EMT Ch 21 Poisoning Overdose Emergencies

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EMT Ch 21 Poisoning Overdose Emergencies
2010-07-05 16:50:37
EMT Poisoning Overdose Emergencies

Poisoning and Overdose Emergencies
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  1. S&S of Acetaminophen poisoning
    Nausea and Vomiting. Jaundice delayed sign. There may be no S&S.
  2. What are the S&S of Acids and alkalis ingested poisoning
    Burns on or around the lips, burning in the mouth, throat, and abdomen, and vomiting are S&S of WHAT?
  3. What are S&S of antihistamines, and cough or cold preparation poisoning?
    Hyperactivity or drowsiness, Rapid pulse, flushed skin, dilated pupils are S&S of?
  4. S&S of Asprin poisoning
    Delayed S&S including ringing in the ears, deep and rapid breathing, and bruising are signs of?
  5. S&S of Food poisoning
    Different depending on what was ingested. Most include abdominal pain, nausea, vomiting, diarrhea, and sometimes fever are S&S of?
  6. S&S of insecticide poisoning
    slow pulse, excessive salivation and sweating, nausea, vomiting, diarrhea, difficulty breathing, constricted pupils S&S of?
  7. S&S of Petroleum product poisioning
    Characteristic odor of breath, clothing, vomit. If aspiration has occured coughing and difficulty breathing S&S of?
  8. S&S of Plant poisoning
    Wide range of symptoms, ranging from none to nausea and vomiting to cardiac arrest. S&S of?
  9. What information will on-line medical direction need in the case of possible ingested poisoning?
    • -What substance involved?
    • -When did the exposure occur?
    • -How much was ingested?
    • -Over how long a period did the ingestion occur?
    • -What interventions has the patient, family, or well-meaning bystanders taken?
    • -What is patient's estimated weight?
    • -What effects is the patient experiencing from the ingestion?

    When are these questions needed to be asked? Why are they needed?
  10. When a poisoning patient requires ventilation what method should you use?
    Pocket face mask with a one-way valve with sup O2, or a positive pressure ventilation.
  11. Indication of activated Charcoal
    Poisoning by mouth is an indication of using
  12. Contraindications of giving activated Charcoal
    • -Patient cannot swallow
    • -Altered mental status (might choke on and aspirate it into lungs)
    • -Patient ingested acids or alkalis (oven cleaners, drain cleaners, toilet cleaners, lye)
    • -Patient who accidently swallowed gasoline.
  13. Dosages of activated charcoal for
    -Adults and Children:
    -Usual adult dose:
    -Usual pediatric dose:
    • Adults and children: 1 gram/kg of body weight
    • Usual adult dose: 25-50 grams
    • Usual pediatric dose: 12.5-25 grams
  14. Administation of activated charcoal involves what?
    • consulting medical direction
    • shake container
    • hide the appearance to improve compliance
    • shake or stir again if charcoal settles
    • Record name, dose, route, and time of administration of medication.
  15. What should be documented regarding the administration of activated charcoal?
    Name dose route and time of admin of the medication.
  16. What is the action of activated charcoal?
    binds to certain poisions and prevents them from being absorbed into the body. (Some brands absorb more than others)
  17. Side effects of activated charcoal
    • black stools
    • patient may vomid. if vomits repeat the dose once.
  18. Ipecac
    -How does it work?
    -How long does it take?
    -Why is it no longer used today?
    • -stimulates the stomach and the vomiting center of the brain
    • -takes 15-20 minutes to work sometimes 20-30
    • -relatively ineffective slow, and has potential for patient to aspirate vomit.
  19. Dilution of a poisonous substance means what should be done?

    What does dilution do?
    drink 1-2 glasses of H2O or milk. (Half glass for child.)

    Slows absorption slightly.
  20. Patient Care for ingested poison:
    • 1.) detect any life threats. Evaluate need for prompt transport.
    • 2.) Focused history and physical exam. Including SAMPLE. Remove any thing left in patient mouth
    • 3.) Baseline VITALS
    • 4.) Medical Direction. Admin Charcoal or dilute as directed.
    • 5.) Transport patient with all containers, bottles, and labels from the substance.
    • 6.) Perform ongoing assessment en route.
  21. Does every poison have an antidote?
    NO! There are only a few genuine antidotes.
  22. What are some common inhaled poisons?
    Carbon Monoxide, Chlorine gas, ammonia, sprayed agricultural chemicals and pesticides, and carbon dioxide.
  23. What questions need to be asked regarding the incidence of inhaled poision?
    • -What substance was involved?
    • -When did the exposure occur?
    • -Over how long a period did the exposure occur?
    • -What interventions has anyone taken?
    • -What effects is the patient experiencing from the exposure?
  24. What is the principle prehospital treatment of inhaled poisoning?
    Maintaining airway and supporting respiration. OXYGEN IS KEY!!
  25. Emergency Care steps for inhaled poision?
    • 1.) make sure safe environment. Detect any life threatening problems.
    • 2.) Focused history and physical exam, SAMPLE
    • 3.) Vitals
    • 4.) High-concentration O2.
    • 5.) Transport with containers, bottles, and labels from the substance.
    • 6.) Perform ongoing assessment en route.
  26. What is the single most important treatment for inhaled poisoning after the patients airway has been opened?
    High-concentration O2.
  27. Carbon Monoxide can be caused/evidenced by?
    Malfunctioning oil gas, coal burning funaces and stoves.
  28. What does carbon monoxide do?
    Prevent the normal carrying of oxygen by the RBCs.
  29. S&S of Carbon Monoxide poisoning
    • Headache
    • Dizziness
    • Breathing difficulty
    • Nausea
    • Cyanosis
    • Altered mental status/unconsciousness
  30. Signs of an injured airway via smoke inhalation
    • Difficulty breathing
    • coughing
    • Breath smoky smell
    • Black (Carbon) residue in the patient's mouth and nose
    • Black residue in any sputum
    • Nose hairs singed from super-heated air.
  31. What questions need to be asked regarding an absorbed poision?
    • What substance involved?
    • When did exposure occur?
    • How much of the substance was the patient exposed to?
    • Over how long a period did the exposure occur?
    • What interventions has anyone taken?
    • What effect is the patient experiencing from the exposure?
  32. Patient care for absorbed poision
    • 1.) life threatening problems.
    • 2.) Focused history and physical exam. SAMPLE, VITALS, REMOVE CLOTHING
    • 3.) Remove poision:
    • Powder: brush powder off the patient, then continue for absorbed.
    • Liquids: irrigate for 20 minutes at least continue en route.
    • Eyes: irrigat for at lease 20 min continue en route.
    • 4.) Transport with containers, bottles, and labels from substance.
    • 5.) Perform ongoing assessment en route.
  33. Should dilute vinegar or baking soda be used to 'neutralize' acids or alkalis?
    NO! the reating produces heat. Never shown to work and may actually make it worse.
  34. Chronic drinkers often have ____
    deranged blood sugar levels, poor nutrition, the ptential for considerable gastrointestinal bleeding and other problems.
  35. What may make patient appear to be intoxicated when they are not?
    Diabetes, epilepsy, head injuries, high fevers, hypoxia.
  36. S&S of Alcohol abuse
    • odor of alcohol.
    • Swaying and unsteadiness of movement
    • slurred speech
    • flushed appearance to the face
    • nausea vomiting
    • poor coordination
    • slow reaction time
    • blurred vision
    • confusion
    • hallucinations
    • lack of memory
    • altered mental status
  37. Alcohol-withdrawn patient may experience what?
    Seizures or delirium tremens
  38. What are Delirium temens? How is it characterized?
    Severe reaction that can be part of alcohol withdrawal. Characterized by sweating, trembling, anxiety, hallucinations.
  39. S&S of Alcohol withdrawl
    • Confusion and restlessness
    • unusual behavior
    • hallucinations
    • gross tremor
    • profuse sweating
    • seizures.
  40. What is a sign that alcohol and drugs have been mixed?
    Depressed Vitals are a sign that what has been mixed?
  41. Patient care of alcohol abuse
    • 1.) Stay alert for airway and respiratory problems.
    • 2.) Be alert for changes in mental status as the alcohol is absorbed into the bloodstream. Keep patient as alert as possible.
    • 3.) Monitor Vitals
    • 4.) Treat for Shock.
    • 5.) protect patient from self-injury.
    • 6.) Stay alert for seizures.
    • 7.) Transport patient to medical facility if indicated.
  42. What are 'uppers'?
    stimulants that affect the CNS to excite the user.
  43. What are examples of uppers?
    Caffeine, amphetamines, cocaine.
  44. What are downers?
    Depressants that depress the CNS used to bring on a more relaxed state of mind.
  45. What are narcotics?
    Class of drug that affects the nervous system and changes many normal body behaviors.
  46. How are narcotics used for medical purposes and illicit?
    Relief of pain, to produce an intense state of relaxation.
  47. What composes the opiate triad?
    Coma, pinpoint pupils, respiratory depression.
  48. What are three signs that characterize narcotic overdoses?
    Coma, pinpoint pupils, and respiratory depression.
  49. What are hallucinogens?
    mind-affecting or mind-altering drugs that act on the CNS to produce excitement and distortion of perceptions
  50. What are examples of hallucinogens?
    LSD, PCP, shrooms, extacy
  51. What are volatile chemicals? Course of high?
    Vaporizing chemicals that are breathed in by the abuser to produce a high. Give an initial rush and then depressant on the CNS.
  52. S&S of Upper drug abuse:
    Excitement, UP pulse, UP breathing, rapid speech, dry mouth, dilated pupils, sweating, gone long time with out sleep.
  53. S&S of Downer drug abuse
    Sluggish, sleepy lacking coordination of body and speech. Pulse and breathing rates low.
  54. S&
  55. S&S of Narcotic drug abuse
    reduced rate of pulse, down rate and depth of breathing. lowering of skin temp, pupils constricted. muscles relazed and profuse sweating. Sleepy and doesnt want to do anything.
  56. S&S of hallucinogen drug abuse
    fast pulse, dialated pupils flushed face. hears/sees things. little concept of real time. may not be aware of true enviroment. makes no sence. may be aggressive or timid.
  57. S&S of Volatile chemical drug abuse
    dazed or showing temporary loss of contact with reality. Patient may develop a coma. lining of nose and mouth may be swollen. Funny numb feeling or tingling inside head. Changes in heart rhythm.
  58. S&S of Drug withdrawal
    Shaking, Nausea, confusion and irritibility, hallucinations, profuse sweating, UP PULSE UP Breathing rate, Anxiety
  59. Patient Care for Substance Abuse:
    • 1.) Initial assessment.
    • 2.) Alert for airway problems. provide O2 if needed.
    • 3.) treat for shock.
    • 4.) talk to patient and gain conidence help maintain level of responsiveness.
    • 5.) Rapid trauma exam or detailed physical exam to assess for injury.
    • 6.) Look for gross soft-tissue damage resulting from the injection of drugs. (Appear as darkened or red areas of scar tissue or scabs over veins.
    • 7.) Protect patient from self and from hurting others.
    • 8.) Transport
    • 9.) Contact medical direction
    • 10.) Perform ongoing assessment monitoring of vitals.
    • 11.) Continue to reassure.
  60. Amphetamine is a
  61. Bipetamine (Bam) is a
  62. Cocaine (Snow, coke, crack) is a
  63. Desoxyn (black beauties) is a
  64. Dextroamphetamine (dexies, dexedrine) is a
  65. Methamphetamine (speed, crank, meth, crystal, diet pills, methedrine) is a
  66. Methylphenidate (Ritalin) is a
  67. Preludin is a
  68. Amobarbital (blue devils, downers barbs, amytal) is a
  69. Barbituarates (dolls, barbs, rainbows) is a
  70. Chloralhydrate (knockout drops, noctec) is a
  71. Methaqualone (Quaalude, ludes, sopor, sopors) is a
  72. Nonbarbiturate sedatives (tranquilizers and sleeping pills, valium diazepam miltown wquanil meprobamate, thorazine compazine librium or chlordiazepoxide, reserpine, tranxene or chlorazepate) are
  73. Paraldehyde pentobarbital (yellow jackets, barbs, nembutal) are
  74. phenobarbital (goofballs, phennies, barbs) are
  75. secobarbital (red devils barbs, seconal) are
  76. Codeine (cough syrup) is a
  77. Demerol is a
  78. Dilaudid fentanyl (sublimaze) is a
  79. Heroin (H horse junk smack stuff) is a
  80. Methadone (dolly) is a
  81. Opium (OP, poppy) is a
  82. Meperidine (Demerol) is a
  83. Paregoric is a
  84. Tylenol with codeine is a
  85. DMT, LSD are
    Hallucinogenic mind altering drugs
  86. mescaline, morning glory seeds are
    hallucinogenic mind altering drugs
  87. PCP (angel dust, hog, peace pills) is
    hallucinogenic mind altering drug
  88. Psilocybin (magic mushrooms) is a
    hallucinogenic mind altering drug
  89. STP (serenity, tranquility peace) is a
    hallucinogenic mind altering drug.
  90. Hash, marijuana, THC are
    nonhallucinogenic mind altering drugs.
  91. amyl nitrate (snappers poppers) are
    volatile chemicals
  92. butyl nitrate (locker room, rush) is
    volatile chemical
  93. Cleaning fluid, furniture polish, gasoline glue hair spray paint thinner are all examples of
    volatile chemicals