Emergency approach for drug, chemical, food, or gas poisoning, including airway protection, removal of the toxic substance, and antidote therapy.
Indication
- Drug overdose (suicide attempt or accidental use)
- Carbon monoxide (CO) poisoning (stove or chimney obstruction)
- Mushroom poisoning
- Food poisoning (severe, with dehydration)
- Pesticide (organophosphate) exposure
- Accidental ingestion of household chemicals in children
- Snake, scorpion, and spider bites
Preparation
- When the patient is brought to the emergency room, the box, blister pack, or sample of the substance ingested or contacted is brought along
- The amount, time of exposure, and developing symptoms are recorded
- Vomited contents, if any, are kept for examination
- Level of consciousness and respiration are monitored
How it's performed
- In the emergency room, contact is made with the National Poison Control Center hotline (184 UZEM in Turkey) to confirm the substance-specific treatment protocol
- Airway, breathing, and circulation (ABC) are secured; oxygen and IV access are provided as needed
- Activated charcoal is administered for ingested substances (usually within the first hour, in conscious patients; not recommended for corrosive/petroleum derivative/lithium/iron/alcohol poisoning)
- For poisonings with antidotes (N-acetylcysteine for paracetamol, naloxone for opioids, atropine/pralidoxime for organophosphates, high-flow oxygen for CO), specific therapy is initiated
- Blood and urine tests, ECG, and drug level measurements are performed if needed
- In severe cases, intensive care, hemodialysis, or plasmapheresis is considered
Post-procedure
- In mild poisonings, discharge is considered after 6-24 hours of observation
- Cases with altered consciousness or ECG abnormalities are followed in intensive care
- Psychiatric consultation is performed before discharge in suicide attempts
- Follow-up at 1-2 weeks for late neurological complications in carbon monoxide poisoning
- Families are informed about accident prevention in children, with medications and chemicals stored in locked places
Risks
- Aspiration pneumonia (inhalation into the lungs during vomiting)
- Nausea and constipation due to activated charcoal
- Antidote reactions (allergy, hypotension)
- Permanent organ damage (liver, kidney, brain)
- Cardiac arrhythmia and respiratory arrest (in severe cases)
FAQ
Should you induce vomiting in a poisoning case?
No. Inducing vomiting at home is no longer recommended; it increases the risk of aspiration and esophageal damage. Seek emergency care quickly and contact the national poison control center.
What is the 184 UZEM hotline?
It is the National Poison Control Center of the Turkish Ministry of Health, available 24/7. It provides free toxicology consultation to citizens and healthcare professionals.
Is activated charcoal used in every poisoning?
No. It is ineffective or harmful for substances such as corrosives (acid/base), petroleum derivatives, iron, lithium, and alcohol. The indication is determined by the physician.
What should be done in carbon monoxide poisoning?
The patient is moved to fresh air immediately, windows are opened, the stove or water heater is turned off, and emergency services are called. High-flow oxygen or hyperbaric oxygen therapy may be required in the emergency room.
Related Information
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