iii. Poisoning by Unknown Chemicals

in the MSDS for the chemical (note that current law requires chemical producers to provide

MSDSs to those who purchase chemicals from them). An MSDS file should be maintained in

every laboratory.

Even if the chemical causing the injury is not known and the victim is unconscious so that

no direct information is available, an examination of the circumstances of the accident and an

examination of the victim’s lips, skin, mouth, and tongue could provide helpful information on

whether the victim swallowed a poisonous substance or inhaled a toxic vapor, or whether the

injury was due to absorption through the skin. If the abdomen is distended and pressing on it

causes pain, the likelihood is that a corrosive or caustic substance has been ingested. Various

other symptoms such as nausea, vomiting, or dizziness can occur if the person has ingested

or inhaled a toxic substance. If there are blisters or discoloration of the skin, then external

exposure is likely. Any information on the nature of the harmful material will be helpful to the

emergency personnel or physician who will treat the victim.

iv. Poisoning by Inhalation

1. When poisoning by inhalation is suspected, evacuate the victim to a safe area as soon

as possible. If there are fumes still suspected to be present, a rescuer should wear a

self-contained respirator. Do not take a chance which might result in a second

victim.

2. Check for unusual breath odors if the victim is breathing.

3. Loosen tight clothing around the victim’s neck and waist.

4. Maintain an open airway.

5. If the victim is not breathing, perform artificial respiration using the manual method. It is

dangerous to the person providing aid to give mouth-to-mouth artificial respiration if

the toxic material is not known.

v. Poisoning by Ingestion

1. Examine the lips and mouth to ascertain if the tissues are damaged as a possible

indicator that the poison was ingested, although the absence of such signs is not

conclusive. Check the mouth and remove any dentures.

2. If the victim is not breathing, perform manual artificial respiration.

3. If the victim becomes conscious, try to get the victim to vomit, unless it is possible

tha t the poisoning is due to strong acids, caustics, petroleum products, or hydrogen

peroxide, in which case additional injuries would be caused to the upper throat

esophagus, and larynx. Vomiting may be induced by tickling the back of the throat.

Lower the head so that the vomit will not reenter the mouth and throat. Dilute the

poison in the stomach with water or milk.

4. If the victim has already vomited, collect a sample of the vomit, if possible, for

analysis.

5. If convulsions occur, do not restrain the victim, but remove objects with which he

might injure himself or orient the victim to avoid his striking fixed, heavy objects.

6. Watch for an obstruction in the victim’s mouth. Remove if possible, but do not force

fingers or a hard object in between the victim’s teeth. If a soft pad can be inserted

between the victim’s teeth, it will protect the tongue from being bitten. A badly

bleeding tongue immensely complicates the patient’s problems.

7. Loosen tight clothing, such as a collar, tie, belt, or waistband.

8. If the convulsions cease, turn the victim on his side or face down so that any fluids in

the mouth will drain.

9. Treat for shock if the symptoms for shock are noted.

vi. Poisoning by Contact

1. If the chemical got into the victim’s eyes, check for and remove any contact lenses.

Take the victim immediately to an eyewash station (if one is not available, to a shower

or even a sink) and wash the eyes, making sure that the eyelids are held widely open.

Wash for at least 15 minutes. If the chemical is caustic rather than acidic, the victim



©2000 CRC Press LLC



2.

3.

4.



5.



may not feel as much pain and may wish to quit earlier, since an acid causes pain due

to the precipitation of a protein complex. An alkali or caustic chemical is more

dangerous than an acid as it does not precipitate the protein and continues to

penetrate the globe of the eye and may even lead to global rupture. It is imperative that

the eye be flushed out thoroughly.

Do not use an eye ointment or neutralizing agent.

If the chemical only came in contact with the victim’s exposed skin, such as the hands,

wash thoroughly until the chemical is totally removed.

If the chemical was in contact with the clothed portion of the body, remove the

contaminated clothes as quickly as possible, protecting your own hands and body,

and place the victim under a deluge shower. If the eyes were not affected initially,

protect them while washing the contaminated areas. Be careful not to damage the

affected skin areas by rubbing too firmly. Let the flowing water rinse the chemical off.

A detergent is sometimes used, but be careful not to carry the offending chemical to

other parts of the body. Be particularly careful to clean folds, crevices, creases, and

groin.

If both the eyes and portions of the body were exposed, there should preferably be a

combination eyewash and deluge shower unit available. If not, take the victim to the

deluge shower and tilt the head back, holding the eyelids widely open, and wash the

entire body.



vii. Heat Burns

First Degree (minor): Painfu l and red. No blisters. Skin elastic. Epidermis only. Minimal

swelling.

1. Apply cold water to relieve pain and facilitate healing.

2. Avoid re-exposure, as the already injured skin can be more susceptible to further

damage than normal skin.

Second Degree: Severe and painful, but no immediate tissue damage. Pale to red.

Weeping blisters, vesicles. Marked swelling. Involves epidermis and dermis.

1.

2.

3.

4.

5.



Immerse affected area in cold water to abate the pain.

Apply cold, clean cloths to the burned area.

Carefully blot dry.

Do not break blisters.

If legs or arms are involved, keep them elevated with respect to the trunk of the body.



Third Degree: Deep, severe burns, likely tissue damage. White, red, or black and dry and

inelastic tissue. No pain, involves full thickness of skin. May involve subcutaneous

tissue, muscle, and bone.

1. Do not remove burned clothing from the burned area.

2. Cover the burned area with a thick, sterile dressing or clean cloths.

3. Do not immerse an extensively burned area in cold water, because this could exacerbate the potential for shock and introduce infection. A cold pack may be used on

limited areas such as the face.

4. If the hands, feet, or legs are involved, keep them elevated with respect to the trunk of

the body.

5. Third-degree burns must be treated by a physician and/or hospital. They may need

reconstruction, skin grafting, and prolonged care. Control of infection is mandatory.



©2000 CRC Press LLC



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©2000 CRC Press LLC



Science,



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1110 Sangamon

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ACS