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Anticoagulant rodenticides poisoning

Anticoagulant rodenticides are poisons used to kill rats. Rodenticide means rodent killer. An anticoagulant is a blood thinner.

Anticoagulant rodenticide poisoning occurs when someone swallows a product containing these chemicals.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

  • 2-isovaleryl-1,3-indandione
  • 2-pivaloyl-1,3-indandione
  • Brodifacoum
  • Chlorophacinone
  • Coumachlor
  • Difenacoum
  • Diphacinone
  • Warfarin

Note: This list may not be all-inclusive.

Where Found

  • D-Con Mouse Prufe II, Talon (brodifacoum)
  • Ramik, Diphacin (diphacinone)

Note: This list may not be all-inclusive.

Symptoms

  • Blood in the urine
  • Bloody stools
  • Bruising and bleeding under the skin
  • Confusion, lethargy, or altered mental status from bleeding in the brain
  • Low blood pressure
  • Nosebleed
  • Pale skin
  • Shock
  • Vomiting blood

Home Care

DO NOT make a person throw up unless told to do so by poison control or a health care professional.

Before Calling Emergency

Determine the following information:

  • Person's age, weight, and condition
  • The name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • How much was swallowed

Poison Control

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. The person may receive:

  • Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent the person from breathing in blood.
  • Blood transfusion, including clotting factors (which help your blood clot) and red blood cells
  • Chest x-ray
  • EKG (electrocardiogram, or heart tracing)
  • Endoscopy -- a camera down the throat to see the esophagus and stomach
  • Fluids through a vein (IV)
  • Medicines to treat symptoms
  • Medicine (activated charcoal) to absorb any remaining poison and laxatives to move it quickly through the body
  • Medicine (antidote) such as vitamin K to reverse the effect of the poison

Outlook (Prognosis)

Death may occur as late as 2 weeks after the poisoning as a result of bleeding. However, getting the right treatment usually prevents serious complications. If blood loss has damaged the heart or other vital organs, recovery may take longer and the person may not fully recover.

Alternative Names

Rat killer poisoning; Rodenticide poisoning

References

Cannon RD, Ruha AM. Insecticides, herbicides, and rodenticides. In: Adams JG, ed. Emergency Medicine Clinical Essentials. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 146.

Janz TG, Hamilton GC, Eckstein M, et al. Disorders of hemostasis. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 122.

Update Date 11/2/2014