Poisoning management

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 conditionInitial Treatment for Poisoning

In severe poisoning cases, the goal of initial treatment is basic life support (e.g., perform cardiopulmonary resuscitation [CPR], prevent or treat shock, treat serious burns). When the person is not breathing and is unresponsive following exposure to a toxic substance, administer CPR (i.e., rescue breaths and chest compressions) and call 911.

If the person may have been exposed to a poisonous substance, If possible, provide the following information:

Person's name, age, weight, address, telephone numberAgent that was ingested (have the package with you when you call), inhaled, etc.Amount of the substance that was swallowed, spilled on the skin, etc.Person's condition and symptomsAmount of time that has passed since the agent was ingested, inhaled, etc.

Always follow the advice of the Poison Control Center or a qualified health care provider regarding treatment for poisoning. In some cases, the ingested poison should be diluted by drinking milk or water.

Using syrup of ipecac to induce vomiting (emesis) at home is no longer recommended. Activated charcoal, which binds ingested poisons so they are not easily absorbed, may be recommended instead. Administer syrup of ipecac or activated charcoal only as directed by the Poison Control Center or by a qualified health care provider.

If the person has inhaled (breathed in) a poisonous substance (e.g., smoke, gas, fumes), move him or her to fresh air immediately and call 911. If the person is in cardiopulmonary arrest, administer CPR. Do not return to any area where toxic fumes may be present.

If the child's skin or clothing has been exposed to a toxic substance, remove the clothing as quickly and carefully as possible and flush all exposed areas of skin with plenty of water. Call 911 or your health care provider.
If the child has gotten a poisonous substance in his or her eye, rinse the eye thoroughly with plain water that is room temperature for about 15 minutes. Call 911 or your health care provider.

When the poisonous agent is unknown, call 911 or your health care provider, or transport the child to the nearest emergency room. Bring all possible sources of the poisoning with you.

Medical Treatment for Poisoning

The goals of childhood poisoning treatment are to reduce absorption and increase elimination (excretion) of the toxin and provide supportive care. Medical treatment may include the following:

Activated charcoal (substance that binds ingested poisons and reduces absorption)Induce vomiting (only under the supervision of a qualified health care provider)Lavage (used only rarely in children; involves using a stomach tube to remove contents of the digestive tract)Alkaline diuresis (involves using sodium bicarbonate to increase the alkalinity of the urine)Dialysis (e.g., hemodialysis, peritoneal dialysis; used to remove toxins from the blood)Intravenous (IV; administered through a vein) fluids

Medications may be used instead of or in addition to activated charcoal to treat certain types of poisoning. These drugs, which may be administered orally, intramuscularly (into muscle), or through an IV, include the following:

Acetylcysteine (e.g., to treat acetaminophen poisoning)Diazepam (e.g., to treat amphetamine or antihistamine poisoning)Dimercaprol (e.g., to treat arsenic, mercury, or lead poisoning)Dexamethasone (e.g., to treat swelling in the brain [cerebral edema] caused by carbon monoxide poisoning)

Surgical Treatment for Poisoning

Childhood poisoning that involves a foreign object (e.g., small toy, battery) may require surgery to remove the object. In most cases, however, the object passes safely through the child's digestive tract. X-rays may be used to make sure that the object has not come apart of become trapped (e.g., in the esophagus). Sharp or caustic items may cause severe tissue damage and may be removed surgically.

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