To manage a poisoned patient properly, obtain a patient history relating to the
poisoning. Question the patient, family members, and bystanders asking the following:
a. What was taken? If a plant was the source of poison, find out what part of the
plant was eaten--roots, leaves, stem, flower, or fruit.
b. When was the poison taken?
c. How much of the poison was taken?
d. Has the patient vomited, urinated, or defecated since taking the poison?
(Bring samples to the hospital.)
e. What have bystanders done for or to the patient--tried to induce vomiting,
given an antidote, etc.?
THERAPEUTIC PROCEDURES FOR REMOVAL OF POISONS
Different poisons require different procedures for removal. Generally, however,
begin by supporting the patient's vital functions. Maintain the airway and respiration,
combat shock, and deal with specific medical problems as they arise. Next, administer
an antidote if it is available and you are authorized to do so. Specific techniques for
removal of poisons include the following:
a. Removal by Emesis. Using a good emetic drug (a drug that will induce
vomiting) is the quickest and most effective way to evacuate the contents of the
stomach. An additional advantage is that this method can be done immediately and at
the site of the poisoning. Household emetics are rarely effective. Two methods of
inducing vomiting are by syrup of ipecac taken orally and apomorphine hydrochloride
(1) Syrup of ipecac. Many emergency room doctors recommend ipecac to
induce vomiting when the patient has taken liquid poison. Give an adult patient one
tablespoon of ipecac followed by 200 to 300 milliliters of water. For increased emetic
action, give the patient up to a liter of warm water. Repeat the dose in twenty minutes
and walk the patient. If there is no effect after the second dose, lavage (wash out) the
stomach. For a patient under one year old, give 5 to 10 milliliters of ipecac. Do not give
ipecac if the patient is drowsy, convulsive, or has ingested products containing acid,
alkaline, or kerosene. Also, ipecac is not effective after the patient has been given
activated charcoal. Do not give ipecac after the poison has been absorbed into the
blood. Ipecac will not be helpful and may be harmful if the vomitus gets into the lungs.