Dealing with Poisoning

This leaflet is created from first aid advice provided by St John Ambulance, the nation's leading first aid charity. This advice is no substitute for first aid training - find a training course near you.

Alcohol poisoning

Alcohol (chemical name, ethanol) is a drug that depresses the activity of the central nervous system - in particular, the brain.

Prolonged or excessive intake can severely impair all physical and mental functions, and the person may sink into deep unconsciousness.

There are several risks to the person from alcohol poisoning:

  • An unconscious person risks inhaling and choking on vomit.
  • Alcohol widens (dilates) the blood vessels. This means that the person loses heat, and hypothermia may develop.
  • A person who smells of alcohol may be misdiagnosed and not receive appropriate treatment for an underlying cause of unconsciousness, such as a head injury, stroke, or heart attack.

Recognition

There may be:

  • A strong smell of alcohol.
  • Empty bottles or cans.
  • Impaired consciousness: the person may respond if roused, but will quickly relapse.
  • Flushed and moist face.
  • Deep, noisy breathing.
  • Full, bounding pulse.
  • Unconsciousness.

In the later stages of unconsciousness:

  • Dry, bloated appearance to the face.
  • Shallow breathing.
  • Weak, rapid pulse.
  • Dilated pupils that react poorly to light.

Treatment

Aims:

  • To maintain an open airway.
  • To assess for other conditions.
  • To seek medical help if necessary.

If the person is conscious:

  • Cover a person with a coat or blanket to protect them from the cold.
  • Assess the person for any injuries, especially head injuries, or other medical conditions.
  • Monitor and record vital signs - level of response, pulse and breathing - until the person recovers or is placed in the care of a responsible person.

If the person becomes unconscious:

  • Open the airway and check breathing.
  • Be prepared to give chest compressions and rescue breaths if necessary.
  • Place them into the recovery position if the person is unconscious but breathing normally.
  • Dial 999/112 for an ambulance.

DO NOT induce vomiting.

Drug poisoning

Poisoning can result from an overdose of either prescribed drugs or drugs that are bought over the counter. It can also be caused by drug abuse or drug interaction.

The effects vary depending on the type of drug and how it is taken (see table below). When you call the emergency services, give as much information as possible. While waiting for help to arrive, look for containers that might help you to identify the drug.

Recognition

Category Drug Effects of poisoning
Painkillers Aspirin (swallowed)
  • Upper abdominal pain
  • Nausea and vomiting
  • Ringing in the ears
  • Sighing when breathing
  • Confusion and delirium
  • Dizziness
  Paracetamol (swallowed)
  • Little effect at first, but abdominal pain, nausea and vomiting may develop
  • Irreversible liver damage may occur within 3 days (malnourishment and alcohol increase the risk)
Nervous system depressants and tranquillisers Barbiturates and benzodiazepines (swallowed)
  • Lethargy and sleepiness, leading to unconsciousness
  • Shallow breathing
  • Weak, irregular, or abnormally slow or fast pulse
Stimulants and hallucinogens Amfetamines (including ecstasy) and LSD (swallowed); cocaine (inhaled)
  • Excitable, hyperactive behaviour, wildness and frenzy
  • Sweating
  • Tremor of the hands
  • Hallucinations
Narcotics Morphine, heroin (commonly injected)
  • Small pupils
  • Sluggishness and confusion, possibly leading to unconsciousness
  • Slow, shallow breathing which may stop altogether
  • Needle marks which may be infected
Solvents Glue, lighter fuel (inhaled)
  • Nausea and vomiting
  • Headaches
  • Hallucinations
  • Possibly, unconsciousness
  • Rarely, cardiac arrest

Treatment

Aims:

  • To maintain breathing and circulation.
  • To arrange removal to hospital.

If the person is conscious:

  • Help them into a comfortable position.
  • Ask them what they have taken.
  • Reassure them while you talk to them.
  • Dial 999/112 for an ambulance.
  • Monitor and record vital signs - level of response, pulse and breathing - until medical help arrives.
  • Look for evidence that might help to identify the drug, such as empty containers. Give these samples and containers to the paramedic or ambulance crew.

If the person becomes unconscious:

  • Open the airway and check breathing.
  • Be prepared to give chest compressions and rescue breaths if necessary.
  • Place them into the recovery position if the person is unconscious but breathing normally.
  • Dial 999/112 for an ambulance.

DO NOT induce vomiting.

Food poisoning

Food poisoning is usually caused by consuming food or drink that is contaminated with bacteria or viruses. Some food poisoning is caused by poisons (toxins) from bacteria already in the food. The salmonella or E. coli group of bacteria, which are found mainly in meat, are common causes of food poisoning.

Symptoms may develop rapidly (within hours), or they may not occur until a day or so after eating contaminated food.

Toxic food poisoning is frequently caused by poisons produced by the staphylococcus group of bacteria. Symptoms usually develop rapidly, possibly with 2 to 6 hours of eating the affected food.

One of the dangers of food poisoning is loss of body fluids. The dehydration that results from this fluid loss can be serious if the fluids are not replaced quickly enough. Dehydration is especially serious in the very young and the very old, and, in some cases, treatment may be required in hospital.

Recognition

There may be:

  • Nausea and vomiting.
  • Cramping abdominal pains.
  • Diarrhoea (possibly bloodstained).
  • Headache or fever.
  • Features of shock.
  • Impaired consciousness.

Aims

  • To encourage the person to rest
  • To give the person plenty of bland fluids to drink
  • To seek medical help if necessary.

Treatment

  • Advise the person to lie down and rest. Help them if necessary.
  • Give the person plenty of bland fluids to drink and a bowl to use if they vomit.
  • Call a doctor for advice.

If the person's condition worsens:

Dial 999/112 for an ambulance.

Poisonous plants and fungi

Many young children eat plant leaves or brightly coloured berries, but serious poisoning as a result rarely occurs.

However, ingesting even small amounts of foxglove or wild arum can cause nausea, vomiting, and stomach cramps; and large amounts are potentially fatal. Seizures may occur after ingesting laburnum seeds.

Serious poisoning as a result of eating mushrooms is also rare. Mushrooms found in the garden may cause nausea, vomiting, and occasionally, hallucinations. Death cap mushrooms cause vomiting and severe watery diarrhoea between 6 and 12 hours after ingestion and can be fatal.

Recognition

There may be:

  • Nausea and vomiting.
  • Cramping abdominal pains.
  • Diarrhoea.
  • Seizures.
  • Impaired consciousness.

Treatment

Aims:

  • To identify the poisonous plant, if available.
  • To manage any seizures.
  • To seek medical aid if necessary.

If the person is conscious:

  • Ask them what they have eaten and reassure them.
  • Try to identify the poisonous plant, and find out which part of it has been eaten.
  • Get medical advice at once so that the appropriate treatment can be given.
  • Keep any small pieces of the plant that you have found to show to the doctor or send with the person to hospital.

If the person becomes unconscious:

  • Open the airway and check breathing.
  • Be prepared to give chest compressions and rescue breaths if necessary.
  • Place them into the recovery position if the person is unconscious but breathing normally.
  • Dial 999/112 for an ambulance.

DO NOT induce vomiting.

Chemicals that are swallowed may harm the digestive tract, or cause more widespread damage if they enter the bloodstream and are transported to other parts of the body.

Hazardous chemicals include common household substances. For example, bleach, dishwasher detergent, and paint stripper are poisonous or corrosive if swallowed. Drugs, whether they are prescribed or bought over the counter, are also potentially harmful if they are taken in overdose. The effects of poisoning depend on the substance that has been swallowed.

Recognition

Depends on the poison, but there may be:

  • Vomiting, sometimes bloodstained.
  • Impaired consciousness.
  • Pain or burning sensation.
  • Empty containers in the vicinity.
  • History of ingestion/exposure.

Treatment

Aims:

  • To maintain the airway, breathing, and circulation.
  • To remove any contaminated clothing.
  • To identify the poison.
  • To arrange urgent removal to hospital.

If the person is conscious:

  • Ask them what they have swallowed.
  • Try to reassure them.
  • Dial 999/112 for an ambulance.
  • Give as much information as possible about the swallowed poison. This information will assist doctors to give appropriate treatment once the person reaches hospital.

If the person becomes unconscious:

  • Open the airway and check breathing.
  • Be prepared to give chest compressions and rescue breaths if necessary.
  • Place them into the recovery position if the person is unconscious but breathing normally.
  • Use a face shield or pocket mask for rescue breathing if there are any chemicals on the person's mouth.

Swallowed poisons

Chemicals that are swallowed may harm the digestive tract, or cause more widespread damage if they enter the bloodstream and are transported to other parts of the body.

Hazardous chemicals include common household substances. For example, bleach, dishwasher detergent, and paint stripper are poisonous or corrosive if swallowed. Drugs, whether they are prescribed or bought over the counter, are also potentially harmful if they are taken in overdose. The effects of poisoning depend on the substance that has been swallowed.

Recognition

Depends on the poison, but there may be:

  • Vomiting, sometimes bloodstained.
  • Impaired consciousness.
  • Pain or burning sensation.
  • Empty containers in the vicinity.
  • History of ingestion/exposure.

Treatment

Your aims:

  • To maintain the airway, breathing, and circulation.
  • To remove any contaminated clothing.
  • To identify the poison.
  • To arrange urgent removal to hospital.

If the person is conscious:

  • Ask them what they have swallowed.
  • If bleach has been swallowed, give them sips of water to soothe any burns to the airway.
  • Try to reassure them.
  • Dial 999/112 for an ambulance.
  • Give as much information as possible about the swallowed poison. This information will assist doctors to give appropriate treatment once the casualty reaches hospital.

If the person becomes unconscious:

  • Open the airway and check breathing.
  • Be prepared to give chest compressions and rescue breaths if necessary.
  • Place them into the recovery position if the person is unconscious but breathing normally.
  • Use a face shield or pocket mask for rescue breathing if there are any chemicals on the person's mouth. 

Note: these hints are no substitute for thorough knowledge of first aid. St John Ambulance holds first aid courses throughout the country.

This leaflet was taken from the St John Ambulance website: alcohol poisoning, drug poisoning, food poisoning, poisonous plants and fungi, swallowed poisons. Copyright for this leaflet is with St John Ambulance.