Poisioning forensic medicine ,part one .pdf

poisoning ,introduction

1. WELCOME TO
FIRST AID PART 4
1 Homeobook.com

2. POISONING……….
•Poising any harmful substance introduced into the
body by
•ingestion,
•inhalation,
•injection
•or excessive intake of drugs
–It ranges from mere food poisoning or house hold
poisoning
–Suicidal , Homicidal or accidental intake
–grave industrial poisoning
–from insect bite to fatal snake bite
2 Homeobook.com

3. •Ipecac is often found in larger household first
aid kits or can be purchased in drug stores. It
is not meant to be used regularly and can
cause long term damage to the heart if
deliberately abused .

•You may be asked to follow the Ipecac with 1-
2 glasses of water.

•If you don't have Ipecac, another way to
induce vomiting is to mix table salt with water,
and then drink the solution.


3 Homeobook.com

4. •If vomiting does not occur, you can follow with a glass
of room temperature soda or other carbonated
beverage.

•If syrup of Ipecac isn't available ……. mix a combination
of Luke warm water and hydrogen peroxide.


•When vomiting begins, have the victim vomit into a
plastic bag or basin. Avoid vomiting into a toilet.


•Note that activated charcoal may interfere with the
effectiveness of Ipecac.


4 Homeobook.com

5. •Important point:
•Distinguish the poisons which are corrosive from others
–Look at mouth for any grayish discoloration, numbness, or
burning


INSTANCES WHEN VOMITING SHOULD NOT BE INDUCED
•If unresponsive.
•Cannot maintain an airway open.
•Has ingested an acid, a corrosive lye, or a petroleum
product such as gasoline or furniture polish , Instead gastric
lavage to be done
•Corrosive poisons ingestion
•Has a medical condition that could be complicated by
vomiting, such as heart attack, seizures and pregnancy.


5 Homeobook.com

6. •To summarize :
– the action plan in case of any poisoning
• Intension of the “ Attempt”
•Nature of Poison
•Vital Parameters
•Effect of poison
•Collection of material for hospital
•Inform if need, to legal authorities
6 Homeobook.com

7. •Kerosene, Petrol poisoning…..
•Patho physiology of Hydrocarbon Toxicity
–Hydrocarbons is directly related to their physical
properties.
–Viscosity ---as the viscosity increases, the
aspiration potential decreases.
–Volatility ----more likely to be inhaled or aspirated
into the respiratory system , causing pneumonia ,
and CNS and cardiac poisoning.
7 Homeobook.com

8. •Aliphatic hydrocarbons Fuels


•Solvents
•Furniture polish and paints
•Aromatic hydrocarbons
•Plastics Solvents
•Glues
•Halogenated hydrocarbons
•Refrigerants
•Propellants
•Cleaning products
•Paint strippers
•Solvents
•Wood distillates
•Turpentine
•Pine oil

8 Homeobook.com

9. FIRST AID…
•Remove the clothing.
•With a dry cloth, blot the poison from the
skin.
•If the poison is a dry powder, brush it off.

•Flood the area with copious amount of water.

•Continually monitor the patient's vital signs.
•Collect suspected materials such as bottles,
packets etc. And should be sent to hospital


9 Homeobook.com

10. •IRON TONIC “ Poisoning”

10 Homeobook.com

11. 11 Homeobook.com

12. 12 Homeobook.com

13. 13 Homeobook.com

14. 14 Homeobook.com

15. 15 Homeobook.com

16. 16 Homeobook.com

17. •BEE STING TREATMENT
•The first step removal of the stinger
• The stinger should be removed as quickly as
possible without regard to method
•Once the stinger is removed, pain and swelling
should be reduced with a cold compress.
•Many traditional remedies have been
suggested
17 Homeobook.com

18. •Bee venom is acidic as it contains the highly acidic
• And the amount of venom injected is typically very
small (between 5 and 50 micrograms of fluid)
•And placing large amounts of alkali near the sting site
is unlikely to produce a perfectly neutral pH to stop
the pain.
•Many people do claim benefit from these home
remedies. The effect is probably related to rubbing
the area or the mind perceiving benefit.

•For about 2 percent of people, anaphylactic shock
from certain proteins in the venom can be life-
threatening and requires emergency treatment.
18 Homeobook.com

19. •
WASP BITE

•Ice: Place an ice cube or ice pack on sting and press on
wound for about 20 minutes, will help reduce pain.
•Ice can also be used to help reduce the swelling that
will occur.
•Make sure to protect the skin by covering ice with a
thin cotton towel or paper towel first.
•Baking Soda: Make a thick paste with water and apply
to sting.
•Salt: Make a thick paste with water and apply to sting.
•Apple Cider Vinegar: Soak a small cotton pad with
apple cider vinegar and hold on wound until pain
disappears (the acid content neutralizes the venom).
19 Homeobook.com

20. •Vinegar: Same treatment as apple cider
vinegar, can also drizzle a few drops directly
onto skin (the acid content neutralizes the
venom).
•Lemon Juice: (the acid content neutralizes the
venom).
•Lemon:
•Garlic: Crush a fresh clove of garlic and apply
to stung area, cover with a band aid.
•Onion: Slice an onion and press in place over
the stung area until pain disappears.
20 Homeobook.com

21. •Marigolds: Rub the flower head of a marigold
over the stung area (must be a freshly picked
marigold and not dried).

•Aloe Vera: Split open a leaf and apply the aloe
gel directly to the bite area

•Plantain: Chop roughly and mix with a bit of
warm water then apply to wound. You can
also chew a leaf or two then apply to bite.

21 Homeobook.com

22. SNAKE BITES
22 Homeobook.com

23. MALABAR PIT VIPER
23 Homeobook.com

24. KRAIT
24 Homeobook.com

25. KING COBRA
25 Homeobook.com

26. INDO CHINESE RAT SNAKE
26 Homeobook.com

27. YELLOW RAT SNAKE
27 Homeobook.com

28. INDIAN KRAIT
28 Homeobook.com

29. 29 Homeobook.com

30. 30 Homeobook.com

31. 31 Homeobook.com

32. 32 Homeobook.com

33. 33 Homeobook.com

34. 34 Homeobook.com

35. 35 Homeobook.com

36. The first antivenom was developed in 1895 by French
physician ALBERT CALMETTE for the treatment of Indian
cobra bites
36 Homeobook.com

37. •Try and get a good look at the snake.

•Get away from the snake and try to calm the
victim .

•Make the victim lie down on a bed or mattress.

•If fang marks are visible, the snake was probably
of the poisonous variety.


37 Homeobook.com

38. •The victim should move as little as possible.
The more the victim moves, the quicker the
venom will spread through the body.

•Keep the bitten limb below the level of the
heart. This slows down the spread of the
poison to the heart.


38 Homeobook.com

39. •Some advise that you should wash the bite with
soap and water, and then apply an antiseptic,
while others advise that it is better not to wash
the bite. The doctor will be able to treat the
victim much better if he has traces of the venom.

•It is a good idea to wipe the area clean with an
antiseptic and retain the wipe for venom traces.

•Don't apply ice to the bite.


39 Homeobook.com

40. •Tie a band or cloth about two inches away
from the wound. If there has been swelling,
tie the band about two inches from the
swelling.

•The band should be at least an inch thick, and
it should be tied within 20 minutes of the bite,
if it is to have any effect.

•The band should be firm and tight, but not so
tight that it completely blocks blood flow. A
good rule of thumb is that the bandage should
be loose enough for a finger to slip through.
40 Homeobook.com

41. •As far as possible, DO NOT LET THE VICTIM WALK.
Remember, the limb should be moved as little as possible.

•Do not give the patient anything to eat or drink.

•It is important that consumption of alcohol, a known
vasodilator which will speed up the absorption of venom.
•Do not administer stimulants or pain medications to the
victim.
• Remove any items or clothing which may constrict the
bitten limb if it swells (rings, bracelets, watches, footwear,
etc.)

•Do not incise the bitten site.

41 Homeobook.com

42. ALCOHOL POISONING
42 Homeobook.com

43. •How To Tell If Someone has Alcohol Poisoning:

•If the person is breathing less than twelve
times per minute or stops breathing for
periods of ten seconds or more . If one finds
empty bottle or cans of alcohol beverages near the
casualty.

•If the person is asleep and you are unable to wake them up

•Look at the person's skin. If it is cold, clammy, pale, bluish in
colour

43 Homeobook.com

44. MANAGEMENT OF ALCOHOLIC POISONING
•Put the person in the recovery position
•Make sure they're breathing and that their mouth
is empty
•Clear any vomit, away from their mouth
•Stay with a person who is vomiting. Try to keep
the person sitting up. If they must lie down, keep
them on the recovery position.
•Watch for choking; if the person begins to choke,
get help immediately
•If they stop breathing, start CPR (mouth to mouth
resuscitation)
•Loosen any tight clothing that might restrict their
breathing
44 Homeobook.com

45. •Keep them warm - use blankets or a coat (but not
too warm)

•Call an ambulance as soon as possible. Explain to
the ambulance crew what has happened and
what you have done

•Don't Ignore someone who is unconscious or
vomiting

•Give someone fluids (even water) if you think
they're in shock or unconscious

45 Homeobook.com

46. Dehydration

Dehydration can result in:Cramps in the leg,
back and arms
•Failure to sweat
•Headaches and dizziness
•Vomiting
•Suddenly feeling very tired
46 Homeobook.com

47. •Feeling like urinating, but not doing so when
you go
•Fainting

Prevent and treat dehydration by : Drinking
water, fruit juice or a sports drink and avoiding
alcohol
•Eating something that keeps the salt levels in
the body up. Salty snacks, fruit juice, and
sports drinks will all help to keep the body
provided with the minerals it needs

47 Homeobook.com

48. •Never ignore someone who is having a bad time or is sick.

• Don't give the person a cold shower; the shock of the
cold could cause unconsciousness.

• Don't give the semiconscious person food or fluids (not
even water) It could cause vomiting, choking or aspiration.


• Don't panic. Even if things aren't going to plan, try to
stay calm.
DON’TS
48 Homeobook.com

49. METHYL ALCOHOL POISONING
•Early manifestations such as nausea, vomiting, headache, vertigo
and gastritis are primarily caused by Methanol itself. High serum
levels of Methanol (>40 mg/dl) is associated with convulsions and
coma.
•Late manifestations such as visual disturbances, severe metabolic
acidosis, seizures, coma and death are common after 30 hours after
ingestion.

•Severe poisoning leads to myocardial depression, bradycardia and
shock.

•Administration of Ethanol to saturate alcohol dehydrogenase in the
liver, preventing the formation of toxic metabolite, formaldehyde.
Folic acid to form carbon dioxide and water
49 Homeobook.com

50. End of Part 4
50 Homeobook.com