Poisoning
Many substances are toxic when used inappropri-
ately or through accidental exposure. Personal
protection and safety are crucial for the first
responder, who must first determine that there is
no risk for becoming another victim of the same
exposure. This is especially of concern with poi-
sonous BITES AND STINGS, CONTACT TOXINS, and
INHALED TOXINS. Though the FIRST RESPONSEshould
always be to call 911 to summon emergency med-
ical aid, contact with a poison control telephone
hotline can provide specific advice for the first
responder until emergency medical personnel
arrive. In the United States, there is a nationwide
toll-free telephone hotline available 24 hours a
day, 7 days a week.
US national poison control hotline:
1-800-222-1222
Available 24 hours a day, 7 days a week,
from anywhere in the United States.
The number is toll-free.bites and stings Poisoning or HYPERSENSITIVITY
RESPONSE(allergic reaction) to insect and reptile
venoms. Though numerous insects sting and spi-
ders and snakes bite, most are not poisonous
(harmful beyond local discomfort at the site of the
sting or bite). Rapid FIRST RESPONSE efforts can
often reduce the severity of the resulting injury
from poisonous stings and bites.
Remove rings, watches, and other jew-
elry in the area of a bite or sting to
prevent further injury if swelling
occurs. Significant swelling is especially
common with poisonous snake bites.Hymenoptera stings The most common stings
come from wasps, hornets, yellow jackets, honey
bees, and fire ants, collectively known as the
Hymenoptera order. For the two million Ameri-
cans who are allergic to the venom of these
insects, the sting is far more significant than irrita-
tion or discomfort. Severe hypersensitivity
response can cause swelling of the THROATthat
blocks the airway; anaphylactic SHOCK is a life-
threatening circumstance.
First response for Hymenoptera stings:- Gently scrape the stinger out of the wound
with the edge of an object such as a credit card.
Do notgrasp the stinger with tweezers or fin-
gernails as this squeezes the venom sack and
forces more venom into the wound. - Apply ice until the area is numb.
- Make a paste of baking soda and water and lib-
erally spread it over the area of the sting.
(Alternately, apply a small amount of hydro-
cortisone cream or diphenhydramine cream.) - Seek further evaluation and treatment from a
health-care provider when PAIN persists or
worsens, or when the person stung has a
hypersensitivity response (allergic reaction).
Poisonous spider bites and scorpion stings
There are only two types of poisonous spiders in
North America, the widows (of which the black
widow is the most notorious species) and the
brown recluse. There is one species of poisonous
scorpion, Centruroides sculpturatus, found in the
southwestern United States (particularly Arizona)
and northern Mexico. The venom of a widow spi-
der is a neurotoxin that produces pain and
swelling at the site of the bite and systemic effects
that may include generalized discomfort or pain,
MUSCLE CRAMP, and muscle SPASM. It may also ele-
vate BLOOD PRESSURE(HYPERTENSION). Many people
do not notice the bite of the brown recluse spider381