Poisoning Emergencies

Most poisoning emergencies result from ingesting a toxic substance; less common are poisonings caused by inhaling gases, such as exhaust fumes; absorbing chemicals through the skin; or injecting drugs into the body.
More than 75 percent of poisonings reported in the United States each year are of children under age five who have swallowed toxic substances ranging from excessive doses of vitamins and medications to household cleaners. Another high-risk group is the elderly, who accidentally (or intentionally) take an overdose of a drug or other toxic substance.

Symptoms of poisoning vary. Some substances produce vomiting, cramps, abdominal pain, and other intestinal problems; others primarily affect the central nervous system, causing an altered state of consciousness, blurred vision, or paralysis, for example. Certain poisons work almost instantly, others may not produce symptoms for a number of hours or even days.

Diagnostic Studies and Procedures

At a hospital or emergency room, blood tests may be performed to determine how much poison is circulating in the body. Depending on the substance, blood and urine tests and X-rays may be needed to evaluate its impact on various organs, especially the liver, kidneys, and kings. If a caustic substance has been ingested, endoscopy may be done to assess the extent of damage to the esophagus and stomach.

Medical Treatments

Depending on the poison ingested, medical personnel may be able to give an antidote, such as atropine for an organic phosphate or acetylcysteine for an overdose of acetaminophen. Metal poisoning, including an overdose of iron pills -- one of the most common childhood poisoning episodes -- may respond to administration of a chelating agent that binds to the metal and facilitates its elimination from the body.

In other cases, vomiting may be induced with medication and/or a pump device might be used to empty the stomach. In addition, activated charcoal may be left in the stomach to absorb any remaining poison.
A person who is unconscious or having trouble breathing will be given extra oxygen or will be placed on life-support equipment, and possibly given intravenous fluids and replacement electrolytes to treat dehydration.

If a caustic substance has burned the esophagus or damaged the airway, a tracheostomy will be performed to facilitate breathing.

Renal dialysis will be used if kidney function has been damaged or if the procedure will speed elimination of the poison from the bloodstream. Intravenous nutrition and medication also may be provided as needed.

Alternative Therapies

There are no alternative therapies for poisoning victims.

Self-Treatment

The best approach is prevention. Never take medication in the dark. Always store toxic substances in their original containers and keep them out of the reach of small children, preferably on a high shelf in a cabinet that can be locked. When giving medication to youngsters, never present it as a treat. Keep syrup of ipecac, which induces vomiting, in your home and first aid kit. Post phone numbers of the local poison control center and hospital emergency room near your telephone.

Certain self-care measures that were once presented on product labels or in now outdated first aid manuals, may do more harm than good for the victims of poisoning. These are things you should never do:

• Do not give vinegar or citrus fruit juice following ingestion of drain or oven cleaners and lye-containing products, based on the mistaken assumption that they will provide a neutralizing effect on these alkalis. These natural acids may increase gastrointestinal burning.
• Do not give butter, cooking oil, or other fatty substances to soothe the effects of lye and other caustic substances. Fats coat and conceal the amount of damage, interfering with medical diagnosis and treatment.
• Do not give sodium bicarbonate to anyone who has ingested an acidic substance, thinking that it will have a neutralizing effect. It could cause serious stomach damage instead.
• Do not induce vomiting with a salt and water solution at any time. It is usually ineffective and could cause fatal salt poisoning.

Other Causes of Poisoning

Food poisoning can result from eating something contaminated with bacteria or bacterial toxins produced by certain organisms. The most common offending bacteria are staphylococcus, Clostridia, and salmonella. Rarer, but more severe, is botulism, caused by a toxin that is produced by a strain of Clostridium bacteria. Poisoning also may occur from the bites of insects, marine life, or snakes.