Overview
A poison is any substance that harms the body. It can be swallowed, breathed in, absorbed through the skin or injected, and whether something is poisonous often depends on the amount: an ordinary medicine becomes dangerous at the wrong dose.
Poisoning can be an accident, especially in young children who put things in the mouth, or an occupational exposure while spraying pesticide, or deliberate. Anyone who has taken something in order to harm themselves needs emergency medical care and kind, urgent support, and thoughts of self-harm should always be told to a doctor straight away.
Symptoms
Symptoms depend on the substance, and there may be none at first. Common ones are:
- Feeling sick, being sick, stomach pain or diarrhoea
- Drowsiness, confusion, dizziness or a fit
- Difficulty breathing, coughing or chest pain
- Blurred vision, small or very large pupils
- Burns, blisters or staining around the lips and mouth
- Sweating, drooling, watering eyes and twitching, which can follow pesticide exposure
- Headache, sickness and drowsiness affecting several people in the same room, which can mean fumes
When to see a doctor
See a doctor within a few days after a medicine has been taken twice by mistake with no symptoms, after skin or eye irritation from a chemical, or for headaches and sickness that keep returning in a room where a stove or heater is used.
Causes
The common causes are medicines taken in too large a dose, household products such as bleach, acid, phenyl and detergents, and agricultural pesticides and weedkillers.
Others include kerosene and other fuels, carbon monoxide from stoves, heaters and generators used in closed rooms, alcohol and recreational drugs, certain plants, seeds and mushrooms, and industrial chemicals at work.
Risk factors
- Children under five, who explore by putting things in the mouth
- Chemicals decanted into drink bottles or unlabelled containers
- Medicines kept loose in a handbag, on a table or in a low cupboard
- Farm work involving pesticide mixing and spraying, without gloves or a mask
- Stoves, heaters, coal angithis and generators used in rooms without ventilation
- Older people taking many medicines, and anyone who cannot read the labels
- Depression, alcohol use and times of severe personal stress
Complications
Poisoning can stop a person breathing, upset the heart rhythm, or cause a fit. Vomit breathed into the lungs causes a serious chest infection, and corrosive chemicals burn the mouth, food pipe and stomach, which can narrow later.
Some substances damage the liver or kidneys over the following days, and fumes that contain carbon monoxide can leave lasting problems with memory and concentration.
Prevention
- Keep every chemical in its original labelled container, never in a water or soft drink bottle
- Store medicines, pesticides and cleaning products high up or locked, away from food
- Read the label before using any chemical, and follow the instructions on it
- Wear gloves, cover the skin and use a mask when mixing or spraying pesticide, and wash and change afterwards
- Keep stoves, heaters and generators out of closed rooms, and keep a window open
- Return old and unused medicines rather than keeping them at home
- Ask a doctor or pharmacist before combining medicines, and use one written list for an elderly relative
Diagnosis
Most of the diagnosis is the story: what was taken, how much, when, and by what route. That is why the container, label or strip is so useful, and why any vomit is worth keeping.
The doctor examines the person and may order blood and urine tests, blood gases, an and, for some substances, tests that measure the level in the blood. Some tests are repeated after several hours.
Treatment
While waiting for help or transport:
- Move the person away from fumes into fresh air, opening doors and windows, without going into a gas-filled space alone
- Remove contaminated clothing and wash the skin with plenty of water, or rinse a splashed eye with running water
- If they are unconscious but breathing, lay them on their side and keep checking their breathing
- Give nothing to eat or drink, and do not make them vomit
- Collect the container, label, leftover substance and any vomit to take with you
In hospital, breathing and circulation are supported first. Depending on the poison, treatment may include a charcoal drink that binds some substances, a specific antidote, fluids and medicines into a vein, treatment for fits, and occasionally . People are monitored even when they feel well, and support from a mental health team is offered after deliberate poisoning.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Make the person vomit at once to get the poison out.”What is true?
Fact
Forcing vomiting is not recommended unless a doctor or poison centre specifically advises it. The substance can go into the lungs on the way back up, and corrosive chemicals burn the food pipe a second time. Take the person, and the container, to hospital instead.
Myth“Give milk, curd, lemon juice or vinegar to cancel the poison.”What is true?
Fact
There is no household drink that neutralises a poison, and first aid guidance advises against trying to neutralise one with lemon juice, vinegar or anything similar unless a professional tells you to. Anyone who is drowsy or unconscious should be given nothing by mouth at all.
Myth“He looks fine now, so we can wait and see.”What is true?
Fact
Some poisons cause no symptoms for hours or even days while they are already damaging the liver, kidneys or nerves. Paracetamol overdose is a well-known example. Guidance is not to wait for symptoms before getting help, and hospitals observe people who feel well.
Myth“A herbal or traditional antidote will flush the poison out of the body.”What is true?
Fact
There is no cure-all antidote. Treatment depends on which substance was taken and how much, and for some poisons there is a specific medicine that only a hospital can give. Time spent on home remedies is time the antidote is not working.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
A child may have swallowed something but we are not sure. Do we go in?
Yes. It is far safer to be assessed and sent home than to wait for symptoms. Look for the container the child may have reached, note roughly how much is missing and when it could have happened, and take the container with you.
What should we do about a chemical splashed in the eye?
Rinse the eye immediately with clean running water, holding the eyelid open, and keep rinsing for a long time while someone arranges transport. Do not rub the eye or put drops in it, and take the container or label to hospital.
How do we know if fumes in the house are the problem?
Suspect it when more than one person in the same room has headache, sickness, dizziness or drowsiness that improves when they go outside, particularly where a stove, angithi, heater or generator is used indoors. Open the doors and windows, get everyone into fresh air, and have them checked.