PDP 406 CLINICAL TOXICOLOGY

Transcription

1 PDP 406 CLINICAL TOXICOLOGY Pharm.D Fourth Year

2 ENVENOMATION Mr.D.Raju.M.Pharm., Lecturer

3 POISONING Poisonous substances can be swallowed, injected, inhaled, absorbed. Poisoning and envenomation can be life threatening and require rapid first aid. Signs and symptoms of poisoning vary according to the type of poison and amount taken. MANAGEMENT OF POISONING 1. DRABCD 2. Mouth to nose rescue breaths may be required for some cases of poisoning 3. If the casualty is unconscious place in recovery position and call Collect information about the poison 5. Call the Poisons Information Centre on Follow the advice of the Poisons Information Centre

4 BITES & STINGS The pressure immobilisation technique is recommended only for use for the following types of bites or stings: All Australian snake bites, including sea snake bites Funnel web spider bites Bee, wash, ant stings and paralysis tick envenomation in allergic individuals Blue-ringed octopus bites Cone snail (cone shell) stings

5 IN ANY ENVENOMATION: DO NOT get bitten yourself DO NOT suck the venom out DO NOT apply a tourniquet DO NOT cut, bleed or wash the bite site DO NOT express the venom or remove any previously applied bandages.

6 SNAKE BITES MANAGEMENT OF A SNAKE BITE 1. DRABCD Be careful not to get bitten yourself 2. Rest the casualty, do not let them move or walk around 3. Call for help as soon as possible 4. Pressure immobilisation technique (P.I.T.) 5. Provide reassurance

7 SPIDER BITES Management of a Funnel Web Spider Bite 1. DRABCD 2. Rest the casualty 3. Call for help 4. Pressure immobilisation technique 5. Provide reassurance Management of a Red Back Spider Bite 1. DRABCD 2. Rest the casualty 3. Apply ice to the bite site 4. Seek medical help 5. Provide reassurance

8 STINGS MANAGEMENT OF A BEE STING DRABCD Remove the sting or barb with a sideward scraping movement Apply a cold pack Observe for signs of an allergic reaction If an allergic reaction does occur, use the pressure immobilisation technique Provide reassurance MANAGEMENT OF AN ANT STING DRABCD be careful not to get stung Apply ice or a cold pack Observe for signs of allergic response Provide reassurance

9 PARALYSIS TICK A Tick bite can cause serious ill effects MANAGEMENT OF A TICK BITE 1. DRABCD 2. Do not squeeze tick 3. Remove the whole tick using tweezers and a levering motion 4. Inspect all skin areas for more ticks 5. Clean the tick bit site and the tweezers 6. Observe for signs of an allergic reaction 7. Provide reassurance 8. Seek medical assistance.

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11 MARINE ANIMAL BITES AND STINGS In the waters around Australia there are many types of marine animals that can inflict painful and sometimes life threatening bites and stings. Be alert when near water, rock pools, rivers, creeks or the ocean. When a person has been bitten or stung there is also the danger that the person might panic and drown. If it is safe to do so remove casualty from the water as soon as possible.

12 BLUE RINGED OCTOPUS The blue ringed octopus has lethal venom in its saliva that can be injected via a painless bite. The venom can cause paralysis and may stop a person from breathing. Note even though the casualty may be unable to move, they are often aware of their surrounding and require extensive reassurance. MANAGEMENT 1. DRABCD call 000/lifesaver 2. Remove casualty from the water 3. Give Basic Life Support 4. Pressure immobilisation 5. Provide reassurance 6. Closely monitor signs of life

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14 BOX JELLY FISH STING Found in northern Australia. Often very difficult to see in the water the sudden and severe pain of the sing may be first sign of its presence. The tentacles of the box jellyfish have a typical banded ladder appearance and leave similar markings and tentacles on the skin of the casualty. MANAGEMENT 1. DRABCD and call 000/lifesaver 2. Remove casualty from water if safe to do so 3. Give Basic Life Support 4. Wash tentacles and skin with vinegar 5. Apply cold pack for pain relief 6. Provide reassurance 7. Closely monitor for signs of life

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16 BLUEBOTTLE JELLYFISH STING Found all over Australian coastline. Though a sting can cause severe local pain, the venom is not lethal and no deaths have been recorded. MANAGEMENT 1. DRABCD and call 000 or call lifesaver 2. Apply a cold pack for pain relief 3. Provide reassurance NOTE DO NOT RUB THE AFFECTED AREA

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18 CONE SNAIL (CONE SHELL) The Cone Snail is found in tropical regions of Australia. The shell is usually brown and white and contains a poisonous spine that sticks into the skin when the shell is handled. MANAGEMENT 1. DRABCD call 000 or lifesaver 2. Remove casualty from water is safe to do so 2. Apply pressure immobilisation technique 3. Give Basic Life Support required and monitor signs of life

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20 STONEFISH The Stonefish lives in northern NSW and the tropical regions. Envenomation occurs during handling and when stepping on the poisonous spines along the back of the fish. MANAGEMENT 1. DRABCD remove casualty from the water and call Immerse the area in hot water but avoid scalding 3. closely monitor signs of life 4. Give Basic Life Support as required 5. Provide reassurance.

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22 ALLERGIC REACTIONS A severe allergic reaction is called Anaphylaxis and occurs when a sensitive person is exposed to a substance i.e. food, food additive, chemical, medicine, bite or sting or synthetic materials such as latex. Anaphylaxis is life threatening and requires immediate first aid and urgent medical attention call 000] Signs and symptoms Management Breathlessness 1. DRABCD and call 000 Chest tightness 2. Give Basic life support Collapse and unconsciousness 3. Remove contact with allergen if Tiredness or weakness known and if possible Difficulty in speaking /swallowing 4. If allergic response due to bite Swelling to any part of body or sting apply pressure Red marks and rashes immobilisation technique Wheezing/itching 5. Assist in administration of Palpitations/anxiety adreline (via Epi Pen)