treat for shock. Immobilize the injured part, keep it at rest, and protect it from further injury. Sometimes the victim will be more comfortable if the bruised area is bandaged firmly with an elastic or gauze bandage. If possible, elevate the injured part. A sling may be used for a bruised arm or hand. Pillows or folded blankets may be used to elevate a bruised leg.
POISONS AND DRUG ABUSE
A poison is a substance that, when taken into the body, produces a harmful effect on normal body structures or functions. Poisons come in solid, liquid, and gaseous forms and may be ingested, inhaled, absorbed, or injected into the system. Children are most susceptible to toxic substances, but as a hospital corpsman you must also be prepared to respond to the accidental or intentional poisoning of adult victims. The handling of drug abuse cases will be covered at the end of this section.
OBTAINING INFORMATION
As a general rule, your first contact, whether on the phone or in person with a suspected poisoning victim or the victim’s relatives or friends, will be complicated by excitement, especially if you are dealing with a parent. It is absolutely essential that you be calm, professional, and systematic if you are to be able to elicit all the essential information you will need.
After maintenance of life support systems, the first priority is to identify the poison. If the poisoning was not witnessed, and if the victim cannot or will not identify the agent, it becomes necessary to obtain the container that held the poison. A commercial label on the container should identify the name of the product, the ingredients, and the antidote to any toxic substance it may contain. If there is no label or if you suspect that the container held an unidentified substance other than that listed on the side, send the container along with the victim to the hospital for laboratory analysis.
The second priority is to determine the quantity of poison taken. Once again, if the victim cannot or will not provide the information, the container must be checked. Whatever is not in the container is normally considered to be in the victim, unless someone familiar with the container can verify the quantity previously used.
The third priority is to determine as closely as possible the time the poisoning occurred. If it was not witnessed, careful questioning of bystanders and the victim may be needed to approximate the time.
The fourth priority is to establish as accurately as possible the victim’s symptoms and medical history. The symptoms will give you a good idea of the severity of the poisoning and its progression. They will also give you a clue as to whether the victim has taken any additional poisons. The medical history can establish if this is a repeat poisoning and if the victim has any illnesses or is using medications that may contraindicate certain methods of treatment.
Quick systematic questioning will give basic information about the poison and the victim’s condition. Additional information about the toxic ingredients of almost every commercial product, along with recommended antidotes and treatments, is readily available through poison control centers at medical treatment facilities throughout the country. Area centers are listed in the front of every telephone directory. Also, be familiar with your command’s antidote locker and poison chart. With all this information in hand, a medical professional will be able to quickly assess the situation and plan and implement a course of treatment.
GENERAL TREATMENT
In most situations, the treatment of a poisoning victim will be under the direction of a medical officer. However, in isolated situations, a hospital corpsman must be ready to treat the victim.
Poisoning should be suspected in all cases of sudden, severe, and unexpected illness. Once poisoning has been established, the general rule is to quickly remove as much of the toxic substance from the victim as possible. For most ingested poisons, there is a choice between emetics and gastric lavage, followed by absorbents and cathartics; for inhaled poisons, oxygen ventilation is the method of choice; for absorbed poisons, this primarily means cleansing the skin; and for injected poisons, antidotal medications are recommended.
INGESTED POISONS
Noncorrosives
The many different noncorrosive substances have the common characteristic of irritating the
