Prevention of Further Absorption of Poison

The primary methods include emesis (induced vomiting), gastric lavage, activated charcoal, and cathartic agents. Emesis expels stomach contents using ipecac syrup or saltwater stimulation. Gastric lavage uses an orogastric tube to cleanse the stomach. Activated charcoal adsorbs toxins due to its large surface area, while cathartic agents like polyethylene glycol electrolyte solution enhance gut decontamination through whole bowel irrigation.

Emesis should be avoided when the intoxicant is caustic, a petroleum distillate, or a central nervous system stimulant. It is also contraindicated if the patient is in a delirium state, coma, or unconscious. These situations risk severe complications such as aspiration, airway damage, or further internal injury from corrosive substances.

Gastric lavage uses an orogastric tube to clean and remove stomach contents, including toxins. In comatose patients, lavage can cause aspiration of stomach contents into the lungs. This risk is prevented by protecting the airway with an endotracheal tube before performing the procedure.

Although activated charcoal has a large surface area and effectively adsorbs many drugs and toxins, it poorly adsorbs metals, alcohols, and cyanides. This limitation means alternative or additional decontamination methods must be used when patients have ingested these specific substances.

Whole bowel irrigation uses cathartic agents, such as polyethylene glycol electrolyte solution, to enhance gut decontamination and remove toxins from the gastrointestinal tract. The solution is administered orally until the rectal effluent becomes clear, ensuring complete removal of toxins before systemic absorption occurs.

The entry point should be promptly cleaned and disinfected, then sealed with sterile dressings. Bleeding at the injection site must be controlled to minimize toxin spread. Elevation of the affected limb helps reduce systemic dissemination. Administering antidotes or specific treatments and providing supportive care with vital sign monitoring are essential for managing complications.

External decontamination prevents continued poison exposure through the skin and prevents recontamination during treatment. It involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is complete, attention can focus on limiting further absorption through the gastrointestinal tract using methods like activated charcoal and enhanced elimination of poison.