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Poisoning

Overview

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Poisoning can result from ingestion, inhalation, injection, or skin contact with harmful substances. These substances might include chemicals, medications, plants, or animal venoms. The severity of poisoning depends on the type of poison, the amount, the route of exposure, and the individual's health status.

These substances might include chemicals, medications, plants, or animal venoms. The severity of poisoning depends on the type of poison, the amount, the route of exposure, and the individual's health status.

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Symptoms

Symptoms of poisoning vary widely depending on the substance involved but can include:

  • General Symptoms: Nausea, vomiting, diarrhea, abdominal pain, headache, dizziness.
  • Neurological Symptoms: Confusion, seizures, loss of consciousness, blurred vision.
  • Respiratory Symptoms: Difficulty breathing, coughing, wheezing.
  • Cardiovascular Symptoms: Rapid or irregular heartbeat, high or low blood pressure.
  • Dermatological Symptoms: Rash, itching, burns.
Complications

Complications from poisoning can be severe and include:

  • Organ Damage: Liver, kidney, or heart damage.
  • Seizures: Resulting from severe poisoning or neurotoxins.
  • Respiratory Failure: Particularly with poisons that affect breathing.
  • Cardiac Arrest: In cases of severe poisoning affecting the heart.
  • Long-term Effects: Chronic health issues depending on the poison.
Causes

Causes of poisoning can include:

  • Accidental Ingestion: Of household chemicals, medications, or contaminated food.
  • Intentional Self-Harm: Overdose or misuse of substances.
  • Occupational Exposure: To toxic chemicals or pollutants.
  • Environmental Exposure: Contaminants in air, water, or soil.
  • Animal Bites/Stings: Venomous animals or insects.
Prevention

Preventing poisoning involves:

  • Safe Storage: Keeping chemicals and medications out of reach of children and pets.
  • Proper Labeling: Ensuring all chemicals and medications are clearly labeled.
  • Education: Teaching about the dangers of certain substances and proper handling.
  • Using Protective Gear: In occupational settings, using appropriate personal protective equipment.
  • Avoiding Risky Behaviors: Not mixing chemicals or using them inappropriately.
Risk Factors

Risk factors for poisoning include:

  • Age: Children and the elderly are more vulnerable.
  • Pre-existing Health Conditions: Certain health conditions can make individuals more susceptible.
  • Substance Use: Misuse of drugs or alcohol.
  • Environmental Factors: Living in areas with high levels of pollution or exposure to toxic substances.
  • Occupational Exposure: Jobs that involve handling hazardous materials.
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How is it treated?

Treatment for poisoning depends on the type and severity of exposure but may include:

  • Immediate Care: Calling emergency services and providing first aid if trained.
  • Decontamination: Removing the person from exposure, washing affected skin, or decontaminating the environment.
  • Activated Charcoal: Administered to absorb toxins in some cases of ingestion.
  • Antidotes: Specific antidotes for certain poisons (e.g., naloxone for opioid overdose).
  • Supportive Care: Monitoring and supporting vital functions (e.g., breathing, heart rate).
  • Hospitalization: For severe cases requiring specialized care and monitoring.
  • Prompt medical attention is crucial for managing poisoning effectively and reducing the risk of serious complications.
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How is it Diagnosed?

Diagnosing poisoning involves a systematic approach combining clinical assessment, toxicological history, physical signs, and laboratory investigations. The aim is to identify the toxin, assess the severity of poisoning, and initiate timely treatment.

The first step in diagnosis is a detailed history, either from the patient, relatives, or emergency responders. Important information includes the substance involved, route of exposure (oral, inhalation, dermal), quantity, timing, and intent (accidental vs. intentional). In unconscious or uncooperative patients, circumstantial evidence such as containers or odors may provide clues.

    A comprehensive physical examination is performed to identify toxidromes—clusters of signs and symptoms associated with particular classes of toxins. Examples include:

  • Anticholinergic toxidrome: dry mouth, dilated pupils, tachycardia.
  • Cholinergic toxidrome: salivation, lacrimation, urination, diarrhea.
  • Opioid toxidrome: pinpoint pupils, respiratory depression, unconsciousness.

    Laboratory investigations help confirm the diagnosis and assess systemic involvement:

  • Toxicology screening (urine and blood): To detect common drugs and toxins.
  • Serum electrolytes, glucose, renal and liver function tests: To monitor metabolic disturbances.
  • Arterial blood gases (ABG): To assess acid-base balance.
  • Electrocardiogram (ECG): To detect cardiotoxic effects.
  • Specific serum toxin levels: For substances like paracetamol, salicylates, or methanol when known or suspected.

In cases of unidentified poisoning, treatment often begins empirically based on clinical signs. Poison control centers and standardized protocols are vital for guiding diagnosis and management. Prompt diagnosis improves outcomes and reduces the risk of complications.

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