EMT-Basic Exam: The Basics of Medical Emergencies - Poisoning/Overdose

Poisonings are a common type of medical emergency that occurs when a person accidentally or intentionally ingests or becomes exposed to a toxic substance. Toxins are substances that can cause negative effects after entering the body. A poisoning can also result from an overdose of medication.
Remember, it is important for EMTs to take the proper precautions to protect themselves from any toxic substances before assessing and treating the patient.

1. History of Poisoning
When assessing a possible poisoning, it is important to focus on the history of the poisoning. There are several key questions you should ask:
- What substance was involved? The most important factor in a poisoning is the type of substance involved. You should look for clues and question family members or other witnesses on the scene for additional information.
- When was the substance ingested? The amount of time that the substance has been in the patient’s system can have a substantial effect on the patient’s condition and on your treatment of the patient.
- How much of the substance was ingested? The volume of the ingested substance can also affect the patient’s condition and treatment needs.
- Over what period of time did the poisoning take place? It is important to determine if the poisoning took place over a long period of time or very quickly.
- What has happened since the poisoning? It is important to determine if the patient has attempted to treat himself or herself or if anyone else has attempted treatment.
- How much does the patient weigh? Weight is a critical factor in how a poisonous substance affects a patient. It is also important to know the patient’s weight if the use of activated charcoal becomes necessary.

2. Types of Toxins
Toxins are classified based on their route of entry. There are four toxin classifications:
- Ingested toxins are consumed orally and may result in nausea, vomiting, diarrhea, abdominal pain, or cramps. Some examples include poisonous mushrooms and cleaning products.
- Inhaled toxins are taken directly into the respiratory system and may result in coughing, gagging, tightness in the throat, stridor, or hoarseness. A common example of an inhaled toxin is carbon monoxide.
- Injected toxins enter the body through skin punctures and may result in dizziness, weakness, nausea, vomiting, chills, and fever. Some examples include snakebites and bee stings.
- Absorbed toxins enter the body through the skin and may result in itching, burning, redness, and swelling. Some examples of these toxins are pesticides and dyes.

3. Treatment
Many forms of poisoning affect the airway, so it is important to monitor the patient’s airway at all times to ensure patency. In some cases, activated charcoal may be used to treat patients who have been poisoned with an ingested toxin. Activated charcoal can bind to certain poisons and prevent further absorption. Patients must be capable of swallowing in order to take activated charcoal. Be sure to contact the medical direction physician for permission and instruction before administering this substance to a poisoning patient.

Tip: If the patient takes a long time to drink the charcoal, stir or shake the liquid to prevent settling.

Related topics you should review:
- Administration of activated charcoal