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By poison, we mean a substance that, if it enters the body, can exert harmful effects, permanent or temporary. The routes by which a poison may enter the body are as follows:
1. Swallowing: may be accidental or deliberate (overdose) and includes a wide variety of substances from alcohol and illicit drugs to household cleaners or plants.
2. Inhalation: this can be of gases, such as carbon monoxide, as well as solvents and vapors.
3. Skin absorption: pesticides and insecticides may be absorbed in this way and particularly strong chemicals may also cause burns.
4. Injection into the skin: this includes venom, such as that injected by snakes and insects, and also illicit drugs injected by abusers.
Detailed instruction on the treatment of specific types of poisoning is out with the scope of this book, but in general the following steps should be taken:
1. Remove the casualty from the scene of danger but ensure that your own safety is not compromised in the case of gas or smoke or chemical spillage.
2. Try to obtain an accurate history of the poisoning incident. If possible, find out exactly what the substance was, how much has been ingested and how much time has elapsed since.
3. Obtain medical assistance immediately. Never attempt to make the casualty vomit as this may cause further damage to the gastro-intestinal tract and may even cause the casualty to inhale the vomit.
4. Place an unconscious casualty in the recovery position and monitor his or her breathing and circulation. If the patient's condition deteriorates then you must be prepared to resuscitate. Try to protect your mouth against any residual poison or chemicals on the patient's lips if you have to give mouth-to-mouth ventilation.
5. Send specimens of the toxin to the hospital with the casualty, if possible, as well as vomit specimens. This will help in identification of the toxin and the amount ingested.
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