injuries poisoning
General Principles of Poisoning
Symptoms and Signs of Poisoning
Symptoms and signs of poisoning vary depending on the substance (see table Symptoms and Treatment of Specific Poisons ). Also, different patients poisoned with the same substance may present with very different symptoms. However, 6 clusters of symptoms (toxic syndromes, or toxidromes) occur commonly and may suggest particular classes of substances (see table Symptoms typically begin soon after contact but, with certain poisons, are delayed. The delay may occur because only a metabolite is toxic rather than the parent substance (eg, methanol, ethylene glycol, hepatotoxins). Ingestion of hepatotoxins (eg, Acetaminophen Poisoning , Ingested and absorbed toxins generally cause systemic symptoms. Caustics and corrosive liquids damage mainly the mucous membranes of the gastrointestinal (GI) tract, causing stomatitis, enteritis, or perforation. Some toxins (eg, alcohol, hydrocarbons) cause characteristic breath odors. Skin contact with toxins can cause various acute cutaneous symptoms (eg, rashes, pain, blistering); chronic exposure may cause dermatitis. Inhaled toxins are likely to cause symptoms of upper airway injury if they are water-soluble (eg, chlorine, ammonia) and symptoms of lower airway injury and noncardiogenic pulmonary edema if they are less water-soluble (eg, phosgene). Inhalation of carbon monoxide, cyanide, or hydrogen sulfide gas can cause organ ischemia or cardiac or respiratory arrest. Eye contact with toxins (solid, liquid, or vapor) may damage the cornea, sclera, and lens, causing eye pain, redness, and loss of vision. ) can cause severe agitation, which can result in hyperthermia, acidosis, and Rhabdomyolysis . 