Poisoning

Patient Communication

Communication about poisoning in the prehospital setting includes: explaining procedures to the patient in simple terms, obtaining informed consent when possible (implied consent for unresponsive patients), providing a calm and reassuring presence, and delivering a structured handoff report (SBAR: Situation, Background, Assessment, Recommendation) to the receiving facility.

Related Procedures

Procedures related to poisoning in the EMS setting:

1. RSI sequence: preoxygenation then sedation (etomidate 0.3mg/kg or ketamine 2mg/kg) then paralytic (succinylcholine 1.5mg/kg or rocuronium 1mg/kg) then intubation then confirm placement with waveform capnography
2. Stroke recognition: Cincinnati Prehospital Stroke Scale (facial droop, arm drift, speech) then last known well time then transport to stroke center
3. AHA ACLS cardiac arrest algorithm: CPR then rhythm check then shock if VF/pVT then epinephrine q3-5min then amiodarone

Safety Considerations

Field safety for poisoning includes scene assessment before patient contact. Ensure BSI (body substance isolation) precautions are in place. PPE selection depends on the mechanism and suspected pathogens. Gloves are the minimum; add mask and eye protection for splash risk, N95 for airborne pathogens.

Never approach a scene involving hazardous materials, violence, or structural instability without proper resources and clearance from incident command.

Workplace Applications

In daily practice, poisoning is applied consistently according to facility protocols and current evidence-based guidelines. Competency is maintained through annual skills validation, continuing education, and quality improvement participation.

Troubleshooting

Troubleshooting poisoning in the field:

• Pulse oximeter: If measures spo2 via infrared absorption through capillary bed fails, verify connections, check battery, try alternate equipment. Available sizes: Finger clip, Earlobe, Pediatric wrap
• AED: If automated external defibrillator for vf/pvt fails, verify connections, check battery, try alternate equipment. Available sizes: Adult pads (over 8yo or 25kg), Pediatric pads (under 8yo or 25kg)
• King airway: If supraglottic blind-insertion airway device fails, verify connections, check battery, try alternate equipment. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)