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Poisoning

This factsheet is written for people who want to know more about the signs and symptoms of poisoning, what to do if someone is poisoned, and how to prevent it.

Poisons are substances that cause injury when they come into contact with the cells of the body. They can be swallowed, inhaled, absorbed or injected. Most cases of poisoning are accidental and involve children or the elderly.

In all of these instances, appropriate first aid can help minimise the harm to the person who is poisoned.

• About poisons
• Symptoms of poisoning
• What to do if someone is poisoned
• Inhalation of poisonous fumes
• Preventing poisoning at home
• What else can I do?
• Further information
• Sources

About poisons

In 2001, about six percent of all deaths due to external causes in the UK were caused by accidental poisoning. Lots of common household substances are poisonous. Examples include:

• medicines, which may be safe at the recommended dose, but poisonous if an overdose is taken - over half of all cases reported to the National Poisoning Information Service are caused by medicines
• cleaning and washing products such as bleach and dishwasher detergent, which are harmful even in small amounts
• other household chemicals such as plant food, paints, solvents, firelighters, weedkiller or slug pellets
• some toiletries such as hair dyes and chemical treatments
• gases, such as carbon monoxide, which is produced by incomplete burning of fuels such as gas, wood or petrol (for example on indoor heating systems, car engines, fires and cooking appliances)

Over a third of all calls to the National Poisoning Information Service are cases of accidental poisoning involving children under 10. Medicines are a particularly common cause in children between two and four years as they can be mistaken for sweets.

You can also be poisoned by germs in food, such as bacteria and mould, and by the toxins they can produce. For more information, please see the separate BUPA health factsheets, Gastroenteritis and Food hygiene.

Symptoms of poisoning

Different poisons affect the body in different ways: they can take effect quickly or over time. Some, such as carbon monoxide, interfere with the blood's ability to carry oxygen. Others, like bleach, burn and irritate the digestive tract.

The range of symptoms can be broad and varied. Poisoning should be considered as a cause if someone suddenly becomes ill for no apparent reason, or acts strangely, particularly if they are found near a poisonous substance. Symptoms of poisoning can include:

• abdominal pain, vomiting, diarrhoea, or nausea
• dizziness, weakness or drowsiness
• fever
• chills (shivering)
• loss of appetite
• headache or irritability
• pain on swallowing or production of more saliva than usual
• skin rash
• burns around the nose or mouth
• double or blurred vision
• muscle twitching
• seizures (fits)
• stupor or unconsciousness

What to do if someone is poisoned

Being poisoned can be a life-threatening situation. If you think someone has swallowed a poison or an overdose of drugs, and they appear to be unconscious, try to rouse them. If they have pills in their mouth, try to get them to spit them out. You can give them to the hospital staff to help identify the cause of poisoning.

Phone 999 for an ambulance, or ask someone else to do this. Be ready to give the following information to the doctor or nurse in accident and emergency, or the ambulance crew:

• the name of what was swallowed, if you know it - keep the container if you have it, and a note of how much has been taken
• the person's age and estimated weight
• the estimated time that the poison was swallowed
• whether or not the person has vomited
• whether the person suffers from any chronic illness (eg heart disease) or takes any medication

There are some other first aid steps to help someone who has been poisoned.

• Don't try to make the person sick, unless instructed to do so by the ambulance control officer; induced vomiting can cause even more damage, especially if a caustic substance has been swallowed. If the person has been sick, collect a sample of the vomit to take to hospital. This may help staff identify the poison.
• If the person is unconscious and you are able, place him or her in the recovery position. If you are trained in emergency resuscitation (cardiopulmonary resuscitation or CPR) check their airway and breathing at least every 10 minutes. Begin CPR if the person is not breathing normally. Use the mouth-to-nose method - this way you avoid any contact with traces of a swallowed poison that might remain around the person's mouth.

For more information, please see the separate BUPA health factsheet, Emergency life support.

Inhalation of poisonous fumes

If you suspect that someone has inhaled poisonous fumes, first assess the situation and what risk you're in - don't put yourself in danger. Call for help. If possible, remove the person from the contaminated area before starting first aid treatment. Avoid inhaling fumes yourself by taking two or three deep breaths before you enter the area, and hold your breath until you are clear.

Once away from the affected area, check their airway and breathing. If the person isn't breathing normally, phone 999 or, preferably, get someone to do it for you. If you know how to, begin CPR.

If the person is breathing and conscious, cover him or her with a blanket and call 999. Check whether they are breathing at least every 10 minutes until help arrives.

Carbon monoxide poisoning

Carbon monoxide is a colourless, odourless, tasteless gas. It is produced when fuel is burnt incompletely.

Dangerous levels of carbon monoxide can develop due to faulty or poorly maintained equipment (eg boilers), or by burning fuels in an enclosed space. Running a car engine in a closed garage can build up dangerous levels of the gas very quickly.

Carbon monoxide is absorbed through the lungs into the blood. It reduces the oxygen carrying ability of the blood. Symptoms of carbon monoxide poisoning can include nausea, dizziness, headache, drowsiness and confusion. It can result in loss of consciousness and eventually death.

If you suspect that you or someone else is affected by carbon monoxide poisoning, leave the area and seek medical advice.

The treatment for carbon monoxide poisoning involves breathing 100 percent oxygen (oxygen therapy) to help replace the carbon monoxide in the blood.

Preventing poisoning at home

You can reduce the likelihood of accidental poisoning in your home. Below are some suggested steps.

• Store all medicines, vitamins and poisonous substances in child-proof containers and lock them in an area that is well out of reach of children. Be vigilant not only with medicines but also with common household products, such as bleach, polishes, paint thinners, white spirit, oven cleaners and paint.
• Never store dangerous products in everyday containers such as milk bottles or drinking glasses. A child may associate these with food or drink and try them out. Check the garden for poisonous plants and berries and remove them.
• Have the boiler and gas fire serviced regularly to reduce the risk of carbon monoxide poisoning, and make sure that bedrooms, in particular, have adequate ventilation. Consider installing carbon monoxide detectors or alarms in your home.
• Don't block air vents, flues or chimneys and don't have indoor fires or stoves without proper ventilation to the outdoors.

What else can I do?

Correct first aid can significantly improve a person's chances of a full recovery. Think about taking a course - you can learn about providing first aid in a wide range of accidents and emergencies. Several organisations offer first aid courses, including vital instructions on CPR - see Further information.

Further information

• St John Ambulance
  08700 10 49 50
  www.sja.org.uk

• British Red Cross
  Check phone book for local branch
  www.redcross.org.uk

• Child Accident Prevention Trust
  020 7608 3828
  www.capt.org.uk

Sources

• Poisoning - Background information. 2006. Prodigy Guidance.
  www.prodigy.nhs.uk
  accessed 5 January 2007
• Adult basic life support. Resuscitation Council (UK).
  www.resus.org.uk
  accessed 5 January 2007

Published by BUPA's health information team, healthinfo@bupa.com, February 2007.

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