two chemicals might react to form carbon dioxide gas (HCl + NaHCO3 → NaCl + CO2(↑)
+ H2O) that could distend or even perforate the stomach.
Administer gastric lavage.
c. Retard Absorption. There are two methods by which the absorption of
toxins can be retarded.
(1) Dilute the poison. Water, milk, flour or cornstarch suspension can be
used to dilute (lower the concentration of) the poison. When the concentration of the
poison is lowered, the amount of poison absorbed in a given period of time is usually
(2) Administer activated charcoal. The activated charcoal adsorbs the
poison and thereby reduces the amount of the poison which is available for adsorption.
It should be noted that if both syrups of ipecac and activated charcoal are to be used,
the activated charcoal must not be given until after the ipecac-induced emesis has
occurred since the charcoal will render the ipecac ineffective.
c. Administer Systemic Antidotes (when possible). As you know, antidotes
are substances which counteract the effects of other substances. Unfortunately, not
every substance which is a toxin has an antidote which will serve to render its effects
harmless. When the physician sees the poisoning victim, he must know what the
identity of the ingested poison is before he considers giving an antidote. Furthermore,
even after the identify of the poison is known, there must be an antidote in existence for
that particular poison. Some examples of antidotes are naloxone (Narcan), for narcotic
poisonings--atropine, for the treatment of certain insecticide poisonings--BAL in Oil, for
arsenic, gold, and mercury poisoning--Edetate Calcium Disodium, for lead poisoning--
and flumazenil (Romazicon) for benzodiazepine overdose.
d. Speed the Elimination of the Poison. As you might expect the effects of a
toxin can be reduced in many instances if that substance is quickly eliminated from the
body. Methods such as forced diuresis, through the administration of hypertonic
solutions and through adjustment of urine pH; peritoneal dialysis, and hemodialysis
(hematodialysis) can be used to speed the elimination of certain poisons from the body.
e. Support the Patient. In all poisonings the patient must be supported. That
is, the physician must carefully monitor the patient--through observation and by
laboratory tests. When required, the physician may administer drugs for pain, replace
fluids and electrolytes, regulate body temperature, maintain respiration, and maintain