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First Aids
Dr. Walid Daoud, MD
A. Professor of Chest Medicine
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Poisons
Poison is a substance that hurts
the body or may lead to death.
Its effect depends on its type,
concentration, duration of
exposure, route of absorption,
organ or tissue absorb the poison
Some poisons affect the nervous
system, others affect respiratory
or cardiovascular system.
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Ways of Poisoning
1. Swallowing:
By eating or drinking
2. Touching:
Touching of poison by skin
3. Inhalation:
Aspiration of poisonous gas
4. Injection:
IV or IM or
Snake bite or scorpion stings
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Effects of Drug Poisoning

1. Rapid effects:
After minutes or hours if the
material is very toxic as cyanide
poisoning, aspirin poisoning
leading to hematemesis.
2. Delayed effects:
After hours or days or more if
low toxicity and long duration as
in kerosene poisoning(pneumonia)
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General lines of treatment of Poisons
1. Stomach wash (gastric lavage) except
in corrosives, acids or alkali
2. Induction of vomiting except in
corrosives by NaCl dissolved in water
3. Antidotes:
Neutralize acid by alkali & vice versa
Adsorbant as charcoal
4. Supportive & symptomatic treatment:
Asphyxia: clear airway, artificial resp.
Pain: pethidine or morphine IM
Convulsions: diazepam IM
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Treatment of inhaled poison

1. Withdraw the patient away from
source of poison
2. Put the patient in the fresh air way
3. Ask the patient to respire well, if he
can not, do artificial respiration
4. Transport the patient to the hospital
for more evaluation.
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Treatment of swallowing poison

If corrosive don’t induce vomiting.
To prevent absorption of poison by GIT:
1. Ask the patient (if conscious) to vomit
if he can not, give him a cup of water
with NaCl to stimulate vomiting.
2. If the patient does not respond, give
apomorphine IM to stimulate vomiting.
3. Give charcoal tablets to prevent its
absorption by GIT.
4. If the patient is unconscious refer to
hospital as quick as you can.
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Kerosene poisoning
Accidental drinking of kerosene specially
in children. It is rapidly absorbed by GIT,
so induction of vomiting is not indicated.
It is rapidly absorbed by respiratory tract
to the lung causing pneumonia.
Effects on GIT:
Itching & irritation of mucous membrane
Effects on nervous system:
Fainting & loss of consciousness
Effects on respiratory system:
Rapid shallow breathing, cyanosis.
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Treatment of Kerosene poisoning

1. Avoid stomach wash & forbid vomiting
2. Warm the patient, ensure fresh air
3. Give demulcent as milk or egg white
4. Give respiratory stimulant as coramine
or sympathetic stimulant as adrenaline
5. Transport the patient to the hospital on
a flat position with head higher than
buttock to prevent reaching of
kerosene to the lung.
6. In hospital crystalline penicillin is given
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Treatment of Corrosive poisoning

(Caustic soda)
1. Avoid stomach wash
2. Avoid any emetic drug
3. Neutralization by orange or lemon juice
4. Demulcent by milk or egg white
5. Pethidine or morphine IM
6. In hospital:
Tracheostomy
Surgical if there is perforation
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Insecticides poisoning
D.D.T. and parathion
Clinical picture:
1. Headache & general fatigue
2. Dizziness & fainting
3. Pinpoint pupil, blurring vision& itching
4. Heavy sweating & skin allergy
5. Dyspnea
6. Abdominal discomfort
7. Loss of consciousness
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First Aids Treatment of Swallowing

Insecticides
1. Try to know type of insecticide to
know if vomiting is indicated or not
2. If vomiting is indicated & the patient is
conscious ask the patient to put his
finger inside oropharynx to induce
vomiting. If failed give apomorphine IM
3. Charcoal 3 spoonful on cup of water
4. Transport to hospital
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Scorpion Stings
Most toxic and may lead to sudden death
Clinical manifestations:
Severe pain at the site of sting or shock
Nausea & vomiting
Abdominal pain
Convulsions then loss of consciousness
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Treatment of Scorpion Stings

1. Analgesic to minimize pain
2. Tie the affected part proximal to heart
3. Try to aspirate toxin from the site of
sting by using syringe
4. Cold fomentation at site of sting to
minimize pain and swelling
5. Artificial respiration if needed
6. Transport to hospital for evaluation:
Anti-scorpion vaccine IM
Anti-shock measures
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Snake Bite
Snake bites types untoxic or toxic:
Clinical manifestations:
1. Severe pain up to shock
2. Swelling at the site of the bite
3. Signs of incisors at the site of the bite
and teeth bites
4. Nausea & vomiting
5. Discoloration at the site of bite
6. Respiratory distress
7. Convulsions, coma & death
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Treatment of Snake Toxic Bite

1. Tie the affected part proximal to heart
2. Assurance & put him in lying position
with affected part below heart level
3. Incise the site of the bite with sterile
knife to get out the poison
4. Cover the site of bite with sterile gauze
after washing with soap & water
5. Treat shock , artificial respiration
6. Transport to hospital for anti-snake
vaccine and more evaluation