Poison Treatments

POISON TREATMENTS

by

Gary L. Smith

Extension Agricultural Engineer

University of Maryland

Everyone who works with pesticides should have a well thought out plan of action to follow in the event of an accident. It should include basic knowledge of first aid as it relates to pesticide poisoning and a prepared kit.

Call a Doctor or a Poison Control Center

First aid is the initial effort to help a victim while medical help is on the way. Step one in any poisoning emergency is to call an ambulance or doctor. The only exception is when you are all alone with the victim. Then you must see that he is breathing, and out of further exposure to the pesticide before leaving him to make a phone call. Always save the pesticide and the label for the doctor.

Poison on the Skin

The sooner the poison is washed off the patient, the less the injury.

Remove clothing and drench skin with water (shower, hose, faucet, pond, ditch).

Cleanse skin and hair thoroughly with soap and water. (Don't abrade or injure the skin while washing.)

Dry and wrap in a blanket

Warning: Do not allow any of the pesticide to get on you while you are helping the victim.

Chemical Burns of the Skin

Remove contaminated clothing.

Wash the skin with large quantities of cold running water.

Immediately cover loosely with a clean, soft cloth.

Avoid use of ointments, greases, powders, and other drugs in the first aid treatment of chemical burns.

Poison in the Eye

It is very important to wash the eye as quickly, but as gently, as possible.

Hold eyelids open, wash eyes with a gentle stream of clean running water at body temperature.

Continue washing for 15 minutes or more.

Do not use chemicals or drugs in wash water. They may increase the extent of injury.

Inhaled Poisons (Dust, Vapors, Gases)

If victim is in an enclosed area use an air-supplied respirator to get to him.

Carry patient (do not let him walk) to fresh air immediately.

Open all doors and windows.

Loosen all tight clothing.

Apply artificial respiration if breathing has stopped or is irregular.

Keep patient as quiet as possible.

If patient is convulsing, watch his breathing and protect him from falling and striking his head. Pull his chin forward so his tongue does not block his air passage.

Do not give alcohol in any form.

Swallowed Poisons

The most important decision you have to make when aiding a person who has swallowed a pesticide is whether to induce vomiting or not. The decision must be made quickly and accurately; the victim's life may depend on it. Usually it is best to get rid of the swallowed poison fast. But: NEVER induce vomiting if the victim is unconscious or is in convulsions. The victim could choke to death on vomitus.

Find out what poison has been ingested. NEVER induce vomiting if the victim has swallowed a corrosive poison. A corrosive poison is a strong acid or alkali (base) such as dinoseb (DN Compounds). The victim will complain of severe pain and have signs of severe mouth and throat burns. A corrosive poison wil burn the throat and mouth as severely coming up as it did going down.

Most labels on emulsifiable concentrate and solution formulations suggest the victim should not have vomiting induced. However, when the toxicity of the pesticide is marked, its removal may be essential.

To Induce Vomiting

Give one (1) tablespoon (1/2 ounce) of syrup of ipecac to a child over one (1) year of age or one (1) fluid ounce (2 tablespoons) to an adult, followed by a glass of water. If vomiting does not occur in 15 minutes, the dose may be repeated. Do not waste a lot of time waiting for the vomiting. Get the victim to a hospital.

Make sure the victim is kneeling forward or lying on his right side while retching or vomiting. Do not let him lie on his back because vomitus could enter the lungs and do more damage. Catch the vomitus in a container and save for the doctor. He may need it for chemical tests.

An ounce of syrup of ipecac may be obtained without prescription from your pharmacist.

If you do not have syrup of ipecac, give 1 cup of milk or water for victims up to five (5) years and older. Induce vomiting by putting your finger or the blunt end of a spoon on the very back of his tongue. Do not use anything which is sharp or pointed.

A glass of soapy water (such as Ivory soap from a bar dissolved in water) may also cause the victim to vomit.

Corrosive Poisons

The best first aid is to dilute the poison as quickly as possible. For acids or alkalis (bases), give the patient water or preferably milk or ice cream - one (1) cup for victims under five (5) years; or one (1) to two (2) glasses for patients over five (5) years. Milk or ice cream is better than water because it dilutes and helps neutralize the poison. Water only diluteas the poison.

It is very important that the victim get to a hospital without delay. DO NOT INDUCE OR ENCOURAGE VOMITING FOR CORROSIVE POISONS!

Activated Charcoal

After first-aid suggestions for noncorrosive poisons have been followed and medical help is delayed due to travel or other reasons, activated charcoal may be administered to hopefully absorb the remaining poison. It does not absorb all poisons and a rather large amount may be required for it to be effective. For example: it takes 1-1/2 ounces of charcoal powder (about 10 grams) to bind 3 adult aspirin. Mix the charcoal with water into a thick soup for the victim to drink.

Individuals who work with insecticides should purchase from their pharmacist a sealed pint jar of activated charcoal to have available in the event of an accident. The most favorable experience has been with the following products: (1) Norit A (American Norit Co., Jacksonville, FL) (2) Darco G 760 (Atlas Powder Co., Wilmington, DE), but other products may be available locally. Remember that the activated charcoal poison mixture must be removed from the body and medical help is required more than ever.

When syrup of ipecac has been given, do not use activated charcoal until after vomiting has occurred. The charcoal can inactivate the emetic principle in the syrup of ipecac.

Shock

Sometimes poisoning victims go into shock. If untreated or ignored, the victim can die from shock even if the poisoning injuries would not be fatal.

Symptoms of Shock

The skin will be pale, moist, cold and clammy. The eyes are vacant and lack luster with dilated pupils. The breathing will be shallow and irregular. The pulse is very weak, rapid and irregular. The victim may be unconscious or in a faint.

First Aid for Shock

Unless he is vomiting, keep the victim flat on his back with the legs 1 to 1-1/2 feet higher than the head. Keep the victim warm enough to prevent shivering. Do not overheat.

If the victim is conscious and has not swallowed any poison, give small amounts of milk, water or if it is an adult, a dilute salt solution (1/2 teaspoon of table salt to 1 quart of water). Give as often as the victim will accept it. Keep the victim quiet and reassure him often.

WARNING: Never try to give anything by mouth to an unconscious victim.

First Aid Equipment

A well equipped first-aid kit, which is always readily available, can be important in a pesticide emergency. Make up your own Pesticide First-Aid Kit from a lunch pail, tool box, or a sturdy wooden box. It should have a tight fitting cover with a latch so that it won't come open or allow pesticides to leak inside. Label it clearly with paint or a waterproof marker.

Contents

One ounce bottle of syrup of ipecac.

Small plastic bottle of soap solution to quickly wash pesticides off the skin.

Small plastic container of salt. Salt is used with water (1/2 teaspoon salt to 1 quart water) to aid an adult in shock if medical care will be delayed hours.

Pint jar of activated charcoal. Mixed with water and swallowed, activated charcoal acts as an absorber of many pesticides.

Shaped plastic airway for mouth-to-mouth resuscitation.

Two, one-quart containers of clean water. If there is no clean water, in any emergency use any available pond or stream water.

Simple band aids, bandages, and tape. All cuts and scrapes should be covered to prevent pesticides from easily entering the body.

One teaspoon.

A blanket kept in a place where it will not be contaminated by pesticides.

Two quarters, taped to the inside cover of the first-aid kit for emergency phone calls.

Tongue blades (wooden sticks) - one to mix charcoal, another to prevent biting tongue if convulsing.

Two small, plastic empty jars with tight fitting lids; one for a drinking glass or mixing activated charcoal. The other can be used for collecting vomitus to take to the doctor.

Can of evaporated milk (with can opener).

Warn Doctor Ahead of Time

Doctors generally may not be well informed of the symptoms and treatments of pesticide poisoning. This is due to the few cases they treat. Pesticide poisoning symptoms are similar to those of other illnesses and poisonings. The pesticide applicator should tell his doctor which chemicals he will use. Then the doctor can review the symptoms and treatments and have the antidotes on hand.

It is strongly recommended that those with above average use of pesticides establish a regular health surveillance program with their physician.

NFPA Placarding

You may have noticed red, blue and yellow diamond shaped emblems with numbers and letters posted on doors or buildings. These emblems are National Fire Protection Association (NFPD 704) placards. The colors, numbers and their positions on the placards are codes which warn firefighters and other personnel what sort of hazards to expect in that room in case of fire or similar emergency. These placards are used in industrial and institutional facilities which are involved in the manufacture, storage, or use of hazardous materials.

This system identifies the hazards inside the room by three categories. The number inside the left section of the placard with the blue background is associated with health hazards; the top section and red backround is associated with the flammability; and yellow backround on the right side , with "reactivity." The higher the number, the more severe the potential hazard. The highest number used is 4 and the lowest is 0. A 4 for health indicates the presence of a material which could make it too dangerous to enter the area in a fire emergency without special protective equipment. A 4 for flammability indicates an extremely flammable material. A 4 for reactivity indicates a substance which in itself may detonate a normal temperature and pressure. The bottom, white portion of the placard is a space for special information such as the presence of radioactive materials, or to alert the fire fighting personnel to the possible hazard of using water, symbolized by a "w" with a line through it.

SMV Emblem

With spring comes the rush of planting season. A few years ago we experienced a sharp increase in the number of highway collisions involving farm equipment. A major campaign was mounted both to encourage farmers to use Slow Moving Vehicle Emblems correctly and to reeducate the general public to recognizing the SMV Emblem and acting accordingly.

The result of this program was a 35% reduction in the number of accidents. Let's see if we can't continue that trend this year. Replace your worn or faded SMV Emblems. You just might save a life!

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