414

POISONING OR DRUG OVERDOSE

1. Monitor the airway.
2. Administer oxygen.
3. Request Advanced Life Support assistance for patients with respiratory distress/failure or altered mental status, or if so directed by Medical Control.
4. Assess for shock and treat, if appropriate. (See Protocol #415.)
5. For Special Considerations, see below.
6. Bring a sample of the substance or the container(s) to the hospital.
7. Transport.

SPECIAL CONSIDERATIONS

INGESTED SUBSTANCES:

1. Do NOT induce vomiting.
2. Do NOT attempt to neutralize the substance.
3. If patient is potentially unstable or stable, transport after contacting Medical Control with the following information:

• Name of substance (if prescribed medication, note usual dosage);
• Amount taken;
• Time it was taken;
• Age and weight of patient;
• Whether the patient has vomited;
• Whether any antidote has been given.

4. Follow the directions provided by Medical Control.

If directed by Medical Control, but ONLY if the patient is conscious, is able to swallow, and is able to drink without assistance, dilute the ingested substance with water.

If directed by Medical Control, but ONLY if the patient is conscious, is able to swallow, and is able to drink without assistance, bind the substance by the administration of Activated Charcoal in 70% Sorbitol solution, as follows:

INHALED SUBSTANCES:

NOTE: ENSURE THAT THE SCENE IS SAFE TO ENTER.

1. Remove the patient from the contaminated environment.
2. Administer oxygen, especially if carbon monoxide poisoning is suspected.

ENVENOMATIONS:

1. Insect stings:
• Remove stinger by scraping.
• Cover with a sterile dressing.
• Apply cold compresses to the site.
2. Marine:
• Remove stinging bristles by patting the area with adhesive tape, then wipe with alcohol.
• Remove stinging spine.
• Cover with a sterile dressing.
  
  NOTE: TRANSPORT SHOULD NOT BE DELAYED FOR THIS TREATMENT.
3. Snakebite:
• Keep injection site lower than the level of the heart.
• Cover with a sterile dressing.
• Immobilize the area and restrict patient activity.
• Transport to Venomous Bite Center. (See Appendix H.)

ABSORPTIONS:

NOTE: TAKE PRECAUTIONS TO AVOID CONTAMINATION OF YOURSELF AND OTHERS.

1. Remove all contaminated clothing.
2. Brush away any dry agents or blot away any excess liquids from the skin.
3. Flush the area with sterile saline, sterile water, or plain water for at least 10 minutes.

Bandage any contact burns with a saline-moistened, sterile dressing.