POISON

image of poison in a bottle

POISON: Poisons are substances that, when introduced into the body or applied externally, can have harmful effects on human health. These effects range from injury to the destruction of tissues and, in severe cases, can even lead to loss of life. This comprehensive guide will delve into various aspects of poisons, including their definition, causes, classification, and treatment principles.

Definition of Poison

A poison is any substance that, upon entering the body or being applied externally, has the potential to cause harm, injury to health, tissue damage, or loss of life. Poisons can take various forms, and their effects depend on factors such as the route of entry and the specific substance involved.

Causes of Poisoning

Poisoning can occur through various means, and understanding these causes is essential for effective prevention and treatment. The primary causes of poisoning include:

1. Accidental Poisoning:

 

   a. Consumption of Contaminated Food: Accidental ingestion of contaminated food, including spoiled or improperly prepared items, as well as poisonous berries and fungi.

   b. Ingestion of Contaminated Liquids: Accidental consumption of contaminated liquids, such as water or substances from wrongly labeled bottles.

   c. Unintentional Ingestion of Medications: Accidental ingestion of medications or sleeping tablets in excessive quantities.

2. Suicidal Poisoning:

   – Suicidal poisoning should be suspected when an apparently healthy person exhibits signs of illness without seeking medical help.

3. Murder:

   – Poisoning may be employed as a means of attempted murder, either through a single large dose or repeated small doses.

General Signs and Symptoms of Poisoning and Routes of Entry:

Poisoning can manifest through various signs and symptoms, and the route of entry plays a significant role in determining the presentation. The human body can be poisoned through the following routes:

– Oral Route (Mouth): Poisoning can occur through ingestion, including eating, drinking, and swallowing.

– Inhalation Route (Nose): Gases like coal gas, carbon dioxide, and chlorine fumes can lead to poisoning when inhaled.

– Dermal Route (Skin): Certain substances can poison the body through skin contact, especially when there are wounds, such as those caused by snakebites.

General Treatment Principles

The objective of treating poisoning is to minimize harm and prevent further damage to the body. Treatment principles include:

1. Removal of Poisons:

   – Emetics: These substances induce vomiting to remove poison from the stomach before it is absorbed into the bloodstream. Common emetics include salt dissolved in lukewarm water.

   – Aperients: After vomiting, aperients like castor oil or Epsom salt may be administered to eliminate any poison that may have passed into the intestines.

2. Antidotes:

   – Antidotes neutralize the effects of poisons while they are still in the body. Some work by preventing absorption into the bloodstream, while others convert the poison into harmless substances. The choice of antidote depends on the nature of the poison.

3. Counteracting Effects with Demulcents:

   – Demulcents are substances that soothe irritated mucous membranes. They are given after vomiting and can include water, thick barley water, olive oil, liquid paraffin, or flour and water paste.

4. Aims of First-Aid Treatment in Poisoning:

   – Remove or counteract the poison’s effects.

   – Seek medical aid promptly.

   – Arrange for transportation to the hospital urgently, as medical treatment is crucial.

   – Identify the poison by preserving containers, medicine bottles, and any remains of consumed substances for the doctor’s inspection.

   – Preserve vomit, urine, or feces for medical examination if necessary.

   – In the event of death, inform the police and avoid disturbing the vicinity until their arrival.

Classification of Poisons

Poisons can be categorized into three main groups based on their characteristics and effects:

1. Irritant Poisons:

   – Irritant poisons cause irritation and inflammation of the tissues in the alimentary tract. They can be further subdivided into:

     a. Contaminated Food or Animal Irritants: Examples include spoiled meat, decaying fish, and contaminated canned food.

     b. Vegetable Irritants: These include poisonous berries and fungi, such as toadstools that may be mistaken for edible mushrooms.

     c. Chemical Irritants: This category comprises substances like mercury, phosphorous, iodine, lead, and arsenic, some of which are found in paint and weed killers.

   Signs and Symptoms:

   – Burning pain in the mouth, neck, throat, and stomach.

   – Nausea and vomiting, sometimes with blood or mucous membrane shreds in the vomit.

   – Acute abdominal pain, often colicky or griping.

   – Fainting, shock, and prostration.

   – Unconsciousness.

   Treatment:

   – Inducing vomiting until substantial amounts have been expelled.

   – Administering an antidote if the poison is known.

   – Offering demulcents after vomiting.

   – Providing aperients about ten minutes after vomiting cessation.

   – Addressing shock if present and seeking immediate medical assistance.

2. Corrosive Poisons:

   – Corrosive poisons burn the body parts they contact. They can be further divided into:

     a. Acid Corrosives: Including sulfuric acid, hydrochloric acid, nitric acid, and acetic acid.

     b. Alkaline Corrosives: Such as caustic soda, caustic potash, and ammonia.

   Signs and Symptoms:

   – Severe burns around the mouth and lips.

   – Difficulty in speaking and breathing.

   – Severe pain in the mouth, throat, chest, and abdomen.

   – Possible nausea and vomiting.

   – Severe shock.

   Treatment:

   – Avoid inducing vomiting.

   – Administer an antidote, such as copious amounts of water if the type of poison is unknown.

   – Provide demulcents like milk, oil, or thick barley water.

   – Address shock.

   – Seek immediate medical attention.

3. Narcotic Poisons:

   – Narcotics are substances that affect the nervous system, inducing drowsiness, reduced bodily function activity, and, in some cases, unconsciousness. They can be further categorized into:

     a. Hypnotics: These drugs induce sleep and unconsciousness, including substances like opium, morphine, heroin, cocaine, and barbiturates.

     b. Deliriants: Deliriants initially produce excitement and delirium but eventually lead to unconsciousness. Examples include belladonna and atropine.

     c. Convulsants: These substances cause muscle twitching and unconsciousness, such as prussic acid and strychnine.

   Signs and Symptoms of Narcotic Poisoning:

   – Drowsiness.

   – Slow respirations.

   – Feeble pulse.

   – Coma and potential death.

   Treatment for Narcotic Poisoning:

   – Keep the patient awake if conscious.

   – Administer an emetic before the patient loses consciousness and repeat if necessary.

   – Provide the appropriate antidote, like potassium permanganate, for opium poisoning.

   – Offer hot, strong black coffee after vomiting.

   – Administer strong aperients as needed.

   – Monitor the patient’s pulse and breathing carefully when unconscious and provide resuscitation if necessary. Seek immediate specialized medical care.

   Signs and Symptoms of Deliriant Poisoning:

   – Dry mouth and throat.

   – Thirst.

   – Dilated pupils.

   – Unsteadiness and loss of balance.

   – Delirium and potentially coma.

   Treatment for Deliriant Poisoning:

   – Administer an emetic.

   – Provide strong tea or strong black coffee after vomiting.

   – Seek medical aid and perform artificial respiration if the patient loses consciousness.

   Signs and Symptoms of Convulsant Poisoning:

   – Restlessness and anxiety.

   – Feeling of suffocation (asphyxia).

   – Muscle twitching leading to epileptic fits.

   Treatment for Convulsant Poisoning:

   – Administer an emetic when necessary.

   – Provide strong tea after vomiting.

   – Arrange for transportation to the hospital.

   – Apply artificial respiration if breathing ceases.

Carbolic and Lysol Poisoning

Carbolic acid and Lysol are disinfectants that can have unique effects on the human body due to their ability to harden tissues on contact, in addition to causing burns.

Signs and Symptoms of Carbolic and Lysol Poisoning:

   – Burning sensation in the mouth, neck, throat, chest, and abdomen.

   – Severe initial pain, which may later become dull due to the anesthetic effect of carbolic and Lysol.

   – Vomiting.

   – Characteristic odor of the poison on the breath.

   – Stained lips and mouth corners.

   – White appearance of the cheeks and gums.

   – Severe shock.

Treatment for Carbolic and Lysol Poisoning:

   – Administer an emetic.

   – Provide an antidote after the emetic, such as medical liquid paraffin, which also acts as a demulcent, or Epsom salts dissolved in milk.

   – Treat for shock.

   – Apply hot fomentation to alleviate severe pain.

   – Seek immediate medical assistance.

Understanding the intricacies of poisons, their causes, classification, and treatment principles is essential for effective management in cases of poisoning. Prompt and appropriate action can significantly improve the outcome for individuals exposed to harmful substances. Always seek professional medical assistance when dealing with poisoning, as it requires specialized care and treatment.