Poisonings

1. Poisonings A Safety Guide

2. Course Information • Author: Lynne Presley, Staff & Organizational Development, Oklahoma Department of Corrections • Data Sources: Mike Jackson, M.D., Medical Director, Oklahoma Dept. of Corrections;Oklahoma Poison Control Center; OP-040108, “Flammable/Toxic, Caustic Substances;Emergency Care and Transportation of the Sick and Injured, Third Edition, by the American Academy of Orthopaedic Surgeons, 1981, Chicago. Course Released: November 2004.Course Code SAFI 34000.Training Credit: One hour (based on following all links and completing optional course test)

3. Introduction This safety course is about poisons and avoiding their harmful effects. Just what is a poison? A poison is any substance that causes a harmful effect on the body. Poisons act by changing normal metabolic processes or actually destroying body cells. Poisons can result from ingestion, inhalation, injection, surface contact, or absorption through the skin and mucous membranes. Poisonings can be accidental or intentional.

4. Introduction, cont’d. Why should agency employees be concerned about this subject? Because poisonings can produce lethal consequences if unrecognized and untreated!

5. Identification How do we know if a substance is toxic? Most poisonous substances are marked to show toxicity. Learn to examine labels and Material Safety Data Sheets, which frequently contain toxicity and first aid information.

6. What to Do? Obviously, the first thing to do when it’s suspected that an inmate is a poisoning victim is to call for medical assistance. When you work at a facility, medical assistance may be immediately available. However, this isn’t always the case in a community or public setting. Remember that there are some important things you can do while you are waiting for medical help (such as an ambulance) to arrive.

7. Look for Symptoms What if we observe an inmate whom we think may be a poisoning victim? One of the things we can do is look for symptoms. Some of the more common symptoms of poisoning include, but are not limited to: • Nausea • Vomiting • Abdominal pain • Diarrhea • Dilation or constriction of pupils • Excessive salivation or sweating • Unconsciousness or convulsions • Difficulty breathing & possible cyanosis (blue skin color, especially around the lips) • Surface burns or inflammation of the skin

8. Look for the Poison Another thing we can do to help the victim is to determine the nature of the poison. Look for overturned bottles, pills or medicines, fumes, spilled chemicals, or uneaten food or drink. Collect anything that may be relevant and take it to health services (or the hospital) with the victim.

9. Before Medical Help Arrives The Oklahoma Poison Control Center lists some helpful things you can do before medical help arrives. Your actions depend on circumstances: Inhaled Poisonous Fumes or Gases: For inhaled poisons, such as natural gas or carbon monoxide, the immediate action is to move the victim away from the fumes into fresh air. Reminder: a very real danger in this situation is for the rescuer to be overcome by the same fumes, so be cautious!

10. Before Medical Help Arrives Surface/Contact Poisons: Brush off all dry poisons and flood involved parts with large amounts of plain water. Then, wash the skin with soap and water, and rinse. Remove and discard affected clothing.

11. Before Medical Help Arrives Poisons in the Eye: Hold victim’s eyelid open and drip room-temperature water or normal saline over the bridge of the nose for a full 15 minutes. Do not use water under pressure. Do not allow the victim to rub the eye. Do not use medicated drops, such as Visine. Do not use medicated eye drops to wash poisons from the eye!

12. Before Medical Help Arrives Swallowed Poisons/Medications: Look into the victim’s mouth and remove all tablets, powder or any material that is present. Examine the mouth for cuts, burns, swellings, unusual coloring or odors. Rinse and wipe out the mouth with a cloth.

13. Before Medical Help Arrives Injected Poisons: Injection poisoning is almost always the result of a drug overdose, but may be from a venomous bite or sting. If swelling is present, remove all rings, watches and other constricting items above and below the injection site and apply an ice pack to the area to reduce swelling.

14. Don’t Delay Never delay seeking medical help for suspected poisonings, even if the victim appears to have recovered. Remember that some poisons have long-term or delayed action components, and adverse effects may not appear immediately. Always be aware of the victim’s level of consciousness and stay ready to provide basic life support until medical help arrives.

15. The Oklahoma Poison Control Center The Oklahoma Poison Control Center operates 24 hours a day, 365 days per year. The poison center staffs specially trained licensed pharmacists and nurses who provide emergency poisoning management advice to Oklahoma residents and health care professionals. They have a toll-free number that anyone can call to obtain free, expert advice on poisonings: 1-800-222-1222

16. Poisoning Reports • The Oklahoma Poison Control Center collected some interesting statistics for calls they received in 2002 (the most recent date that statistics are available): • 48,325 total initial calls • 33,417 calls regarding human poisoning • 13, 076 poison and drug information calls • 1,700 animal poisoning calls • 27,492 follow-up calls • 75,817 total initial and follow-up calls • It is obvious that center personnel have a wealth of experience in this field, so don’t be afraid to call them and ask for assistance.

17. Agency Precautions Our agency recognizes that toxic (poisonous) substances pose a special risk in a correctional environment. In fact, we have a policy - OP-040108, Flammable/Toxic, Caustic Substances – that contains precautions and prohibitions for employees who issue and supervise the use of these substances. We must make sure that such items are used correctly and safely, and must also guard against theft and possible abuse of these substances.

18. Class I Hazards Our policy lists examples of Class I Hazards (substances that pose a high risk), such as sulfuric acid, caustic soda, tannic acid, and methyl alcohol. Methyl alcohol, also known as wood alcohol or methanol, is particularly dangerous, since drinking it may cause permanent blindness and death. Incidents in which inmates have deliberately ingested methyl alcohol have been documented, so it’s required by policy that staff directly and continuously supervise the use of ANY product containing this substance.

19. Antifreeze Dyes and cements used in leatherworking Ethyl alcohol, isopropyl alcohol, and other antiseptic products Herbicides Lye Pesticides Certain glues Other Toxic Substances Many substances can be toxic. Some that are commonly used at our facilities are: Many other substances used in facilities may be harmful or fatal if swallowed in sufficient quantity, such as bleach, oven cleaner, and cleaning detergents.

20. Don’t Mix Chemicals! Mixing of cleaning agents or other chemicals is never advised unless the product’s instructions specifically recommend doing so. Often mixing two minimally toxic substances can create a highly toxic substance. This is the case with bleach and ammonia, which creates a highly toxic chlorine gas that is lethal and very difficult to treat. Make sure that inmates do not mix chemicals and create a toxic substance! + = bleach ammonia lethal gas

21. “Immediate medical attention is imperative whenever methyl alcohol poisoning or other poisonous substance is suspected.” Point to Remember OP-040108, “Control and Use of Flammable, Toxic and Caustic Substances” contains very clear language that all employees need to remember:

22. Summary Poisoning can result from ingestion, inhalation, injection, surface contact or absorption of any substance which can cause a harmful effect on bodily processes or result in damage to the cells. If you suspect that a poisoning has occurred, call for medical help. Remember that you also have a valuable, free resource in the Oklahoma Poison Control Center. Call them at 1-800-222-1222.

23. Learn More About It Click on the links below to learn more about this subject:  Oklahoma Poison Control Center  Oklahoma University Health Sciences Center Guide to Poison Proofing Your Home  OP- 040108, “Control and Use of Flammable, Toxic and Caustic Substances”

24. Conclusion Thank you for completing this online safety course. Be sure to download the optional course test to measure what you’ve learned. Click the link that says “Download course test” by the link that you clicked to start this course. Exit Course