and operate on a 24-hour a day basis. Every
medical facility should make an attempt to use
the services of the poison control center con-
tiguous to its activity.
TREATMENT OF POISONING
The basic procedure is as follows:
Remove the bulk of the poison out of the
stomach quickly. Removal of the poison
from the stomach may be accomplished by
the use of emetics and by washing out the
stomach through use of a stomach tube.
Administer an antidote for the remainder
of the poison left in the stomach.
Eliminate from the system that portion of
the poison that has been absorbed.
Treat the symptoms as they arise.
Take possession of all foods, medicines,
vomitus, feces, urine, and anything that
may be of value in determining the identity
of the poison and whether taken acciden-
tally or intentionally, or criminally
Cases of poisoning are frequently encountered
where the services of a physician or poison con-
trol center are unavailable. In these cases, it often
happens that it is impossible to obtain much or
any information relative to the nature or type of
poison taken. Since any delay in treatment may
result in serious consequences, every hospital
corpsman should possess some practical
knowledge of how to manage a poisoning case
when the nature of the poison is unknown.
For the purpose of general treatment in
unknown poisons, the case may be considered as
one of two kinds. It may either be a case in which
the local effects of the poison have injured the
mucous lining of the mouth, esophagus, and
stomach to an extent contraindicating the use of
instruments or emetics for evacuating the stomach
or it may be a case where the poison has had little
or no effect on the mucous lining of the alimen-
tary tract and therefore one in which it would be
safe to use a stomach tube or an emetic.
Poisonings coming under the classification of
corrosives generally produce conditions such as
mentioned in the first instance. They have a more
or less injurious and even destructive effect on the
lining of the mouth and stomach. Naturally, in
such cases the introduction of any sort of instru-
ment, even a soft rubber stomach tube, may result
in a perforation in the weakened wall. In such
conditions, rupture of the stomach maybe caused
by emesis. Poisons classified as irritants and
neurotics generally have no special local or in-
jurious action on the mouth and the stomach and
therefore in such cases the stomach may be
evacuated and washed with the aid of a stomach
tube. In the absence of a stomach tube, emetics
may be used without fear of injury.
In cases where there are no signs of injury to
the lining of the mouth, the probabilities are that
the poison is one of the irritants or neurotoxins;
that is, the poison may be a salt of one of the
poisonous metals, such as arsenic, mercury, or
silver. It may be one of the crude drugs, such as
opium, belladonna, or perhaps one of their many
alkaloids, the most common of which are mor-
phine, codeine, heroin, atropine, and strychnine.
There are many drugs that produce nausea and
vomiting, but the number that may be used in-
tentionally to cause a patient to vomit is relatively
small. Vomiting may be stimulated by gagging or
stroking the throat with the finger or a tongue
depressor when the stomach is full of liquid.
When an emetic is required, the following may
1 to 3 teaspoons of powdered mustard in
a glass of warm water
Warm, soapy water
Warm, salty (2 teaspoonfuls of table salt)
Ipecac syrup, 15 to 30 ml
RESPONSIBILITIES PERTAINING TO
ALCOHOL, AND DANGEROUS
Hospital corpsmen handling controlled
substances and other drugs are held responsible
for their proper distribution and custody.
Nowhere is the demand for strict integrity more
important. Misuse, abuse, loss, and theft of these
substances has always, sooner or later, ended in
tragedy and severe consequences. No one has ever
profited by their misappropriation.