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Patient Instructions

Poisoning is caused by swallowing, injecting, breathing in, or otherwise being exposed to a harmful substance. Most poisonings occur by accident.

Immediate first aid is very important in a poisoning emergency. The first aid you give before getting medical help can save a person's life.

Approximately 2.5 million poisonings are reported to United States poison control centers every year, with nearly 1,000 reported deaths.

It is important to note that just because a package does not have a warning label doesn't mean it is safe. You should consider poisoning if someone suddenly becomes sick for no apparent reason, or if the person is found near a furnace, car, fire, or in an area that is not well ventilated.

Symptoms of poisoning may take time to develop. However, if you think someone has been poisoned, do not wait for symptoms to develop before getting that person medical help.

Items that can cause poisoning include:

• Carbon monoxide gas (from furnaces, gas engines, fires, space heaters)
• Certain foods (See: Food Poisoning)
• Chemicals in the workplace
• Drugs, including over-the-counter and prescription medicines (such as an aspirin overdose) and illicit drugs such as cocaine
• Household detergents and cleaning products
• Household and outdoor plants (eating toxic plants)
• Insecticides
• Paints

Symptoms vary according to the poison, but may include:

• Abdominal pain
• Bluish lips
• Chest pain
• Confusion
• Cough
• Diarrhea
• Difficulty breathing
• Dizziness
• Double vision
• Drowsiness
• Fever
• Headache
• Heart palpitations
• Irritability
• Loss of appetite
• Loss of bladder control
• Muscle twitching
• Nausea and vomiting
• Numbness or tingling
• Seizures
• Shortness of breath
• Skin rash or burns
• Stupor
• Unconsciousness
• Unusual breath odor
• Weakness

Seek immediate medical help.

For poisoning by swallowing:

1. Check and monitor the person's airway, breathing, and pulse. If necessary, begin rescue breathing and CPR.
2. Try to make sure that the person has indeed been poisoned. It may be hard to tell. Some signs include chemical-smelling breath, burns around the mouth, difficulty breathing, vomiting, or unusual odors on the person. If possible, identify the poison.
3. Do NOT make a person throw up unless told to do so by poison control or a health care professional.
4. If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat. If the person has been sick from a plant part, save the vomit. It may help experts identify what medicine can be used to help reverse the poisoning.
5. If the person starts having convulsions, give convulsion first aid.
6. Keep the person comfortable. The person should be rolled onto the left side, and remain there while getting or waiting for medical help.
7. If the poison has spilled on the person's clothes, remove the clothing and flush the skin with water.

For inhalation poisoning:

1. Call for emergency help. Never attempt to rescue a person without notifying others first.
2. If it is safe to do so, rescue the person from the danger of the gas, fumes, or smoke. Open windows and doors to remove the fumes.
3. Take several deep breaths of fresh air, and then hold your breath as you go in. Hold a wet cloth over your nose and mouth.
4. Do not light a match or use a lighter because some gases can catch fire.
5. After rescuing the person from danger, check and monitor the person's airway, breathing, and pulse. If necessary, begin rescue breathing and CPR.
6. If necessary, perform first aid for eye injuries (eye emergencies) or convulsions ( convulsion first aid).
7. If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat.
8. Even if the person seems perfectly fine, get medical help.

• Do NOT give an unconscious person anything by mouth.
• Do NOT induce vomiting unless you are told to do so by the Poison Control Center or a doctor. A strong poison that burns on the way down the throat will also do damage on the way back up.
• Do NOT try to neutralize the poison with lemon juice or vinegar, or any other substance, unless you are told to do so by the Poison Control Center or a doctor.
• Do NOT use any "cure-all" type antidote.
• Do NOT wait for symptoms to develop if you suspect that someone has been poisoned.

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

Be aware of poisons in and around your home. Take steps to protect young children from toxic substances. Store all medicines, cleaners, cosmetics, and household chemicals out of reach of children, or in cabinets with childproof latches.

Be familiar with plants in your home, yard, and vicinity. Keep your children informed, too. Remove any poisonous plants. Never eat wild plants, mushrooms, roots, or berries unless you very familiar with them.

Teach children about the dangers of substances that contain poison. Label all poisons.

Don't store household chemicals in food containers, even if they are labeled. Most nonfood substances are poisonous if taken in large doses.

If you are concerned that industrial poisons might be polluting nearby land or water, report your concerns to the local health department or the state or federal Environmental Protection Agency.

Hack JB, Hoffman RS. General management of poisoned patients. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. Columbus, OH: McGraw-Hill; 2006:chap 156.

Updated by: Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.