First rule: protect the rescuer and stop further exposure. Poisoning may occur by swallowing, inhalation, injection, skin or eye contact, and venom may cause paralysis, bleeding, tissue destruction or shock. First aid supports life while urgent professional advice and transport are arranged.
Add an image sequence for scene safety, snakebite immobilisation, skin decontamination and poison containers here.
Learning outcomes
- Recognise common routes, clues and life-threatening effects of poisoning.
- Apply a safe ABCDE approach and collect information for clinicians or a poison centre.
- Give appropriate first aid for swallowed, inhaled, skin and eye exposures.
- Manage snakebites and stings while avoiding harmful traditional or improvised methods.
- Identify drug overdose, chemical exposure, food poisoning and envenomation requiring emergency referral.
1. Scene safety and initial approach
- Do not enter a contaminated room, pesticide cloud, collapsed vehicle or confined space without trained protection.
- Move the casualty away from the source only if it is safe; move yourself upwind from fumes and avoid touching contaminated clothing.
- Wear gloves and eye protection. Remove contaminated clothing and place it in a sealed bag when appropriate.
- Call local emergency services and seek poison-centre/clinical advice. Take the container, label, tablets, plant sample or photograph if safe.
- Assess airway, breathing, circulation, consciousness, seizures, temperature and blood glucose if trained and equipment is available.
2. Clues to poisoning
| Clue | Possible implication |
|---|---|
| Unexplained drowsiness, confusion or collapse | Drug overdose, hypoxia, hypoglycaemia, carbon monoxide or metabolic emergency. |
| Unusual smell on breath, burns around mouth, chemical container | Ingestion or inhalation of a corrosive or volatile substance. |
| Pinpoint pupils and slow breathing | Possible opioid toxicity; respiratory support and naloxone by trained responders may be lifesaving. |
| Sweating, salivation, vomiting, diarrhoea, wheeze and small pupils | Possible organophosphate or cholinergic poisoning; avoid contaminated secretions and seek emergency care. |
| Seizures, abnormal pulse, chest pain or severe breathlessness | Life-threatening toxicity—activate emergency help immediately. |
3. General first aid for suspected poisoning
- Call for emergency help early, especially for breathing difficulty, altered consciousness, seizures, severe pain, repeated vomiting or suspected intentional overdose.
- Maintain airway and breathing. If the person is unconscious but breathing normally, use the recovery position; if not breathing normally, begin CPR.
- Do not induce vomiting. Do not give milk, oil, charcoal, salt water, food or drink unless a poison specialist or clinician specifically directs it.
- Do not neutralise acids with alkalis or alkalis with acids; the reaction can generate heat and worsen injury.
- Do not give anything by mouth to a drowsy, convulsing or unconscious person.
- Keep the container and record the substance, amount, time, route, age/weight, symptoms and first aid already given.
4. Route-specific first aid
| Exposure | Immediate action | Do not do |
|---|---|---|
| Swallowed | Remove remaining material from the mouth only if easily visible; call poison/medical help and keep the container. | Do not induce vomiting or give a neutralising substance. |
| Inhaled | Move to fresh air only if safe; loosen clothing, monitor breathing and call emergency help. | Do not enter a toxic atmosphere without protection or perform mouth-to-mouth in a contaminated environment. |
| Skin | Remove contaminated clothing and wash exposed skin with copious running water. Protect yourself. | Do not scrub aggressively or spread the chemical to clean skin. |
| Eye | Irrigate continuously with clean water or saline, holding eyelids open; remove contact lenses if easy. | Do not rub, apply drops not advised by a professional or patch the eye without assessment. |
| Injection/bite | Call emergency help, keep the person still and monitor for systemic effects. | Do not cut, suck, squeeze or apply a tight tourniquet to a snakebite. |
5. Snakebite envenomation
- Move away from the snake. Do not attempt to catch or kill it; a photograph from a safe distance may help identification.
- Reassure the casualty, keep them still and immobilise the bitten limb in a comfortable position.
- Remove rings, watches and tight clothing before swelling develops. Mark the edge of swelling with the time.
- Arrange urgent transport to a facility capable of assessment and antivenom. Carry the person—do not allow walking.
- Monitor airway, breathing, pulse, consciousness and progression of swelling. Be ready to resuscitate.
- Do not cut or suck the wound, apply herbs, ice, electricity, chemicals or a tight tourniquet, or waste time seeking the snake.
Danger signs: drooping eyelids, double vision, difficulty swallowing or breathing, weakness/paralysis, bleeding, rapidly increasing swelling, vomiting, collapse, dark urine or reduced urine. These require immediate emergency care.
6. Stings and bites
- Bee/wasp: move away from the swarm. Scrape a visible honeybee stinger sideways rather than squeezing it. Apply a cold pack wrapped in cloth and monitor for anaphylaxis.
- Anaphylaxis: difficulty breathing, wheeze, throat/tongue swelling, widespread hives, collapse or severe abdominal symptoms require emergency help. Assist with the person’s prescribed adrenaline auto-injector according to its instructions and local training.
- Animal or human bite: wash with running water and soap, cover and seek assessment for rabies, tetanus, antibiotics and deep-structure injury.
- Tick or other arthropod: remove safely with appropriate technique and seek advice for local disease risks.
7. Drug overdose
Look for packets, missing medicines, alcohol, needles or a witnessed exposure. Protect the airway and breathing, place a breathing unconscious person on their side, call emergency help and do not leave them alone. If opioid overdose is suspected and naloxone is available, a trained responder may administer it while continuing ventilation or CPR; repeated doses and observation may be necessary because its effect can wear off before the opioid.
8. Chemical and pesticide exposure
Protect rescuers from fumes and secondary contamination. Remove the casualty from the source when safe, flush skin or eyes, remove contaminated clothes and seal them. Organophosphate exposure may cause sweating, salivation, vomiting, diarrhoea, pinpoint pupils, wheeze, muscle twitching and collapse. It requires urgent professional treatment; do not touch secretions with bare hands.
9. Food poisoning
Most uncomplicated foodborne illness causes nausea, vomiting, diarrhoea and abdominal cramps. Give oral rehydration solution in small frequent sips if the person is alert and able to swallow. Refer urgently for blood in stool, persistent vomiting, severe abdominal pain, high fever, dehydration, confusion, suspected botulism, pregnancy, extremes of age or a cluster of cases. Do not give anti-diarrhoeal medicine to a severely ill person without professional advice.
10. Scenario
Scenario: A farmer is found confused beside a pesticide container, sweating and wheezing. Response: do not enter the contaminated area without protection; move upwind and call emergency help, remove contaminated clothing only when safe, irrigate exposed skin, support airway and breathing, avoid mouth-to-mouth in contamination, preserve the container and hand over the exposure details.
Exam points and revision questions
- List the routes through which poisons enter the body.
- Explain why inducing vomiting is unsafe in many poisonings.
- Describe first aid for a suspected snakebite.
- List four features of anaphylaxis after a sting.
- Explain the first-aider’s priorities in an unconscious drug overdose.