Substance Abuse and Poisonings

1. Substance Abuse and Poisonings Chapter 17

2. Identifying the Patient and the Poison • Poison- any substance who’s chemical reaction can damage body structures or impair body functions • Poisons act by changing the normal metabolism of cells or by destroying them • Poisonings may act: • Acutely (heroin overdose) • Chronically (alcohol abuse) • Substance abuse- the misuse of any substance to produce a desired effect • Symptoms and signs of poisoning or overdose will vary depending upon the substance

3. Ingestion- (swallowing) • If the patient has ingested a poison you may want to ask the following questions: • What did you take? • When did you take it? • How much did you take? • What actions have been taken? • How much do you weigh? • Also, investigate the scene

4. How Poisons Get Into the Body • Inhalation • Absorbed /surface contact • Ingested • Injected

5. Administration of Activated Charcoal • When a poison has been ingested DO NOT induce vomiting • Administer activated charcoal by mouth and transport immediately

6. Specific Poisons • Over time a patient who routinely misuses a substance will need increasing amounts to achieve the same effect; this is called developing a tolerance. • Addiction- an overwhelming desire to continue using the substance

7. Alcohol • The most commonly abused drug in the united states is alcohol • It is a powerful CNS depressant that • Dulls the sense of awareness, slows reflexes, and reduces reaction time • Sedative- decreases activity and excitement • Hypnotic- induces sleep • A person in alcohol withdraw may experience Delirium tremens (DT’s)- frightening hallucinations characterized

8. Opiods • CNS depressants and may cause severe respiratory depression • Patient may appear sedated, cyanotic, and have pin point pupils • The only way to reverse the effects is the administration of Narcan (which must be done by ALS) http://www.youtube.com/watch?v=8xU_vcb3kso

9. Sedative - Hypnotic Drugs • CNS Depressant which exhibits signs and symptoms similar to alcohol • Does not produce desired effects by itself and usually taken with alcohol or Opiods • These are sometimes given to people as a “knock out drug” such as rohypnol

10. Sympathomimetics • CNS stimulants that frequently cause hypertension, tachycardia, and dilated pupils • Common substances include: • Cocaine • MDMA ecstasy • Meth • Speed

11. Hallucinogens • Alter an individual’s sensory perception which causes severe behavioral changes that can cause a person to become violent or self destructive • Most common include: • LSD • PCP • Mushrooms • The person may not be aware of ingestion if it has been laced into another drug

12. Anticholinergic • Have properties that block the parasympathetic nerves and may cause cardiac arrhythmias • Common substances include: • Atropine • Benadryl • Anti depressants

13. Cholinergic • Nerve gasses designed for chemical warfare • Over stimulate normal body functions • Signs and symptoms include: DUMBELS or SLUDGE • Defication • Urination • Miosis (pupil constriction) • Bronchorrhea (discharge of mucus from lungs) • Emesis • Lacrimation (tearing) • Salivation

14. Food Poisoning • There are 2 main types of food poisoning • The organism itself causes disease • The organism that causes the disease is called salmonella and symptoms appear within 72 hours of ingestion • The organism produces toxins that cause disease • The toxin is called Staphylococcus and symptoms will appear within 3-4 hours of ingestion or as long as 8-12 hours