What is a poison? Clarifying poison-related terms

What is a poison?

Simply put, a poison is any substance that can cause harm to the body. In books and movies, poisons are often presented as strange and mysterious chemicals or products that, when consumed, touched or inhaled, cause intense sickness or immediate death. In real life, most poisonings are actually much less dramatic, but can affect the human body in complicated ways. 

• Poisons come in all different shapes, sizes, and forms.

• Poisoning can be intentional (on purpose) or unintentional (accidental).

• Poison exposures can be acute (a single event, short-term) or chronic (longer-term). 

• Poison exposures can occur by many different routes - by mouth, eye, skin, inhalation, injection or bites and stings.

Almost anything can be poisonous or toxic when used in the wrong way, wrong amount or dose, or by the wrong person. Even usually harmless substances like water can be poisonous in certain circumstances.

Toxicity refers to the ability of a substance to cause harm to the body. As was described by Paracelsus (1493-1541): “What is it that is not poison? All things are poison and nothing is without poison. It is the dose only that makes a thing not a poison.”

SWALLOWED Poisons

Drink a small amount of water or milk immediately if:

• The product swallowed is burning, irritating or caustic, AND

• The person is conscious, not having convulsions, and able to swallow. 

Do not induce vomiting. Ipecac syrup is no longer recommended.

Then, get help from poison experts. There are 2 ways to get help:

1. Use the webPOISONCONTROL online tool to get specific recommendations based on age, substance, amount and symptoms, OR

2. Call a poison center at 1-800-222-1222 for expert guidance.

In the EYE

It's important to irrigate (rinse) the exposed eyes, immediately.

• Every second matters and a delay could result in loss of sight.

• Remove contact lenses.

• Use lots of room temperature water and irrigate for at least 15 to 20 minutes.

  • Adults and older children may find it easier to hop in the shower.

  • Wrap young children in a towel and let water from the faucet in the kitchen sink run over the eye - or slowly pour water from a pitcher. Let the water hit the bridge of the nose and gently run into the eyes rather than pouring the water directly into the eye.

  • Important: Irrigate for at least 15 to 20 minutes. Encourage blinking.

• After the 15 to 20 minute irrigation, let the eye rest while you use the webPOISONCONTROL tool or call your poison center at 1-800-222-1222 for additional help.

• If irritation, pain, visual problems, redness, swelling, or tearing persist an hour after irrigation is started, you'll need an urgent ophthalmic exam. That means a trip to an urgicenter or emergency room right away, unless an eye doctor can see you immediately. If the symptoms are severe, don't wait an hour - go straight to an emergency room after irrigating.

On the SKIN

It's important to rinse the exposed skin immediately.

• Remove contaminated clothing first (that's clothing with a spill).

• Every second matters. Don't delay.

• Use lots of room temperature running water and rinse for at least 15 minutes.

  • For large spills, adults and older children may find it easiest to hop in the shower.

  • Mild hand soap can be used to remove material that sticks to the skin.

  • Important: Rinse for at least 15 minutes.

• After the 15 minute rinse, use the webPOISONCONTROL tool or call a poison center at 1-800-222-1222 for additional guidance.

• If blistering, large or deep burns, pain, redness, or swelling worsen or persist, you will need to see a doctor right away. But first, call a poison center to see whether a trip to an urgicenter or emergency room is urgent or necessary. If the symptoms are severe, go straight to an emergency room after rinsing. Don't wait.

INHALED

It's important to move to fresh air immediately.

• Stay away from all toxic fumes and gases.

• Thoroughly ventilate the involved area.

After moving to fresh air, use the webPOISONCONTROL tool or call a poison center at 1-800-222-1222 for additional help.

Ingested a battery? Here's what to do.

Every year in the United States, more than 3,500 people of all ages swallow button batteries. Worse still, an estimated 3,000 to 8,000 people worldwide have serious complications or die from ingested button batteries. These miniature batteries are used to power hearing aids, watches, toys, games, flashing jewelry, singing greeting cards, remote control devices, and many other items. Call 1-800-498-8666, use webPOISONCONTROL, or call a poison center at 1-800-222-1222 for guidance if someone swallows a battery. Don't delay. Immediate treatment decreases severity.

Most button batteries pass through the body and are eliminated in the stool. However, sometimes batteries get "hung up", and these are the ones that cause problems. A battery that is stuck in the esophagus is especially likely to cause tissue damage. An electrical current can form around the outside of the battery, generating hydroxide (an alkaline chemical) and causing a tissue burn. When a battery is swallowed, it is impossible to know whether it will pass through or get "hung up".

If anyone ingests a battery, this is what you should do:

1. Immediately call the 24-hour National Battery Ingestion Hotline at 1-800-498-8666, use webPOISONCONTROL, or call your poison center at 1-800-222-1222

2. If readily available, provide the battery identification number, found on the package or from a matching battery.

3. In most cases, an x-ray must be obtained right away to be sure that the battery has gone through the esophagus into the stomach. If the battery remains in the esophagus, it must be removed immediately. Most batteries move on to the stomach and can be allowed to pass by themselves.  Based on the age of the patient and size of the battery, the National Battery Ingestion Hotline specialists can help you determine if an immediate x-ray is required.

4. Don't induce vomiting. 

5. If the battery was swallowed within the prior 12 hours, especially if it might have been a lithium coin cell, and the child is able to swallow, give 2 teaspoons of honey every 10 minutes while going to the ER. DO not delay going to the ER to give honey. Other than honey, don't eat or drink until an x-ray shows the battery is beyond the esophagus.

6. Batteries stuck in the esophagus must be removed as quickly as possible as severe damage can occur in just 2 hours.

7.  Watch for fever, abdominal pain, vomiting, or blood in the stools. Report these symptoms immediately.

8. If removal was not required, check the stools until the battery has passed.

9. Your physician or the emergency room may call the National Button Battery Ingestion Hotline at 1-800-498-8666 for consultation about button batteries. Expert advice is available 24 hours a day, 7 days a week.

Button batteries may also cause permanent injury when they are placed in the nose or the ears. Young children and elderly people have been particularly involved in this kind of incident. Symptoms to watch for are pain and/or a discharge from the nose or ears. DO NOT use nose or ear drops until the person has been examined by a physician, as these fluids can cause additional injury if a battery is involved.

What are the most dangerous types of poisons for children?

These are especially hazardous household items. To help prevent poisoning, buy small quantities, discard unneeded extras, and make sure they are always out of a child's reach.

• Medications: Medicines are OK in the right amount for the right person, but they can be dangerous for children who take the wrong medicine or ingest too much. And we don't just mean prescription medications; even over-the-counter medicines can be very dangerous!

• Carbon monoxide: Not all poisons are swallowed; some are inhaled, or breathed in. Carbon monoxide gas is an invisible killer. It has no color or odor. Take it seriously. Make sure there's a carbon monoxide alarm in every sleeping area of your home.

• Button batteries: Button batteries (sometimes called disc batteries or coin cells) can be found in musical greeting cards, remote controls, key fobs, and other small electronic devices. Be especially mindful of the 20 mm lithium coin cell battery. When swallowed by a child, especially one younger than 4 years, it often lodges in the esophagus causing burns within just 2 hours. A hole in the esophagus may develop and the burn can extend into the trachea or aorta. More than 70 children have died from ingesting button batteries.

• Iron pills: Adult-strength iron pills are very dangerous when ingested by children. Vomiting up blood or having bloody diarrhea can occur in less than an hour.

• Cleaning products that cause chemical burns: These can be just as bad as burns from fire. Products that cause chemical burns include drain openers, toilet bowl cleaners, rust removers, and oven cleaners. Inhalation of bleach, toilet bowl cleaner, the contents of laundry detergent pods, and oven and drain cleaners are also poison hazards.

• Nail glue remover and nail primer: Some products used for artificial nails can be poisonous in surprising ways. Some acetonitrile-containing nail glue removers have caused cyanide poisoning when ingested by children. Some nail primers have caused burns to the skin and mouth of children who tried to drink them. 

• Hydrocarbons: This is a broad category that includes gasoline, kerosene, lamp oil, motor oil, lighter fluid, furniture polish, and paint thinner. These liquids are easy to choke on, or aspirate, if swallowed. If that happens, they can go down into the lungs instead of the stomach. If a hydrocarbon gets into someone’s lungs, it can make it hard to breathe. They can also cause lung inflammation (like pneumonia). Hydrocarbons are among the leading causes of poisoning death in children.

• Pesticides: Chemicals to kill bugs and other pests must be used carefully to keep from harming humans. Many pesticides can be absorbed through skin. Many can also enter the body by inhaling the fumes. Some can affect the nervous system and can make it hard to breathe. 

• Windshield washer solution and antifreeze: Small amounts of these liquids are poisonous to humans and pets. Methanol-containing windshield washer solution can cause blindness and death if swallowed. Antifreeze can cause kidney failure and death if swallowed. 

• Wild mushrooms: Many types of mushrooms grow in many areas of the country. Some are deadly to eat. Only experts in mushroom identification can tell the difference between poisonous mushrooms and safe mushrooms. 

• Alcohol: When children swallow alcohol, they can have seizures, go into a coma, or even die. This is true no matter where the alcohol comes from. Mouthwash, facial cleaners, and hair tonics can have as much alcohol in them as alcoholic beverages.

• Drain cleaners and toilet bowl cleaners: These caustics cause devastating burns to the mouth, throat and stomach. Drain cleaners may be strongly alkaline and toilet bowl cleaners may be strong acids. If swallowed, they must be diluted immediately to limit the damage that rapidly occurs.

• Topical anesthetics: These medicines can cause seizures or a condition called methemoglobinemia which keeps the blood from carrying oxygen to the tissues. Be especially careful with teething gels, hemorrhoid preparations, anti-itch creams, and sunburn relief agents.