Poisoning

Poisoning

Many die every year from accidental or intentional ingestion of toxic substances. Most cases of poisoning, however, are innocent and often occur in small children. Since infants are so prone to put unfamiliar substances in their mouth, careful surveillance by parents is necessary to prevent these incidents. The home should be inspected to be sure that cleaning fluids, medicines, insect poisons, and solvents are carefully secured beyond the reach of children. Never put toxic substances into soft drink bottles or other containers that are normally used for food. Particularly harmful preparations should be kept in a locked cabinet. As children are able, they should be instructed carefully concerning the danger of many household chemicals.

When accidental ingestion of a poisonous substance occurs, usually the first procedure is to induce vomiting. The sooner this is done after the ingestion of the poison, the better the results will be. Many substances are absorbed rapidly. If syrup of Ipecac is not available, give some lukewarm water or other liquid to dilute the poison. Then prepare at once to visit an emergency room.

Sticking the finger in the throat to induce gagging may be helpful when pills have been ingested, but should never be used in the case of swallowed lye, strong acids, gasoline, kerosene, or other hydrocarbons. Aspiration may result, producing a serious pneumonia. The caustic properties of lye make further corrosive burning of the esophagus a possibility. Even perforation may result if vomiting is instituted.

Activated Charcoal

The most helpful remedy for poisoning is the early administration of activated charcoal. Every home should have a box of powdered charcoal on hand, as well as the “activated” capsules. Charcoal has phenomenal powers to adsorb poisonous chemicals. The usual dose of charcoal is thirty to sixty grams (2 to 4 tablespoons of the powder). It is mixed with water to make a “slurry.” One must drink this water suspension as quickly as possible. The charcoal, administered early, can adsorb most drugs. Because of its insolubility, it is not absorbed into the bloodstream.

Many poisonous plant substances and mushrooms may be ingested.Botanical field guides are helpful to identify these substances. Some of the more common ones will be mentioned here. Every adult, especially every parent, should know how to identify the most common plants around their locality, and particularly be able to recognize the toxic species. Mushrooms are a most interesting class of plants. Some of them are nutritious and quite tasty, while others may be deadly when swallowed. The Amanita species are among the most toxic substances known to affect man. The recognition of this extremely poisonous mushroom should be thoroughly understood, so that no accidents will occur.

Many suicides take place each year through the ingestion of harmful drugs. Overdoses of sedatives or tranquilizers are common. Most cases can be salvaged by early recognition and gastric lavage. All emergency rooms should be equipped with materials to wash out (lavage) an individual’ s stomach. However, the early induction of vomiting may make this unpleasant procedure unnecessary. Activated charcoal is usually administered to adsorb the drug and prevent its effect on the system. REMEMBER to take suicide notes, hints, and actual attempts very seriously!

Often the best response is a willingness to listen and sincerely attempt to understand the plight of the distressed individual. Tragic deaths or deliberate overdoses could be prevented by the exercise of love and mutual understanding when disturbances arise in the family. As in many other aspects of emergency medicine, your loving attention may reduce the toll that accidents are now taking in our turbulent society.