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Emergency care 13th edition Chapter 21 poisoning and overdose emergencies. Flashcards

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11027727486PoisonAny substance that can harm the body by alternating cell structure or function0
11027727487Toxina poisonous substance secreted by bacteria, plants, or animals1
11027727488Acetaminophen (Tylenol)Nausea and vomiting. Jaundice is a delayed sign. There may be no signs or symptoms2
11027727489Antiarrhythmics(drugs to regulate electrical impulses and the speed of the heart)Bradycardia, hypotension, decreased consciousness, and respiratory depression.3
11027727490Acids and AlkalisBurns on or around the lips. Burning in mouth, throat, and abdomen. Vomiting.4
11027727491AntidepressantsTachycardia, hypertension, nausea, and tremors.5
11027727492Anthtihistines and cough or cold preparationsHyperactivity or drowsiness. Rapid pulse, flushed skin, dilated pupils.6
11027727493Antipsychoticsdrowsiness, coma, tachycardia7
11027727494AsprinDelayed signs and symptoms, including ringing in the years, deep in rapid breathing, bruising.8
11027727495food poisoningDifferent types of food poisoning have different signs and symptoms of varying onset. Most include abdominal pain, nausea, vomiting and diarrhea, and sometimes a fever9
11027727496Ibuprofen and other nonsteroildal anti-inflammatory drugs(NSAIDS)Upset stomach, nausea, vomiting, drowsiness, abdominal pain, gastrointestinal bleeding10
11027727497InsecticidesSlow pulse, excessive salivation and sweating, nausea, vomiting, diarrhea, difficulty breathing, constricted pupils11
11027727498Petroleum productscharacteristic odor of breath, clothing, vomitus. If aspiration has occurred, coughing and difficulty breathing12
11027727499PlantsWide range of signs and symptoms, ranging from nine to nausea and vomiting to cardiac arrest13
11027727500Corrosive or irritantDestroying skin and other body tissues14
11027727501Suffocating agentDisplaying oxygen in the air15
11027727502systematic poisonsCausing Harm to the entire body or to an entire body system.16
11027727503Corrosive, Irritant, suffocating agent, and systemic poisons can Critically depressed or overstimulate the central nervous system causingVomiting and diarrhea, prevent red blood cells from caring oxygen, or interfere with the normal biochemical process in the body at the level of the cell.17
11027727504ingested poisons(swallowed)Can include many common household in industrial chemicals, medications, and properly prepared were stored foods, plant materials, petroleum products, and agriculture products made specifically to control rodent, weeds, insects, and crop diseases.18
11027727505Inhaled poisons(breathed in)Gases, vapors and sprays. Many of these substances are common use in the homes, industry and agriculture. Such poisons include carbon monoxide(from car exhaust, wood-burning stove and furnaces), ammonia, chlorine, insect sprays, and the gases produced from volatile liquid chemicals.19
11027727506Absorb poisons(skin)Poisons that are taken into the body through unbroken skin. Many are corrosive or irritants that will injure the skin then be slowly absorbed into the body tissue in the bloodstream.20
11027727507Injected poisonspoisons that are inserted through the skin, for example by needle, snake fangs, or insect stinger21
11027727508What substance was involved?It is important to get the exact spelling of the substance. If it is possible and safe, bring the container to the hospital with the patient22
11027727509When did exposure occur?It is important for the emergency department personnel to know as closely as possible the time of ingestion so that appropriate testing and treatment can be done. If you cannot get an exact time, determine their earliest and latest possible times of exposure.23
11027727510How much was ingested?When the amount cannot be readily estimated, determine the maximum amount that might've been ingested.24
11027727511What effects is the patient experiencing from ingestions?Nausea and vomiting or two of the most common result of poison ingestion, but you may also find altered mental status, abdominal pain, diarrhea, chemical burns around the mouth and unusual breath oders.25
11027727512What is the patients weight?This estimate, in combination with the amount of substance ingested, maybe critical in determining the appropriate treatment.26
11027727513Activated Charcoala substance that absorbs many poisons and prevents them from being absorbed by the body27
11027727514Medication names for activated charcoalGeneric: activated charcoal Trade: Superchar, InstaChar, Actidose, Liqui-Char.28
11027727515Contraindications to activated charcoalaltered mental status, ingestion of acids or alkalis, inability to swallow29
11027727516medication form of activated charcoal1. premixed with water to form a slurry 2. powder - which should be avoided in the field30
11027727517Dosage of activated charcoalAdults and Children: 1g of body weight adult dose: 25-50g Pediatric dose: 12.5-25g31
11027727518Administration of activated charcoal steps1. Consult medical direction 2. Shake container thoroughly 3. Provide a covered container and a straw will prevent the patient from seeing the medication and so may improve the patient's compliance. 4. If the patient does not drink the medication right away, the charcoal settle. Shake or stir it again before administering. 5. Record the name, dose, route, and time of administration of the medication.32
11027727519actions of activated charcoal1. Activated charcoal absorbs(binds) Certain poisons and prevents them from being absorbed into the body 2. Not all brands of activated charcoal are the same. Some of us are much more than others, so consult medical direction about the brand to use.33
11027727520Side effects of activated charcoal1. some patients have black stools 2. some patients may vomit, particularly those who have ingested poisons that cause nausea. if patient vomits, repeat the dose once.34
11027727521Reassessment strategies for activated charcoalBe prepared for the patient to vomit or further deteriorate35
11027727522DilutionThinning down or weakening by mixing with something else. Ingested poisons are sometimes diluted by drinking 1 to 2 glasses water or milk. A child should be given 1/2 to 1Full glass of water or milk.36
11027727523dilution with waterMay slow absorption slightly37
11027727524Dilution with milkMay sooth stomach upset.38
11027727525Dilution with water or milkIs frequently advice for patients who, as determined by medical direction or poison control, do not need transport to the hospital39
11027727526Step 1 for Patient care of ingested poisonsDetect and treat immediately life-threatening problems in the primary assessment. Evaluate the need for prompt transport for critical patients.40
11027727527Step 2 for Patient care of ingested poisonsPerform a secondary assessment. Used glove hands to carefully remove any pills, tablets, or fragments from the patient's mouth; package the materials and transport with the patient.41
11027727528Step 3 for Patient care of ingested poisonsAssess baseline vital signs42
11027727529Step 4 for Patient care of ingested poisonsConsult medical direction. As directed, administer activated charcoal to absorb the poison, or water or milk to dilute it. This can be done in route43
11027727530Step 5 for Patient care of ingested poisonsTransport a patient with our containers, bottles, and labels from the substance44
11027727531Step 6 for Patient care of ingested poisonsPerform reassessment en route45
11027727532antidotea substance that will neutralize the poison or its effects46
11027727533Most frequent victims of accidental poisonings?Children47
11027727534Medication name for NaloxoneGeneric: Naloxone Trade: Narcan48
11027727535Indications for Naloxone1. Suspected narcotic overdose 2. Coma of unknown cause49
11027727536Medication form of NaloxoneLiquid50
11027727537dosage of naloxone0.4-2.0mg51
11027727538Administration steps of Naloxone1. Obtain medical direction, either online or off-line, as directed by your local protocols 2. Inspect the patients nostrils. Make sure there's no obstructions in the nostrils 3. Consider restraining the patient before drug ministration if you believe the patient may become combative 4. Attach the atomizer to the syringe containing the Naloxone 5. Push the atomizer gently but firmly into the national opening 6. Push the plunger of the syringe Firmly but briefly until the desired amount of liquid has been expelled from the syringe. Limit the amount of fluid and ministered at one time to 0.5 mL per nostril 7. Repeat as needed with other nostril and record the name does Shrout and time of the ministration of the medication(Naloxone).52
11027727539Actions of NaloxoneReverse the effects of narcotics, including depressed level of consciousness and respiratory depression53
11027727540side effects of naloxoneMay precipitate withdrawal in patients dependent on the narcotics54
11027727541Reassessment strategies after using NaloxoneEvaluate level of consciousness and respiratory rate and depth frequently. Effects of Naloxone do not last long as some narcotics, so some patients may relapse in coma with respiratory depression.55
11027727542Often from swimming pool chemicalsChlorine gas56
11027727543After release from household cleanersammonia57
11027727544From industrial sourcesSprayed agricultural chemicals and pesticides, and carbon dioxide.58
11027727545Patient assessment of and inhaled poisons• what substance was involved? - Get exact name. • when did the exposure occur? - estimate as well as you can when the patient was exposed to the poisonous gas by finding out the earliest and latest possible times exposure. • Over how long a period to the exposure of occur? - The longer someone is exposed to a poisonous gas, the more poison that will probably be absorbed. • what interventions has anyone taken? - did someone remove the patient or ventilate the area right away? When did this happen? • what effects is the patient experiencing from the exposure? - nausea and vomiting are very common and poisons of all types. With inhaled poisons, find out if the patient is having difficulty breathing, chest pain, coughing, hoarseness, dizziness, headache, confusion, seizures, or alter mental status.59
11027727546Step 1 of Patient care for inhaled poisonsIf the patient is in an unsafe environment, have train rescuers remove the patient to a safe area. Detect and treat immediate life-threatening problems in the primary assessment. Evaluate the need to properly transport critical patients.60
11027727547Step 3 of Patient care for inhaled poisonsPerform a secondary assessment, obtain vital signs,61
11027727548Step 2 of Patient care for inhaled poisonsOpen airway, Insert OPA or NPA and Administer high concentration oxygen via nonrebeather. This is the single most important treatment for in hell poisons after the patient's airway is opened62
11027727549Step 4/5 of Patient care for inhaled poisonsContact medical direction, Transport the patient with all containers, bottles, and labels from the substance. Perform reassessment in route63
11028412836Most commonly inhaled poisons?Carbon Monoxide(CO)64
11028412837The number of Carbon monoxide cases has increased recently becauseThe use of improperly vented wood burning stove and the use of charcoal for heating and indoor cooking in areas without adequate ventilation. Also, The indoor use of gasoline powered small engines such as electrical generators or pumps is another common cause of carbon monoxide poisoning.65
11028412838When looking for indications of possible carbon monoxide poisoning look forWood burning stove, doors that lead to a garage, bedrooms above a garage or motor repair work is in progress, and evidence that suggests the patient has been a long period of time sitting in an idling motor vehicle.66
11028412839Signs and symptoms of carbon monoxide poisoningflu-like symptoms, nausea, vomiting, altered LOC, headache, dizziness, breathing difficulties, headache, cyanosis, unconsciousness(severe case).67
11028412840You should suspect carbon dioxide poisoning when ever you were treating a patient withFlu like symptoms who has been in an enclosed area or When a group of people are in the same Area and have similar symptoms68
11028412841100% Oxygen is the antidote for car monoxide poisoning, but it takes time to "____ ____ "Carbon dioxide from the patient's blood stream"Wash Out"69
11028412843What is not a SIGN typically seen with carbon oxide poisoningCherry red skin.70
11028412844Smoke in elation is often associated withThermal burns with The effect of chemical poisons with in the smoke.71
11028412845Modern building materials contain plastics or synthetics. When those plastics and other synthetics burn or are overheated they releaseToxic fumes. It is possible for the substances found in smoke to burn the skin, irritate the eyes, injure the airway, cause respiratory arrest, and in some cases cardiac arrest.72
11028412846Signs and symptoms that indicate an airway injury by smoke inhalation.Difficulty breathing, coughing, breath that has a smoky smell or the odor of chemicals involved at the scene, black carbon residue in the patient's mouth and nose, black residue in any sputum coughed up by the patient, and nose hair cinched from super heated air.73
11028412847Patient care for smoke inhalationMove the patient to a safe area, assess the patient, administer high concentration oxygen viva nonrebreather, and transport. If the patients Plus oximeter is reading 100%, administer high concentration oxygen. Carbonoxyhemoglobin is Red, like oxyhemoglobin and the two cannot be distinguished by a pulse oximeter.74
11030203470Detergent SuicidesMethod of suicide started in Japan Mix two easily obtained chemicals to release hydrogen sulfide gas Commonly released inside an enclosed space such as a car. If you see a note or sign warning people not to approach should be taken seriously. Call the appropriate agency to open the space and remove the body.75
11030203471Hydrogen sulfide is best known for its?Rotten egg smell.76
11030203472mild exposure to hydrogen sulfideCoughing, Eye irritation and sore throat.77
11030203473More severe cases of exposer to hydrogen sulfideDizziness, nausea, shortness of breath, headache and vomiting78
11030203474Most severe case of exposure to hydrogen sulfidePulmonary Edema(fluid collecting at the Lungs), resulting in death.79
11030480406Patient care for absorbed poisons1. primary assessment - detect any life threats 2. secondary assessment - and vital signs 3. remove poison 4. transport - make sure to grab bottles or wrappers of poison 5. perform reassessment en route80
11030480407Remove poisons by doing one of the followingPowders- brush powder off the patient Liquids-your gate with clean water for at least 20 minutes continue in route if possible Eyes-your gate with clean water for at least 20 minutes and continue in route if possible81
11030480408Neutralizing acids or alkalis with solutions such as dilute vinegar or baking sodaShould not be done.82
11030613355Poisons that act almost immediately usually produceObvious signs83
11030613356Slow acting poisons can produce effects That mimicInfectious disease or some other medical emergency84
11030613357Poisonous control number(24 hours a day)1-800-222-122285
11030613358How should you communicate with poison control centersBy Telephone.86
11030613359How should you memorize the poison control centers number?Paste it inside your kit.87
11030613360To help poisonous control center staff always gather what?All the information you need before your call88
11030613361The poisonous control center can provide valuable information for what types of poisonsAll types of poisons.89
11030851672Chronic drinkers(alcoholics) often havederangements in blood sugar levels, poor nutrition, potential for considerable gastrointestinal bleeding, and other problems.90
11030851673When alcohol is combined with other depressants such as antihistamines and TranquilizersThe effects of alcohol can be more pronounced and in some cases, lethal.91
11030851674Medical problems that may appear to make the patient look intoxicated when he is notDiabetes, epilepsy, head injuries, high fevers, and hypoxia.92
11030851675Signs and symptoms of the Alcohol abuseOdor of alcohol on the patients breath or clothing, Swain and unsteadiness of movement, slurred speech, rambling thought patterns, I flushed appearance in the face(Often with patients sweating and complaining of being), nausea and vomiting, poor coordination, slow reaction time, blurred vision, confusion, hallucinations, lack of memory(blackout), and altered mental status93
11030851676withdrawalreferring to alcohol or drug withdrawal in which the patient's body reacts severely when deprived of the abused substance94
11030851677delirium tremensA severe reaction that can be part of alcohol withdrawl, characterized by sweating, trembling, anxiety, and hallucinations. Severe alcohol withdrawal with DTs can lead to death if untreated.95
11030851678Signs of alcohol withdrawalconfusion and restlessness unusual to insane behavior hallucinations gross tremor profuse sweating seizures hypertension tachycardia96
11030851679Patient care for alcohol abuseStay alert for airway and respiratory problems, Assess for trauma the patient may be unaware of this because of his intoxication, be alert for changes in mental status as alcohol is absorbency the bloodstream(Talk to the patient in an effort to keep him as alert as possible), Monitor vital signs, treat for shock, protect the patient from self injury, stay alert for seizures, and transport patient to a medical facility.97
11030907740Common head injurie in alcoholicsSubdural hematoma98
11030907741If patient is under the influence of drugs, alcohol or any substance that alters mental status, rememberHe cannot make an informed decision or Refuse transport. Act on implied consent.99
11031235663substance abuseIndicates a chemical substance is being taken for other than therapeutic(medical) reasons100
11031235664UppersStimulates that affect the nervous system and excite the user. Many of users use these drugs in an attempt to relieve fatigue create feelings of well-being. Examples are caffeine, amphetamines, and cocaine.101
11031235665DownersDepressants affect on the central nervous system. This type of drug may be used as a relaxing agent, sleeping pill, or tranquilizer. Barbiturates are examples usually in pill or capsule form.102
11031235666NarcoticsDrugs capable of producing stupor or sleep. They are often used to relieve pain. Many drugs legitimately use for these purposes such as codeine are also abused, affecting the nervous system and changing many of the normal activities of the body, often producing an intense state of relaxation or feeling of well-being. (OxyContin, Heroine)103
11031235667HallucinogensLSD, PCP, and certain types of mushrooms remind affecting drugs that act on the nervous system to reduce an intern state of excitement or a distortion of the users perceptions. This class of drug has few legal uses. They are often eaten or dissolved in the mouth and absorb through the mucous membranes. A new hallucinogen is Ecstasy(XTC, X, or MDMA). Often taken at rave parties. Hallucinogens also have the stimulate properties of uppers.104
11031235668Narcotic overdose is are generally categorized by three signsComa, pinpoint pupils, and respiratory depression. Together these are referred to as "opiate triad".105
11031235669Volatile chemicalsVapors that can be inhaled. They can give an initial rush then act as a depressant on the central nervous system. Cleaning fluid, glue, model submit, and correction fluid used to correct ink-based errors are commonly abused volatile chemicals106
11031235670designer drugssynthetic drugs that are made to imitate the effects of other drugs107
11032021388If a patient mixed drugs and alcohol he will haveDepressed vital signs108

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