By Sarah Hannan The National Hospital of Sri Lanka in their statistics reveals that the highest amount of admissions due to poisoning are reported as a result of toxic effects from pesticides and in 2016, there were 348 patients admitted into hospitals islandwide. However, the most number of deaths due to poisoning is recorded as a result of toxic effects of other substances, which stood at 42,095 for 2016. We inquired from the Toxicology and National Poison Information Centre Head of Department Dr. Waruna Gunathilake about the common signs we should look out for in order to understand that a person is poisoned, the type of first aid that should be provided to someone in that occasion, and what should be avoided. “Poisoning can take place through various mediums and the most common type of poisoning takes place through food. Apart from that, one might also get gas poisoning, poisoning through animal bites, poisoning by alcoholic beverages and pharmaceuticals, or even day-to-day chemicals that are used for household cleaning and pesticides, as well as toxic plants. In any case, it is always important to know what type of first aid should be provided for a person who is poisoned until they are referred to a health professional,” Dr. Gunathilake stated. It is important to know what caused the poisoning, so you could provide the appropriate first aid. But most importantly, when you are calling for professional help or taking the person to the doctor, they would treat them efficiently. Common signs to look out for if you suspect that a person is poisoned: sleepiness, confusion or other unexpected signs, abnormal behaviour, dizziness, double vision, headache, irritability, seizures, weakness, loss of consciousness and muscle twitching, abdominal pain, diarrhoea, vomiting, loss of appetite, nausea, burning pain in the skin and eyes, cough, difficulty breathing or shortness of breath, palpitations, loss of bladder control, skin rash or burns, redness around the mouth and lips or bluish lips from drinking certain poisons, stains and odours on the person, on clothing, on furniture, floor, rugs, or other objects in the surrounding area, empty medication bottles or scattered pills nearby. First aid for poisoning by swallowing

• Try to make sure that the person has actually been poisoned
• If possible, try to identify the poison (some signs include chemicals-smelling breath, burns around the mouth, difficulty in breathing, vomiting, or unusual odours from the person)
• Carefully handle the poisoned patient
• If the person vomits, clear the person's airway
• Wrap a cloth around your fingers before cleaning out the mouth and throat
• If the person has been ill from a part of a plant, preserve the vomitus to be sent for analysis
• If the person gets convulsions, give first aid accordingly – keep the patient in a left lateral position until medical help arrives
• If the poison has spilled on the person's clothes, remove the clothing and flush the skin with water
• Preserve and hand over the containers and the labels to the medical staff if possible

First aid for inhalation of poison

• Call for emergency help. Never attempt to rescue a person without notifying others first
• If it is safe to do so, rescue the person from the dangers of gas, fumes, or smoke. Open windows and doors to remove the fumes
• Take several deep breaths of fresh air, and then hold your breath as you go in. Hold a wet cloth over your nose and mouth
• Do not light a match or use a lighter because some gases can catch fire
• After rescuing the person from danger, check and monitor the person's airway, breathing, and pulse. If necessary, begin CPR
• If necessary, perform first aid for eye injuries or convulsions
• If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat
• Even if the person seems perfectly well, get medical help

First aid for snake bites

• Immobilise the patient to retard systemic absorption of venom
• Reassure and control early symptoms of envenoming
• Attend to the site of bite
• Establish ABC (Airway, Breathing, Circulation) and prevent hypoxaemia
• Take the patient to the nearest hospital immediately
• Do not make any incision at the site of the bite and avoid administering any medicines, traditional medicines, nasal insufflations of medicines, or applying tourniquets
• Do not give aspirin or alcohol

Avoid performing the following actions on a person that is poisoned:

• Do not give anything by mouth to an unconscious person
• Do not induce vomiting unless you are told to do so by the Poison Control Centre or a doctor (may lead to aspiration pneumonia)
• Do not try to neutralise the poison with lemon juice, vinegar, or any other substance, unless you are told to do so by the Poison Control Centre or a doctor
• Do not use any antidote without medical advice
• Do not wait for symptoms to develop if you suspect someone has been poisoned

Prevention and precaution Be aware of poisons in and around your home. Take steps to protect small children from toxic substances. All medicines, cleaners, cosmetics, and household chemicals should be stored out of reach from children, or stored in cabinets/cupboards with childproof latches. Be familiar with plants in your home, yard, and vicinity and keep your children informed too. Remove any poisonous plants and never eat wild plants, mushrooms, roots, or berries unless you are very familiar with them. Teach children the dangers of substances that contain poisons and label all poisons. Do not store household chemicals in food containers, even if they are labelled so. Most non-food substances are poisonous if taken in large doses. If you think that industrial poisons might be polluting nearby land or water, report it to the local health department or public health inspector. Alternatively, you could contact the National Poison Information Centre through 0112 686 143 or on 0112 691 111 on extension number 2430. They operate 24 hours a day, seven days a week.