Overview of Poisoning

The symptoms caused by poisoning depend on the poison, the amount taken, and the age and underlying health of the person who takes it. Some poisons are not very potent and cause problems only with prolonged exposure or repeated ingestion of large amounts. Other poisons are so potent that just a drop on the skin can cause severe symptoms.

Some poisons cause symptoms within seconds, whereas others cause symptoms only after hours, days, or even years. Some poisons cause few obvious symptoms until they have damaged vital organs—such as the kidneys or liver—sometimes permanently.

Ingested and absorbed toxins generally cause bodywide symptoms, often because they deprive the body's cells of oxygen or activate or block enzymes and receptors. Symptoms may include changes in consciousness, body temperature, heart rate, and breathing and many others, depending on the organs affected.

Caustic or irritating substances injure the mucous membranes of the mouth, throat, gastrointestinal tract, and lungs, causing pain, coughing, vomiting, and shortness of breath.

Skin contact with toxins can cause various symptoms, for example, rashes, pain, and blistering. Prolonged exposures may cause dermatitis.

Eye contact with toxins may injure the eye, causing eye pain, redness, and loss of vision.

The first priority in helping a poisoned person is for bystanders not to become poisoned themselves.

People exposed to a toxic gas should be removed from the source quickly, preferably out into fresh air, but rescue attempts should be done by professionals. Special training and precautions must be considered to avoid being overcome by the toxic gases or chemicals during rescue attempts. (See also Overview of Incidents Involving Mass-Casualty Weapons Overview of Incidents Involving Mass-Casualty Weapons Mass-casualty weapons are weapons that can produce a mass-casualty incident. Mass-casualty incidents overwhelm available medical resources because they involve so many injured people (casualties)... read more .)

In chemical spills, all contaminated clothing, including socks and shoes, and jewelry should be removed immediately. The skin should be thoroughly washed with soap and water. If the eyes have been exposed, they should be thoroughly flushed with water or saline. Rescuers must be careful to avoid contaminating themselves.

If the person appears very sick, emergency medical assistance (911 in most areas of the United States) should be called. Bystanders should do cardiopulmonary resuscitation First-Aid Treatment for Cardiac Arrest Cardiac arrest is when the heart stops pumping blood and oxygen to the brain and other organs and tissues. Sometimes a person can be revived after cardiac arrest, particularly if treatment is... read more (CPR) if needed. If the person does not appear very sick, bystanders can contact the nearest poison control center for advice. In the United States, the local poison center can be reached at 800-222-1222. More information is available at the American Association of Poison Control Centers web site (www.aapcc.org). If the caller knows or can find out the identity of the poison and the amount ingested, treatment can often be initiated on site if this is recommended by the poison center.

Containers of the poisons and all drugs that might have been taken by the poisoned person (including over-the-counter products) should be saved and given to the doctor or rescue personnel. The poison center may recommend giving the poisoned person activated charcoal Prevent absorption of poison before arrival at a hospital and, rarely, may recommend giving syrup of ipecac to induce vomiting, particularly if the person must travel far to reach the hospital. However, unless specifically instructed to, charcoal and syrup of ipecac should not be given in the home or by first responders (such as ambulance personnel). Syrup of ipecac has unpredictable effects, often causes prolonged vomiting, and may not remove substantial amounts of poison from the stomach.

Identifying the poison is helpful to treatment. Labels on bottles and other information from the person, family members, or coworkers best enable the doctor or the poison center to identify poisons. If labels are not available, drugs can often be identified by the markings and colors on the pill or capsule. Laboratory testing is much less likely to identify the poison, and many drugs and poisons cannot be readily identified or measured by the hospital. Sometimes, however, urine and blood tests may help in identification. Blood tests can sometimes reveal the severity of poisoning, but only with a very small number of poisons.

Doctors examine people to look for signs that suggest a certain type of substance. For example, doctors look for needle marks or track marks suggesting people have injected drugs (see Injection Drug Use Injection Drug Use Drugs may be swallowed, smoked, inhaled through the nose as a powder (snorted), or injected. When drugs are injected, their effects may occur more quickly, be stronger, or both. Drugs may be... read more ). Doctors also examine people for symptoms characteristic of certain kinds of poisoning. Doctors look to see whether people have traces of a drug or substance on their skin or whether drug patches for drugs absorbed through the skin may be hidden in skin folds, on the roof of the mouth, or under the tongue.

For certain poisonings, abdominal x-rays may show the presence and location of the ingested substances. Poisons that may be visible on x-rays include iron, lead, arsenic, other metals, and large packets of cocaine or other illicit drugs swallowed by so-called body packers or drug mules (see Body Packing and Body Stuffing Body Packing and Body Stuffing To smuggle illegal drugs across borders or other security checkpoints, people may voluntarily swallow packets filled with drugs or hide those packets in body cavities. If a packet tears, a drug... read more ). Batteries and magnets are also visible on x-rays, as are fangs, teeth, cartilaginous spines and other animal parts that may break off and remain embedded in the body after an animal attack or envenomation.

In the United States, widespread use of child-resistant containers with safety caps has greatly reduced the number of poisoning deaths in children younger than age 5. To prevent accidental poisoning, drugs and other potentially dangerous substances should be kept in their original containers and the containers kept where children cannot get them. Toxic substances, such as insecticides and cleaning agents, should not be put in drink bottles or cups, even briefly. Other preventive measures include

Expired drugs should be disposed of by mixing them with cat litter or some other substance that is not tempting and putting them in a trash container that is inaccessible to children. People can also call a local pharmacy for advice on how to properly dispose of drugs. All labels should be read before taking or giving any drugs or using household products.

Limiting the amount of over-the-counter pain reliever in a single container reduces the severity of poisonings, particularly with acetaminophen, aspirin, or ibuprofen. The identifying marks printed on pills and capsules by the drug manufacturer can help prevent confusion and errors by pharmacists, health care practitioners, and others.

Some people who have been poisoned must be hospitalized. With prompt medical care, most recover fully.

The principles for the treatment of all poisonings are the same:

The usual goal of hospital treatment is to keep people alive until the poison disappears or is inactivated by the body. Eventually, most poisons are inactivated by the liver or are passed into the urine.

The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.