Figure 4-70.—Stingray sting.
(fig. 4-70). General signs and symptoms include swelling, nausea, vomiting, generalized cramps, diarrhea, muscular paralysis, and shock. Emergency care consists of prompt flushing with cold sea water to remove the venom and to constrict hemorrhaging blood vessels. Next, debride the wound of any remaining pieces of the spine’s venom-containing integumentary sheath. Soak the wound area in very hot water for 30 to 60 minutes to neutralize the venom. Finally, completely debride the wound, control hemorrhage, suture, provide tetanus prophylaxis and a broad-spectrum antibiotic, and elevate the extremity.
Sea snakes are found in the warm water areas of the Pacific and Indian Oceans. Their venom is VERY poisonous, but their fangs are only 1/4 inch long. It is advisable to follow the first aid steps outlined for the treatment of land snakebites.
DRUG ABUSE
Drug abuse is the habitual or excessive use of drugs for purposes or in quantities for which they were not intended.
Drugs are chemical compounds or biological substances that, when introduced into the body, affect its mental or physical functions. When abused, drugs become a source of “poison” to the body. They can lead to serious illness, dependency, and death. Death is usually due to acute intoxication or overdose.
The group classification used in this manual is intended to categorize drugs most commonly abused into useful clusters. For our purposes, it is considered the most appropriate of several methods of classification. Table 4-8 list the drugs with their recognized trade names, some commonly used street names, and observable symptoms of abuse.
The following sections contain specific information about commonly abused drugs, as classified in table 4-8, including availability and methods of administration.
Narcotic Intoxication
Unfortunately, abuse of narcotic drugs is common. This group of drugs includes the most effective and widely used pain killers in existence. Continual use of narcotic drugs, even under medical supervision, inevitably leads to physical and psychological dependence. The more commonly known drugs within this group are opium, morphine, heroin, codeine, and methadone (a synthetic narcotic). In addition, Darvon and Talwin are included in this group because of their narcotic-like action. Next to cocaine (discussed later), heroin is the most popular narcotic drug because of its intense euphoria and long-lasting effect. It is far more potent than morphine but has no legitimate use in the United States. Heroin appears as a white, gray, or tan, fluffy powder. The most common method of using heroin is by injection directly into the vein, although it can be sniffed. Codeine, although milder than heroin and morphine, is sometimes abused as an ingredient in cough syrup preparations. Symptoms of narcotic drug abuse include slow shallow breathing, possible unconsciousness, constriction (narrowing) of the pupils of the eyes to pinpoint size, drowsiness, confusion, and slurred speech.
The narcotic drug abuser, suddenly withdrawn from drugs, may appear as a wildly disturbed person who is agitated, restless, and possibly hallucinating.
Alcohol Intoxication
Alcohol is the most widely abused drug today. Alcohol intoxication is so common that it often fails to receive the attention and respect it deserves. Although there are many alcohols, the type consumed by people is known as ethyl
