Bodily entry of toxic substances in amounts that cause dysfunction of body systems.
- Microorganisms (food poisoning)
- Fluids and gases (organic), e.g., agricultural chemicals, petrol, paraffin, carbon monoxide
- Metal poisoning (inorganic), e.g., lead, mercury, copper
- Alcohol, drugs of abuse, medicines (in excessive amounts)
Acute poisoning can occur by ingestion, inhalation, injection or cutaneous/mucosal absorption.
Exposure can be intentional (e.g., suicide or homicide attempt), unintentional (e.g., medication error) or environmental/ occupational.
Principles of general management
- If possible, refer patients showing signs of poisoning to hospital for admission. Send a note of what is known about the poison and what treatment has been given
- Also refer/admit patients who have taken slow-acting poisons even if they appear well. These include: acetylsalicylic acid, iron, paracetamol, tricyclic
antidepressants (e.g., amitriptyline, imipramine), paraquat, modified-release products
- Optimal management of the poisoned patient depends upon the specific poison(s) involved, the presenting and predicted severity of illness and time that has elapsed between exposure and presentation
- Treatment includes supportive care, decontamination, antidotal therapy and enhanced elimination techniques
- It may not always be possible to identify the poison and the amount taken. Anyway,
- Only a few poisons have specific antidotes
- Few patients need active removal of the poison
- Most patients must be treated symptomatically
However, knowledge of the poison will help you anticipate the likely effects on the patient.