Poisoning emesis

EMETICS Because treatment of poison ingestion is an emergency, the nurse immediately obtains equipment for treatment. The nurse obtains the drag, an emesis basin, towels, specimen containers for sending contents of the stomach to the laboratory for analysis, and a suction machine and places them near the patient. The nurse obtains the patient s blood pressure, pulse, and respiratory rate and performs a brief physical examination to determine what other damages or injuries, if any, may have occurred. 

It is useless for a non-toxic agent. There are few adequate studies on the matter with the limitation of using undifferentiated poisoned subjects and hence the value for lavage and its outcome are controversial. There is some evidence to suggest that it is effective and better than ipecac-induced emesis. 

Emesis can be induced with ipecac syrup (never extract of ipecac), and this method was previously used to treat some childhood ingestions at home under telephone supervision of a physician or poison control center personnel. However, the risks involved with inappropriate use outweighed the unproven benefits, and this treatment is rarely used in the home or hospital. Ipecac should not be used if the suspected intoxicant is a corrosive agent, a petroleum distillate, or a rapid-... 

SLE systemic lupus erythematosus SLUDGE mnemonic for organophosphate poisoning symptoms Salivation, Lacrimation, Urination, Defecation, Gastrointestinal motility, Emesis SMX sulfamethoxazole SNRIs serotonin-norepinephrine reuptake inhibitors (class of drugs used to treat depression, e.g., venlafaxine)... 

Although emesis is indicated after poisoning by oral ingestion of most chemicals, it is contraindicated in certain situations as follows ... 

If the patient has ingested a corrosive poison, such as a strong acid or alkali (e.g., drain cleaners), emesis increases the likelihood of gastric perforation and further necrosis of the esophagus. 

To prevent further absorption of poison from the gut, oral absorbants (activated charcoal), gastric lavage, emesis, and cathartics are used. Chelating agents are... 

There is no risk of poisoning for animals ingesting taste amounts, but if the amount ingested is unknown, or eannot be estimated, then a loeal Poison Control Center or veterinarian should be eontaeted for instructions on how to induce emesis and obtain a 24 to 48 h blood test (PT) to determine the need for treatment with vitamin Ki (Monday and Thompson, 2003 Murphy and Gerken, 1989 Woody et al, 2003). 

Emesis has been used for children and also for adults who refuse activated charcoal or gastric lavage, or if the poison is not absorbed by activated charcoal. Its routine use in emergency departments has been abandoned, as there is no clinical trial evidence that the procedure improves outcome for poisoned patients. Emesis is induced, in fully conscious patients only, by Ipecacuanha Emetic Mixture, Pediatric (BNF), 10 ml for a child 6-18 months, 15 ml for an older child and 30 ml for an adult, i.e. all ages may receive the same preparation but in a different dose, which is followed by a tumblerful of water (250 ml). The active constituent of ipecacuanha is emetine it can cause prolonged vomiting, diarrhoea and drowsiness that may be confused with effects of the ingested poison. Even... 

Both emesis and lavage are contraindicated for corrosive poisons, because there is a risk of perforation of the gut, and for petroleum distillates, as the danger of causing inhalational chemical pneumonia outweighs that of leaving the substance in the stomach. 

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