Poisoning

A Poison is a substance which when taken in to the body may

damage the health or even kill the person.
Types of poisoning:
1. Organophosphorous poisoning
2. Kerosene poisoning
3. Zink phosphate poisoning
4. Food poisoning
5. Mushroom poisoning

1.Organophosphorous poisoning:
Ingestion of organophosphorous compound (Dalf, Metacid,
Bigen, Malathion, Parathon) is common occurrence in
Nepal. These substances can be fatal if treatment is
delayed.
Diagnostic feature:
 History of intake
 Typical smell from the mouth
 Constricted pupil
 Excessive salivation
 Frequent micturition
  Slow pulse
 Difficulty in breathing
 Abdominal pain associated with diarrhea and
vomiting.

Treatment:
- Clear excessive secretion from the mouth by suction
- Do gastric lavage in a conscious patient repeatedly till
washing become clear
- Maintain an intravenous line
- Inj Atropine (0.6mg/ml) 3 to6 ml is given
intramuscularly, IV: repeat every 15 minutes till sign
of atropine toxicity (dry mouth, tachycardia, and
capillary dilation) appear.
- If possible use N.G Tube for unconscious patient

Note: Every case of poisoning must be referred to the nearby

hospital immediately after giving the patient atropine
(All organophosphorus poisoning cases must be admit
in hospital and closely observed up to 10 days.
2. Kerosene Poisoning (Petroleum products):
Petroleum or Kerosene poisoning is mainly due to
Accident. Usually it is occur in the Children. Main
effect of this poisoning is Aspiration pneumonia which
may leads to acute death.

Clinical feature:

- Nausea and Vomiting

- Abdominal pain
- Difficulty in breathing
- Pulse maybe irregular
- Convulsion
- Cyanosis
- Muscle in co-ordination
- Muscle twitching

First aid:
- Check vital sign
- Clear ABC
- No gastric lavage
- Refer
 3. Zink Phosphate Poisoning( Rodenticide):
- It is mainly use for suicidal tendency
Clinical feature:
- Nausea
- Vomiting
- Abdominal pain
- Diarrhoea
Shock may be present

Treatment:
- Check vital sign
- Clear ABC
- Give oral fluid
- If the patient is Conscious, do Gastric lavage.
- I/V open by 5%Dextrose
- Refer to the Hospital
4. Mushroom poisoning:
In Nepal, there are found about 150 mushroom species,
out of them 40 are Poisonous.
- Muscarine alkaloid is found in mushroom which
stimulates the Parasympthatic activity in body
Clinical features:
- Nausea
- Vomiting
- Colicky abdominal pain
- Excessive salivation
- Excessive lacrimation
- Difficulty in breathing
- Eye pupil contracted
- Hypotension
- Slow pulse rate
- Excessive sweating. etc…
 Food Poisoning:

Food poisoning is an acute gastroenteritis caused by

ingestion of food or drink contaminated with either
living bacteria or their toxins or inorganic chemical
substance and substance derived from plant and animals.

Classification of food poisoning:

Non –bacterial food poisoning: Caused by chemicals

such as: arsenic, certain and sea food and also
contaminated by Fertilizers, Pesticides, Cadmium,
Mercury etc..

Bacterial food poisoning: Following are the types of

Bacterial food poisoning.
i. Salmonella food poisoning:
- It is most common form of food poisoning

Source:

- Salmonellosis is primarily a disease of animals. Man

gets the infection from farm animals and poultry.
Through contaminated meat, milk, and milk products,
Sausages, eggs and egg products

Incubation Period:

- 12-24 hours commonly

- Note: Salmonella food poisoning causes fever

ii. Staphylococcal Food poisoning:

Agent:
- Staphylococcus aureus (Enterotoxin)
Incubation period:
- 1-6 hours (The incubation is short because of
performed toxin)
Note: Staphylococcal rarely causes fever.
 iii. Botulism:
- Most serious but rare

Agent:

- Exotoxin of clostridium botulinum

- Source:
- The organism is widely distributed in Soil, Dust and
intestinal track of animal
- The food most frequently responsible for botulism are
home preserve food such as Home canned vegetables,
Smoked or pickled fish, homemade cheese and similar
low acid food.

Incubation Period:

- 12- 36 hours

Note:

i. It acts on the Parasympathetic nervous system

ii. Fever is generally absent
iii. If we heat up to 100·c before eating food, the toxin will
be Non poisonous.