination (for at least 20 min)
3. Skin decontamination - Remove contaminated cloth.. etc
4. Body cavity evacuation

Question 3

Gastrointestinal decontamination

Answer 3

1. Induction of emesis :

• Syrup of ipecac
• Apomorphine (rarely)

* Not to do it in patients! who are

• unconsciousness
• poisoned with corrosive agents (acid, base)
• poisoned with petroleum distillate (risk of aspiration!!)
• poisoned with convulsant

2. Gastric lavage (if necessary protection of the airway by endotracheal tube)

* Not to do in patients who are poisoned with

• corrosive agents (acid, base)
• poisoned with convulsants
• poisoned with petroleum distillate (risk of aspiration!!)

3. Whole bowel irrigation via gastric tube

(6-8 l isosmotic physiological electrolyte solution , containing polyethylene glycol)

4. Catharsis (e.g. with sorbitol) – NOT in case of paralytic ileus

Question 4

Contraindication of GI decontamination by emesis

Answer 4

Not to do it in patients! who are

1. unconsciousness
2. poisoned with corrosive agents (acid, base)
3. poisoned with petroleum distillate (risk of aspiration!!)
4. poisoned with convulsant

Question 5

contraindication of GI decontamination- gastric lavage

Answer 5

Gastric lavage (if necessary protection of the airway by endotracheal tube)

* Not to do in patients who are poisoned with

1. corrosive agents (acid, base)
2. poisoned with convulsants
3. poisoned with petroleum distillate (risk of aspiration!!)

Question 6

Contraindication of GI decontamination - catharsis

Answer 6

4Catharsis (e.g. with sorbitol) – NOT in case of paralytic ileus

Question 7

Whole bowel irrigation : how? what is used?

Answer 7

3. Whole bowel irrigation via gastric tube

(6-8 l isosmotic physiological electrolyte solution , containing polyethylene glycol)

Question 8

Skin decontamination

Answer 8

● Remove contaminated clothes from skin, seal them in double bags to protect health care workers and for laboratory analysis.

● Wash the skin area that was in contact with clothes with soap and water.

● Example: Liquid Sarin- toxic chemical warfare that irreversibly inactivates acetylcholinesterase