Poisoning First Aid

Routes of Poisoning

1) Swallowed Poison

  1. Gently wipe out the mouth and give a small amount of water to rinse out the mouth. Do not make the person vomit by putting a finger in their throat or giving them Syrup of Ipecac, egg whites, mustard, or any other home remedies.

2) Poison on the Skin

  1. Remove contaminated clothing and jewelry then rinse the skin with lukewarm (not hot) water for 10 minutes. Place the contaminated clothing in a plastic bag and place outside.

3) Poison in the Eye

  1. Flush the eye with lukewarm (not hot) water poured from a large glass two or three inches from the eye, or from the faucet or shower. Continue flushing the eye for 15 minutes. Have the person blink as much as possible while flushing the eye. Do not force the eyelid open.

4) Inhaled Poison

  1. Immediately get the person to fresh air. Open doors and windows or turn on a fan in the area.

Common Poisonings

If you suspect that your child has swallowed or put a magnet in their ear or nose, please contact your doctor or the poison control center.

1) In the Medicine Cabinet:

     Acetaminophen

      1. (brand name: “Tylenol”) is an over-the-counter medicine used commonly for minor aches and pains, as well as to treat fevers. It is available in both pill and liquid form, and is often sold as combination products for pain (e.g. “Percocet,” “Vicodin,” “Motrin Dual Action”), cough and cold (e.g. certain formulations of “Nyquil,” “Sudafed,” “Robitussin”), headaches (e.g. “Excedrin,” ”Goody’s Powder”), and menstrual cramps (e.g. “Midol”). If taken more than directed on the bottle, acetaminophen can cause liver failure.

     Non-steroidal anti-inflammatory drugs

      1. Ibuprofen (brand names: “Advil,” “Motrin”) and naproxen (brand name: “Aleve”) are examples of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are sold over-the-counter to treat minor aches and pains as well as fevers. If taken more than directed on the bottle, NSAIDs can cause intestinal bleeding, kidney damage, and the build-up of excess acid in the blood stream.

     Aspirin

      1. Aspirin is an over-the-counter anti-inflammatory, fever reducing, and anti-platelet (blood clot reducing) medication. It is also sold in combination with other products for headaches (e.g. “Excedrin”, “Goody’s Powder”). If taken more than directed on the bottle, aspirin can cause upset stomach, ringing in the ears, difficulty breathing, seizures, and the build-up of excess acid in the blood stream.

     Diphenhydramine and related allergy medications

      1. Diphenhydramine (brand name: “Benadryl”) is one of many over-the-counter antihistamine medications used to treat allergies and itchiness. These antihistamines are also commonly added to other medications to reduce nasal congestion (e.g. “Alka-Seltzer Plus,” “Coricidin”) and as a sleep aid (e.g. “Nyquil,” “Tylenol PM,” “Unisom”). If taken more than directed on the bottle, antihistamines can cause excessive sleepiness, hallucinations, confusion, and dangerously elevated temperatures.

     Multivitamins

      1. Multivitamins are over-the-counter supplements with a variety of vitamins and minerals thought to be beneficial to human health. Depending on the specific product, these supplements can be very dangerous if taken at dosages larger than recommended on the bottle. Symptoms may vary, but can include vomiting, stomach pain, weakness, and confusion.

     Cough, Cold, and Flu Medicine

      1. Cough, cold, and flu medicines represent a variety of different over-the-counter products designed to make you feel better when you’re sick. They often contain acetaminophen, non-steroidal anti-inflammatory drugs, aspirin, and antihistamines (see relevant sections for further information). These medicines also often include the cough-supressing medication dextromethorphan (brand names: “Delysm,” “Robitussin;” also found in many other combination products). If taken more than directed on the bottle, dextromethorphan can cause excessive sleepiness, hallucinations, confusion, agitation, and dangerously elevated temperatures.

2) Under the Sink

     Dishwasher detergent

      1. Dishwasher detergent contains several chemicals that can be irritating to the eyes, skin, and GI tract. Detergents are typically very basic (have a high pH) and can cause caustic injury to the mouth and esophagus if swallowed.

     Liquid drain cleaner (ex. draino)

      1. Liquid drain cleaner is an extremely caustic liquid that contains sodium hydroxide and is used to unclog sinks and drains. It can cause extensive damage if swallowed; symptoms include pain in the mouth/throat, inability to swallow, difficulty breathing, and vomiting blood.

     Laundry Pods

      1. Laundry pods are packets that contain concentrated detergents used in most modern washing machines. If ingested, laundry pods can cause pain in the mouth/throat, inability to swallow, difficulty breathing, bloody vomit, and lethargy.

3) In the House

     Alcohol

      1. Alcohol (ex. ethanol) is found in most homes in the form of beer, wine, and liquor, but is also found in some mouthwashes, hand sanitizers, and baking supplies like vanilla extract. While generally well tolerate in adults in moderation, alcohol exposure to a child can lead to somnolence, coma, difficulty breathing, low blood sugar, seizures, and death.

     Button Batteries

      1. Button batteries are small, powerful batteries that are found in many electronic devices. They are extremely dangerous; if swallowed they can become lodged in the esophagus and cause erosion into surrounding structures, leading to significant injury and death. Toddlers are particularly at risk.

     Magnets

      1. Sets of tiny, strong magnets are sold as adult toys but can be swallowed by children, resulting in serious injury and even death. The magnets, or a magnet and another metal object, can become stuck to each other, even through folds of intestine or tissue. This will pinch off blood supply to the area, causing tissue death, bleeding, and infection. If you suspect that your child has swallowed or put a magnet in their ear or nose, please contact your doctor or the poison control center.

     Cannabis/edibles

      1. With increasing legalization of cannabis (THC, marijuana, weed), there are more and more reports of children unknowingly ingesting products with large concentrations of THC (the psychoactive ingredient in cannabis). Pediatric exposure to THC leads to altered mental status, somnolence, coma, and occasionally seizures. If you suspect that your child has ingested a cannabis containing product, please contact your doctor or the poison control center.

     Vape liquid/Nicotine

      1. Vape pens that contain liquid nicotine, as well as cigarette butts and chewing tobacco can be extremely dangerous if swallowed. Nicotine poisoning can cause nausea, vomiting, dizziness, tremors, sweating, seizures, and death. If you suspect that your child has ingested a nicotine containing product, please contact your doctor or the poison control center.

4) In the Yard/Garden

     Mushrooms

      1. There are many different mushrooms found in nature. Unfortunately, many of these non-store-bought mushrooms are highly dangerous and can cause effects such as vomiting and diarrhea, liver injury, kidney injury, seizures, hallucinations, and death. Even experienced mushroom foragers can mistakenly consume a dangerous mushroom. If you or a loved one consumes a mushroom, please contact the poison control center. Because identification of the mushroom is crucial to determining toxicity, please take a picture of the mushroom and save it in a brown paper bag.

     Plants

      1. There are many plants in nature, some of which are toxic to humans. Some examples found in the Northeast include the following: Pokeweed is a perennial plant that is 4-10 feet in height, has reddish-purple stems and green leaves, and purplish-blue berries which can appear appetizing, but when consumed will cause abdominal pain, nausea, vomiting, and diarrhea. There are multiple species of yew tree found in the United States including the Canadian yew, which is a conifer shrub with green needles and red berries. All parts of the plant are toxic and when consumed can cause dangerous heart rhythms and death. Lily of the Valley is a short woodland plant with sweet-smelling bell-shaped white flowers and green leaves that can cause vomiting, dangerous heart rhythms, and death if eaten. If you or a loved one consumes an unknown wild plant including any of the above plants, take a picture of the plant, save it in a brown paper bag, and call the poison center immediately.

5) In the Garage

     Hydrocarbons (ex. gasoline, kerosine)

      1. Hydrocarbons are found in sources of fuel such as gasoline, motor oil, lighter fluid, and lamp oil (kerosene). They are generally not harmful if swallowed, but can cause serious damage to the lungs if they are accidentally inhaled or “go down the wrong pipe” and end up in the lungs. This can cause coughing, rapid breathing, and shortness of breath. If you are concerned that you or someone you know has swallowed or inhaled hydrocarbons, do not induce vomiting! Instead, contact your doctor or call the poison control center.

     Ethylene glycol/Methanol

      1. Several chemicals used for automobile maintenance contain toxic compounds. Ethylene glycol and methanol are found in antifreeze and windshield wiper fluid, respectively. These substances can cause dangerously high levels of acid in the blood, as well as vomiting, confusion, abnormal behavior, loss of vision, and even kidney failure. If you are concerned that you or someone you know has swallowed any of these chemicals, call your doctor or the poison control center immediately.

     Rat poison

      1. There are several different types of rat poisons available in the United States that can be harmful if swallowed. A common form of rat poison works as a very powerful blood thinner; in humans, it can put you at high risk of serious bleeding, but most people do not have significant bleeding. Other rat poisons can cause sleepiness, confusion, breathing problems, or heart problems. Some of them cause very little health problems at all. If you are concerned that you or someone you know has swallowed rat poison, call your doctor or the poison control center immediately. Because of the wide range of different toxicities between different rat poisons, you should try to identify the brand and the active ingredient on the container, if available, so that the health care team can give you appropriate guidance.

     Pesticides

      1. Pesticides can be extremely harmful if swallowed or inhaled. Most common pesticides are very irritating to the eyes, skin, and mouth. Certain pesticides, or pesticides in large amounts, can cause vomiting, diarrhea, sweating, difficulty breathing, seizures, and life threatening amounts of mucous and saliva production. You might notice that someone exposed to large amounts of pesticides has very small pupils and a slow heart rate. The body fluids of people exposed can transmit the chemicals and make you sick. If you are concerned you or someone you know has been exposed to pesticides, protect yourself! Do not touch their bodily fluids with your bare-hands, and rinse the exposed area with water. If swallowed, do not induce vomiting. Call your doctor or the poison control center immediately.

     Herbicides

    1. Herbicides are chemicals used to control the growth of plants. Some are dangerous and even life threatening. They can be very damaging to the mouth, throat, and stomach, and can cause vomiting or difficulty breathing. If swallowed, they can cause severe muscle damage, confusion, kidney failure, and permanent lung disease. If you are concerned you or someone you know has been exposed to herbicides, rinse the exposed area with water. If swallowed, do not induce vomiting. Call your doctor or the poison control center immediately.