Poisoning first aid

Millions of poisonings are reported to United States poison control centers every year. Many result in death.

It is important to note that just because a package does not have a warning label does not mean a substance in the package is safe. You should consider poisoning if someone suddenly becomes sick for no apparent reason. Poisoning should also be considered if the person is found near a furnace, car, fire, or in an area that is not well ventilated.

Symptoms of poisoning may take time to develop. However, if you think someone has been poisoned, DO NOT wait for symptoms to develop. Get medical help right away.

Items that can cause poisoning include:

• Carbon monoxide gas (from furnaces, gas engines, fires, space heaters)
• Certain foods
• Chemicals in the workplace
• Drugs, including over-the-counter and prescription medicines (such as an aspirin overdose) and illicit drugs such as cocaine
• Household detergents and cleaning products
• Household and outdoor plants (eating toxic plants)
• Insecticides
• Paints

Symptoms vary according to the poison, but may include:

• Abdominal pain
• Bluish lips (cyanosis)
• Chest pain
• Confusion
• Cough
• Diarrhea
• Difficulty breathing or shortness of breath
• Dizziness
• Double vision
• Drowsiness
• Fever
• Headache
• Heart palpitations
• Irritability
• Loss of appetite
• Loss of bladder control
• Muscle twitching
• Nausea and vomiting
• Numbness and tingling
• Seizures
• Skin rash or burns
• Stupor
• Unconsciousness (coma)
• Unusual breath odor
• Weakness

Seek immediate medical help.

For poisoning by swallowing and some inhalations:

Check and monitor the person's airway, breathing, and pulse. If necessary, begin rescue breathing and CPR.

Try to make sure that the person has indeed been poisoned. It may be hard to tell. Some signs include chemical-smelling breath, burns around the mouth, difficulty breathing, vomiting, or unusual odors on the person. If possible, identify the poison.

1. DO NOT make a person throw up unless told to do so by poison control or a health care professional.
2. If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat. If the person has been sick from a plant part, save the vomit. It may help experts identify what medicine can be used to help reverse the poisoning.
3. If the person starts having convulsions, give convulsion first aid.
4. Keep the person comfortable. The person should be rolled onto the left side, and remain there while getting or waiting for medical help.
5. If the poison has spilled on the person's clothes, remove the clothing and flush the skin with water.

For inhalation poisoning:

Call for emergency help. Never attempt to rescue a person without notifying others first.

If it is safe to do so, rescue the person from the danger of the gas, fumes, or smoke. Open windows and doors to remove the fumes.

Take several deep breaths of fresh air, and then hold your breath as you go in. Hold a wet cloth over your nose and mouth.

1. DO NOT light a match or use a lighter because some gases can catch fire.
2. After rescuing the person from danger, check and monitor the person's airway, breathing, and pulse. If necessary, begin rescue breathing and CPR.
3. If necessary, perform first aid for eye injuries or convulsion first aid.
4. If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat.
5. Even if the person seems perfectly fine, get medical help.

DO NOT:

• Give an unconscious person anything by mouth.
• Induce vomiting unless you are told to do so by the Poison Control Center or a doctor. A strong poison that burns on the way down the throat will also do damage on the way back up.
• Try to neutralize the poison with lemon juice or vinegar, or any other substance, unless you are told to do so by the Poison Control Center or a doctor.
• Use any "cure-all" type antidote.
• Wait for symptoms to develop if you suspect that someone has been poisoned.

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

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.

After doing first aid steps at home, you may need to go to the emergency room. Take the container with you to the hospital, if possible. At the hospital you will have an exam. You also may need the following tests and treatments.

• Activated charcoal
• Airway support, including oxygen, breathing tube through the mouth (intubation), and ventilator (breathing machine)
• Blood and urine tests
• Chest x-ray
• CT (computerized axial tomography) scan
• ECG (electrocardiogram, or heart tracing)
• Fluids through the vein (IV)
• Laxative
• Medicines to treat symptoms, including antidotes to reverse the effects of the poisoning if one exists

Be aware of poisons in and around your home. Take steps to protect young children from toxic substances. Store all medicines, cleaners, cosmetics, and household chemicals out of reach of children, or in cabinets with childproof latches.

Be familiar with plants in your home, yard, and vicinity. Keep your children informed, too. Remove any poisonous plants. Never eat wild plants, mushrooms, roots, or berries unless you very familiar with them.

Teach children about the dangers of substances that contain poison. Label all poisons.

DO NOT store household chemicals in food containers, even if they are labeled. Most nonfood substances are poisonous if taken in large doses.

If you are concerned that industrial poisons might be polluting nearby land or water, report your concerns to the local health department or the state or federal Environmental Protection Agency.

Some poisons or environmental exposures do not require large doses or contact to cause symptoms and injury. Therefore, it is very important to get treatment right away to avoid serious harm. The outcome will depend on the type of poison the person came in contact with and the care received to treat the exposure.

Gummin DD, Mowry JB, Beuhler MC, et al. 2020 Annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th annual report. Clin Toxicol (Phila). 2021;59(12):1282-1501 PMID: 34890263 pubmed.ncbi.nlm.nih.gov/34890263/.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Nelson LS. Acute poisoning. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 102.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.