POISONING

Diagnosis of Poisoning
Prompt diagnosis of poisoning is necessary to determine treatment and help prevent

complications. To diagnose poisoning, physicians often take a patient history (including
information about exposure to toxic substance and symptoms) and perform a physical
examination and laboratory tests (e.g., blood tests).
In children, parents and caregivers should provide as much information as possible about the
toxic substance and the child's exposure to it (e.g., how long was the child exposed, how much
did he or she ingest, how long after exposure did symptoms develop, what symptoms occurred).
Laboratory tests may be used to detect blood or urine levels of the poisonous substance and to
determine how well the child's body is handling (e.g., metabolizing, excreting) the substance.
Treatment for Poisoning
Treatment for poisoning depends on

the type of exposure (e.g., ingestion,
inhalation), the specific toxin
(poisonous substance), and the
severity of the person's condition.
If the person has no symptoms but has taken a potentially

dangerous poison, you should also call a poison control center
or go to the nearest emergency department for an evaluation.
Poisoning Causes
Poisons include highly toxic chemicals not meant for
human ingestion or contact, such as cyanide, paint
thinners, or household cleaning products.
Many poisons, however, are substances meant for

humans to eat, including foods and medicines
Foods
 Some mushrooms are poisonous

 Drinking water contaminated by agricultural or
industrial chemicals
 Food that has not been properly prepared or
handled
Drugs
 Drugs that are helpful in therapeutic doses may

be deadly when taken in excess
Poisoning Symptoms
Some poisons enlarge the pupils, while others shrink them.
Some result in excessive drooling, while others dry the mouth and skin.
Some speed the heart, while others slow the heart.
Some increase the breathing rate, while others slow it.
Some cause pain, while others are painless.
Some cause hyperactivity, while others cause drowsiness. Confusion is often

seen with these symptoms.
Poisoning Diagnosis
A combination of history, physical examination, and laboratory studies will help reveal the cause of most
poisonings. Frequently, treatment must begin before all information is available.
History: As a family member or friend of a poisoned person, you can greatly assist the doctor and
provide valuable clues by telling the doctor about these details:
 Everything the person ate or drank recently

 Names of all prescription and over-the-counter medications the person is taking
 Exposure to chemicals at home or at work
 Whether others in the family or at work have been similarly ill or exposed
 Whether the person has any psychiatric history to suggest an intentional ingestion (suicide
attempt)
A toxicology screen or "tox" screen looks for

common drugs of abuse. Most toxicology
screens will detect:
 acetaminophen,
Testing: Many poisons  aspirin,
can be detected in the
 marijuana,
blood or urine. However,
 opioids (heroin, codeine),
a physician cannot order
 benzodiazepines (diazepam [Valium],
"every test in the book"
chlordiazepoxide [Librium]),
when the diagnosis is
 amphetamines (uppers),
unclear. The tests
 cocaine, and
ordered will be based on
 alcohol.
information revealed in
the history and physical A specific blood test will give serum levels of
exam. some drugs, including phenytoin (Dilantin),
theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-
24, Theolair, Uniphyl, Slo-Phyllin), digoxin
(Lanoxin), lithium (Lithobid), and
acetaminophen.
Some drugs affect the electrical activity of the

heart. An electrocardiogram (ECG) may reveal
toxicity.
Sometimes a person is unconscious for no

obvious reason. A CT scan of the brain will help
Poisoning Medical Treatment
Elimination: Get rid of the unabsorbed poison before it can do any harm.
 If the person is unconscious, the doctor will put a flexible, soft, plastic tube into the
windpipe to protect the person from suffocating in his or her own vomit and to
provide artificial breathing (intubation).
 Once the poison has moved past the stomach, other methods are needed.
 Activated charcoal acts as a "super" absorber of many poisons. Once the poison is
stuck to the charcoal in the intestine, the poison cannot get absorbed into the
bloodstream. Activated charcoal has no taste, but the gritty texture sometimes causes
the person to vomit. To be effective, activated charcoal needs to be given as soon as
possible after the poisoning. It does not work with alcohol, caustics, lithium (Lithobid),
or petroleum products.
 Whole bowel irrigation requires drinking a large quantity of a fluid called Golytely. This
flushes the entire gastrointestinal tract before the poison gets absorbed.

POISONING

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POISONING

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Diagnosis of Poisoning

Prompt diagnosis of poisoning is necessary to determine treatment and help prevent

Treatment for Poisoning

Treatment for poisoning depends on

If the person has no symptoms but has taken a potentially

Many poisons, however, are substances meant for

 Some mushrooms are poisonous

 Drugs that are helpful in therapeutic doses may

Some poisons enlarge the pupils, while others shrink them.

Some speed the heart, while others slow the heart.

Some increase the breathing rate, while others slow it.

Some cause pain, while others are painless.

Some cause hyperactivity, while others cause drowsiness. Confusion is often

 Everything the person ate or drank recently

A toxicology screen or "tox" screen looks for

Some drugs affect the electrical activity of the

Sometimes a person is unconscious for no

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