lar, kidney, LIVER, or neurologic damage. Appropri-
ate FIRST RESPONSEis often crucial.
Site and situation assessment Determine, to
the best extent possible, what and how much of it
the person has swallowed, as well as when. Take
the container or label when it is present.
Responder personal protection measures Latex
or latex-style gloves are essential to prevent
responder contact with the toxin as well as body
fluids from the injured person. A resuscitation
shield is necessary for RESCUE BREATHINGor CAR-
DIOPULMONARY RESUSCITATION(CPR).
First response actions Call 911 to summon
emergency medical personnel when the situation
appears significant or call the poison control hot-
line (in the United States: 1-800-222-1222) for
guidance. Further first response actions:
- If the person is conscious, give small, frequent
drinks of water. - Do notgive anything else and do notinduce
vomiting unless emergency medical or poison
control personnel so instruct. - If the person is unconscious, position the per-
son to lie on a side with the head somewhat
down in case of VOMITING. If vomiting occurs,
clear vomitus from the MOUTHto maintain an
open airway.- If the person is not BREATHING, begin rescue
breathing. - If the person is not breathing and does not
have a PULSE, begin CPR.
Follow-through People who have ingested
toxic substances or overdoses of medications
require urgent treatment at a hospital emergency
department or trauma center.
See also BODY SUBSTANCE ISOLATION; OVERDOSE;
POISON PREVENTION; RESPONDER SAFETY AND PERSONAL
PROTECTION; SITE AND SITUATION ASSESSMENT; SUICIDE
IDEATION AND SUICIDE; SYMPTOM ASSESSMENT AND CARE
TRIAGE.inhaled toxins Substances that, when breathed,
can injure the airways and LUNGSas well as cause
systemic poisoning. Inhaled toxins require urgent
medical care.
Site and situation assessment Attempt to
determine the toxin and whether it remains pres-
ent in the environment. There may be multiple384 Emergency and First Aid
COMMON INHALED TOXINSToxin Common Sources Characteristics
carbon monoxide poorly ventilated furnaces or stoves odorless
automobiles or gas power tools running symptoms include intense sleepiness progressing
in enclosed area such as garages to loss of consciousness, bright redness to face
propane gas; natural gas heating and cooking appliances sulfuric odor (“rotten egg” smell) added to help
detect leaks
symptoms include disorientation and confusion
progressing to loss of consciousness
ammonia gas fertilizer products for commercial strong, pungent odor
agricultural use small exposure is highly toxic
industrial exposures symptoms include severe respiratory irritation,
intense coughing, and chemical BURNSto the
nasal passages and airways
chlorine gas pool cleaning products strong, bleachlike odor
industrial exposures symptoms include intense irritation to eyes, nose,
and respiratory tract