Poisoning: First aid

Overview

Poisoning is injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases. Many substances — such as drugs and carbon monoxide — are poisonous only in higher concentrations or dosages. And others — such as cleaners — are dangerous only if ingested. Children are particularly sensitive to even small amounts of certain drugs and chemicals.

How you treat someone who may have been poisoned depends on:

• The person's symptoms.
• The person's age.
• Whether you know the type and amount of the substance that caused poisoning.

If you are concerned about possible poisoning, call Poison Help at 800-222-1222 in the United States or your regional poison control center. It may help to place a refrigerator magnet or a visible sticker in your home with the poison control number. Poison control centers are excellent resources for poisoning information and, in many situations, may advise that in-home observation is all that's needed.

When to seek emergency help

Call 911 or your local emergency number immediately if the person is:

• Drowsy or unconscious.
• Having difficulty breathing or has stopped breathing.
• Uncontrollably restless or agitated.
• Having seizures.
• Known to have taken medicines, or any other substance, intentionally or accidentally overdosed (in these situations the poisoning typically involves larger amounts, often along with alcohol).

Call Poison Help at 800-222-1222 in the United States or your regional poison control center in the following situations:

• The person is stable and has no symptoms.
• The person is going to be transported to the local emergency department.

Be ready to describe the person's symptoms, age, weight, other medicines the person is taking, and any information you have about the poison. Try to find out the amount ingested and how long since the person was exposed to it. If possible, have on hand the pill bottle, medicine package or other suspected container so that you can refer to its label when speaking with the poison control center.

Symptoms

Poisoning symptoms can mimic other conditions, such as seizure, alcohol intoxication, stroke and insulin reaction. Symptoms of poisoning may include:

• Burns or redness around the mouth and lips.
• Breath that smells like chemicals, such as gasoline or paint thinner.
• Vomiting.
• Difficulty breathing.
• Drowsiness.
• Confusion or other altered mental status.

If you suspect poisoning, be alert for clues such as empty pill bottles or packages, scattered pills, and burns, stains and odors on the person or nearby objects. With a child, consider the possibility that the child may have applied medicated patches, taken prescription medicines or swallowed a button battery.

Treatment

Take the following actions until help arrives:

• Swallowed poison. Remove anything remaining in the person's mouth. If the suspected poison is a household cleaner or other chemical, read the container's label and follow instructions for accidental poisoning.
• Poison on the skin. Remove any contaminated clothing using gloves. Rinse the skin for 15 to 20 minutes in a shower or with a hose.
• Poison in the eye. Gently flush the eye with cool or lukewarm water for 20 minutes or until help arrives.

• Button batteries. The small, flat batteries used in watches and other electronics — particularly the larger, nickel-sized ones — are especially dangerous to small children. A battery stuck in the esophagus can cause severe tissue burns.

  If you suspect that a child has swallowed one of these batteries, immediately take the child for an emergency X-ray to find its location. If the battery is in the esophagus, it will have to be removed. If it has passed into the stomach, it's usually safe to allow it to pass on through the intestinal tract.

• Medicated patches. If you think a child got hold of medicated patches — adhesive products for transdermal drug delivery — carefully inspect the child's skin and remove any that are attached. Also check the roof of the mouth, where medicated patches can get stuck if the child sucks on them.
• Inhaled poison. Get the person into fresh air as soon as possible.
• If the person vomits, turn the person's head to the side to prevent choking.
• Begin CPR if the person shows no signs of life, such as moving, breathing or coughing.
• Call Poison Help at 800-222-1222 in the United States or your regional poison control center for additional instructions.
• Have somebody gather pill bottles, packages or containers with labels, and any other information about the poison to send along with the ambulance team.

In the case of an opioid overdose

If the person is at risk of overdose of opioid pain medication and naloxone (Narcan) is available, please administer. Increasingly, healthcare providers are giving people Narcan injectable prescriptions if they are at risk of overdose. Loved ones should be familiar with how to use them.

What to avoid

• Syrup of ipecac. Don't give syrup of ipecac or do anything to induce vomiting. Expert groups, including the American Association of Poison Control Centers and the American Academy of Pediatrics, no longer endorse using ipecac in children or adults who have taken pills or other potentially poisonous substances. No good evidence proves its effectiveness, and it often can do more harm than good.

  If you still have old bottles of syrup of ipecac in your home, throw them away.