ACCIDENTAL POISONING - a patient's guide
The National Poisons Centre

POISONING PREVENTION

Safe use and storage of household chemicals:

Store all household and garden chemicals in a locked cupboard. Examples include weed or plant sprays, ant, rat or mouse bait, insect repellents, petrol, turpentine etc.

Store all household cleaning products out of reach of children. Examples include furniture polish, bleach, dishwashing liquid, machine dishwasher powder, all-purpose cleaners, washing machine powder or liquid.

Chemicals and cleaning products should always be kept in their original container, with a tightly fitting lid.

Drinking glasses, beverage bottles or food containers should never be used for storage of chemicals. To do this is both very dangerous and illegal.

The manufacturers of chemicals and household cleaning products print "instructions for use" on the container. These instructions are for your safety and should always be read before use, even if you have used the product before.

Protective clothing is designed for your personal safety and should be used correctly. Faulty or broken equipment should be replaced.

Only use garden or agricultural sprays when there is no wind. When spraying you should also remember the safety of your family and neighbours.

If you have chemicals that are no longer needed, it may not be safe, or legal, to simply tip them down a drain or to put them into household rubbish. Contact your local regional council for information on safe disposal.

Safe use and storage of medicines:

Store all medicines, whether tablets, inhalers, or syrup, out of reach of children, and preferably in a locked cupboard. When picking up your medicines from a pharmacist ask for child resistant packaging.

Always keep medicines in their original bottle or packet and never put different tablets or capsules in the same container.

Children should be encouraged to take their medicines without referring to them as lollies, sweets, or soft drinks. Be positive without associating them with food or drink.

Always check the label on the bottle or packet before taking your drugs or if required to give them to somebody else, e.g. your children or someone you care for. If you are not sure about the instructions, check with your doctor.

Medicines which are out-of-date or belong to somebody else should not be used.

Return all unused and out-of-date drugs to your local pharmacist. It is not appropriate to simply dispose of them down the toilet, kitchen sink or in household rubbish.

Garden plants

Children should be encouraged to enjoy the plants in the garden without eating them.

It may not be advisable to have plants which are poisonous within reach of children.

Berries, flowers and other plant material which fall onto lawns or garden paths should be cleared away so that children are not tempted to put them in their mouth.

It is a good idea to know the names of the plants in your garden and your pot plants, so that the correct information can be given if it is needed.

Burning rubbish

If you have to burn any rubbish always do so in an open area, and be careful not to allow the smoke to blow towards your family or neighbours. Smoke may cause irritation to the throat and lungs. Some plant material can produce poisonous fumes if burned, e.g. oleander.

Treated wood (tanalised) and plastics are not safe to burn.

Old chemical containers or medicine packets, especially inhalers, should not be burned.

FIRST AID FOR POISONING

General Guidelines

These general guidelines apply to all cases of poisoning or suspected poisoning:

If you stay calm then the person you are helping will also stay calm.

Protect yourself from poisoning, especially if there is smoke, fumes, or a lot of chemical spilt.

Check to see if the person is conscious by talking to them. If you don't get a reply, check that they are breathing and have a pulse. If the person is unconscious, but is breathing and has a pulse, place them on their side (recovery position).

If there is no pulse and/or they are not breathing, immediately start resuscitation. The mouth-to-nose technique must be used if there is any chance the rescuer may be contaminated by the poison by using the mouth-to-mouth technique.

Call for urgent medical attention, usually an ambulance.

Try to identify the chemical or drug involved so that the correct information can be obtained from the National Poisons Centre.

If a poison is swallowed (ingestion)

The poisoning (or first aid) advice on containers or packets may not be correct. In all cases where a poison has been swallowed contact the National Poisons Centre or a doctor.

It is not advisable to make the person vomit. In some cases this may even be dangerous.

Giving fluids to drink may not be helpful unless the poison is corrosive, e.g. acid or alkaline. If a corrosive substance is swallowed, give water to drink, and immediately contact the Poisons Centre for further advice. Have the name of the poison written down when you call.

Some household products, such as dishwashing liquids, cause irritation to the stomach leading to nausea and vomiting. It is particularly important in children that if vomiting does occur, none of the vomit is inhaled, as damage to the lungs is possible. Children should not be put to bed after swallowing any poison without first contacting the Poisons Centre or a doctor.

Ipecac should only be given on the advice of the National Poisons Centre.

Splashes in the eye

The eyes are very sensitive and are quickly damaged when liquids or powders are splashed into them.

Water is recommended for flushing the eyes after exposure to any chemical or product.

Flush the eye(s) with copious amounts of water. It is necessary to continue flushing the eye(s) for at least 20 minutes, and sometimes longer. Use a glass or low pressure running water.

Always allow the running water to run from the nose to the ear so that the chemical is not flushed into the other eye.

While you are flushing, carefully lift the upper and lower lids so that the water can flush away the chemical from under both eyelids.

If contact lenses are worn, these should be removed while flushing is in progress.

Whenever something is splashed into the eye you should go to the nearest hospital or medical centre so that an assessment of the eyes can be made. Do this after you have flushed the eyes.

If corrosive products, e.g. acids or alkalis, are splashed in the eye do not hesitate to call an ambulance. Ambulance officers can assist with the flushing while travelling to the hospital.

If in doubt always call the National Poisons Centre, a doctor or ambulance.

Smoke, fumes of gases

Protect yourself.

Remove the person from the source as quickly as possible, making sure they can get plenty of fresh air.

Stay upwind of the source.

Call for medical assistance from the ambulance service or a doctor.

Skin exposure

Remove the person from the source of the chemical and immediately flush the affected skin area with copious amounts of water.

Remove contaminated clothing and jewellery, unless there is burnt skin or the clothing is stuck to the skin.

If a large area of skin has been exposed, call an ambulance while still flushing the affected area.

If only a small area is involved, continue flushing with water for 15-20 minutes. If pain, swelling or irritation persists seek medical attention from a hospital or medical centre.

The Fire Service may be needed to assist with chemical spills. Do not hesitate to call them if you are unsure.

Insects and animals

If you are bitten or stung, wash the bite with a mild soap and water.

Local application of an ice pack may be helpful in reducing pain and swelling.

Jellyfish tentacles can be removed by flushing them with sea water or scrapping them off with a plastic card.

Any open wounds should be treated by a doctor, especially if foreign material is present.

If excessive swelling, redness of the skin, itchy hive-like areas, difficulty breathing or swallowing, or a general feeling of illness develop, a doctor should be consulted as soon as possible.

Spider bites

If possible keep the spider for positive identification.

Wash the bite area with a mild soap and water.

Apply an ice pack over the area to help relieve pain and swelling if they occur.

If signs of infection develop, i.e. redness, swelling, tenderness, medical attention should be sought.

Signs of generalised illness such as abdominal pain, or localised sweating around the bite area, may indicate a serious bite and urgent medical attention should be sought.

Good advice

Lock away all medicines and chemicals.
Know the phone phone for the Poisons Centre and your own family doctor.
Learn how to do CPR (resuscitation).
Know the plants and trees in your garden.
Use common sense at all times.

Getting help

Call and ambulance and seek urgent help from your local hospital if poisoning occurs.

The National Poisons and Hazardous Chemicals Information Centre (NPHCIC) can also help with information and advice. It is an integral part of the National Toxicology Group within the University of Otago.

The NPHCIC is best known for the 24-hour emergency telephone service which it operates from Dunedin. This service provides information and advice to health care professionals and members of the public in cases of acute poisoning or accidents involving chemicals, either in the workplace or home. In addition the Centre provides written information where non-urgent advice is required.

New Zealand: The staff at the Centre maintain a computer database on the health effects of the various chemicals, medicines, plants and animals. For urgent advice phone (03) 474 7000, and non-urgent advice phone (03) 479 1200.

UK: Telephone advice from NHS Direct 0845 4647. In an emergency, dial 999 for an ambulance.