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Poisoning: general information
Medical expert of the article
Poisoning as a result of accidents and intentional self-inflicted (deliberate) poisoning are a common reason for contacting emergency departments and a number of deaths.
General information about poisoning
Poisoning - contact with substances that have a toxic effect. Symptomatology is diverse, but some characteristic syndromes can indicate the type of toxic agent. The diagnosis, in the first place, is based on clinical data, but with some poisonings, urine and blood tests can make a difference. Treatment for most poisonings is symptomatic, specific antidotes are needed only in a few cases.
Prevention of poisoning includes clear labeling of packages with drugs, storage of poisons out of reach for children.
Most poisonings are dose-dependent. Poisoning can be the result of exposure to an excessive amount of the substance, in usual doses of non-toxic. Some substances are toxic in any amount. Poisoning differs from hypersensitivity and idiosyncrasy, which are unpredictable and do not depend on the dose, and also on intolerance (a toxic reaction to the normally nontoxic dose of the substance).
Poisoning, as a rule, occurs when swallowed, but is possible as a result of injections, inhalation, or contact with the surface of the body (skin, eyes, mucous membranes).
Most commonly ingested non-food substances are non-toxic, but almost any substance can exhibit toxic properties when taken in excess. Accidental poisonings are often found in young children who are curious and swallow indiscriminately, despite the poisonous taste and smell; as a rule, one substance is swallowed. Poisoning is also characteristic among older children, adolescents and adults with suicidal attempts; in this case, poisoning with several toxic substances (alcohol, paracetamol, other drugs sold without a prescription) is possible. Accidental poisoning is possible in elderly people due to forgetfulness, poor vision, mental disorders or the appointment of the same medicines by different doctors.
Poisonings are possible for the purpose of killing or deprivation of legal capacity (for example, during robbery or rape). Drugs used to temporarily disenfranchisement, as a rule, have sedative and amnestic effects (scopolamine, benzodiazepines, hydroxybutyrate derivatives).
Substances not normally harmful if swallowed
- Barium sulfate
- Floating toys for the bathroom
- Chalk school (calcium carbonate)
- Suppositories (insecticidal / repellent suppository may be toxic)
- Carbowax (polyethylene glycol)
- Carboxymethylcellulose (dehydratant, encapsulated in packs of drugs, film, etc.)
- Castor oil
- Cetyl alcohol
- Pencils (children's, marked AR, CP or CS 130-46)
- Dichloroal (herbicide)
- Dry batteries (alkaline)
- Glyceryl monostearate
- Resins (gum arabic, agar)
- Ink (in the volume of one pen)
- Salts of iodine
- Linoleic acid
- Flaxseed oil (non-boiling)
- Magnesium silicate (antacid)
- Mineral oil (if not aspirated)
- Clay and other materials for modeling
- Paraffin, chlorinated
- Pencil rod (graphite)
- Pepper, black (except for massive inhalation)
- Vaseline oil
- Polyethylene glycol
- Polyethylene glycol stearate
- Shaving cream
- Quartz (silicone dioxide)
- Stearic acid
- Talc (except for cases of inhalation)
- Lubricant for wheels
- Fluid from a thermometer (including liquid mercury)
- Titanium Oxide
- Triacetin (glyceryl triacetate)
- Children's multivitamins, with or without iron
- Multivitamins without iron
* This is an indicative table; these substances can be combined with phenol, gasoline or other toxic substances. In the toxicological center you can get the necessary information. Almost all substances can become toxic in certain amounts.
There are cases of poisoning of children by parents who have some knowledge in medicine, for unclear mental reasons, or for the purpose of obtaining medical assistance (see Munchhausen syndrome).
Most poisons are metabolized, pass through the digestive tract, or excreted by the kidneys. In some cases, tablets (acetylsalicylic acid, iron, capsules with a protected shell) form large clusters (bezoars) in the digestive tract, get stuck and continue to be absorbed, increasing the poisoning.
Symptoms of poisoning
Symptoms of poisoning depend on the poison. In addition, different patients who are poisoned by the same agent may have very different symptoms. Nevertheless, 6 groups of symptoms (toxic syndromes) are considered characteristic and can indicate a class of a specific poison. In patients who have taken several substances, the likelihood of developing symptoms specific to individual agents is low.
Diagnosis of poisoning
The first stage of diagnosis is the evaluation of the patient's general condition. Severe poisoning may require emergency measures to treat acute cardiovascular failure (collapse).
The fact of poisoning can be known on admission. In patients with difficult-to-explain symptoms, especially with changes in consciousness, poisoning should be suspected. Targeted self-poisoning in adults involves the possibility of using several poisonous substances. Anamnesis sometimes plays a major role.
Treatment of poisoning
Patients with severe poisoning may require mechanical ventilation and / or treatment of cardiovascular collapse. In the case of mental disorders, continuous monitoring and fixation may be required.
Treatment for poisoning with various substances is presented in the tables. In all cases, except the easiest, a consultation with the poison control center is indicated.