Chapter 22: Toxicology Assignment

What is toxicology?

Study of poisons and harmful substances.

Routes of poisoning

Ingestion, injection, absorption, inhalation.

Poison vs toxin

Poison = harmful substance; Toxin = biological poison.

Most common EMS toxicology call

Substance abuse.

Chronic vs acute toxic exposure

Chronic exposure is more common.

Opiates/opioids examples

Heroin, morphine, methadone, oxycodone.

Opiates signs

Respiratory depression, pinpoint pupils, sedation/coma, altered LOC, hypotension.

Sympathomimetics examples

Cocaine, meth, epinephrine.

Sympathomimetics signs

Hypertension, tachycardia, dilated pupils, agitation, seizures, hyperthermia.

Sedative-hypnotic examples

Xanax, Valium, Versed, phenobarbital.

Sedative-hypnotic signs

Slurred speech, sedation/coma, hypoventilation, hypotension.

Alcohol + benzos

Synergistic respiratory depression; worsens symptoms.

Anticholinergic examples

Benadryl, antipsychotics (Haldol).

Anticholinergic signs

Tachycardia, hyperthermia, dilated pupils, dry skin, agitation, seizures.

Anticholinergic memory phrase

Hot as a hare, mad as a hatter.

Cholinergic examples

Nerve gas, organophosphates.

SLUDGE mnemonic

Salivation, Lacrimation, Urination, Defecation, Gastric upset, Emesis.

Cholinergic danger pathway

Muscle twitching → seizures → coma → death.

Identify toxin questions

What taken? How much? When? Route? Environment?

Scene clues

Placards, spills, gas clouds, pill fragments, bottles, syringes.

Key toxicology safety rule

Do not become a patient; call hazmat if needed.

Inhalation poisoning examples

Carbon monoxide, fumes, gases.

Inhalation red flag

Multiple people with headache, nausea, vomiting → CO poisoning.

Absorption poisoning signs

Rash, irritation.

Absorption treatment

Brush powders, flush with water, remove clothing, irrigate eyes.

Ingestion poisoning signs

Burns around mouth, empty bottles nearby.

Activated charcoal requirements

Early ingestion, correct substance, patient awake.

Injection poisoning examples

Heroin, meth, bee/wasp stings, snake bites.

Injection considerations

Fast onset; mark swelling, remove rings, monitor for anaphylaxis.

Primary assessment priority

ABCs first.

Toxicology airway concern

Have suction ready, especially for organophosphates.

Transport rule

Do not transport until patient is decontaminated.

Reassessment times

Unstable: 5 min; Stable: 15 min.

Activated charcoal dose

Usually 50 g.

Activated charcoal notes

Not for all toxins; requires alert patient.

Drug tolerance

Repeated use → higher doses needed → overdose risk.

IV drug user risks

Hepatitis B/C, HIV.

Alcohol intoxication signs

Decreased LOC, poor coordination, nausea/vomiting.

Alcohol biggest danger

Aspiration from vomiting.

Best position for intoxicated patient

Left lateral recumbent (LLR).

Chronic alcoholism complications

Varices, ulcers, malnutrition.

Delirium tremens signs

Seizures, tremors, sweating, fever, vomiting, hallucinations, agitation.

DTs danger

Life-threatening emergency; needs immediate treatment.