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2017 HCHB_digital

Poisonings Any substance

Poisonings Any substance that has the potential to cause injury, illness, or death if it enters the body, is considered a poison. This means that almost anything can be poisonous if taken in a large enough quantity. Children and older adults and people with coexisting medical conditions are at a much higher risk of fatality from poisoning. Poisoning in children More than 300 children are admitted to hospital in New Zealand each year as a result of unintentional poisoning; 81% of these poisonings occur in the home or the home of a family friend or relative. Chemical or cleaner poisonings account for most cases among children aged less than two, and prescription and over-thecounter medicines (notably anti-inflammatories, antidepressants, multivitamins, opioids, oral contraceptives, and paracetamol) are responsible for most incidents in children under five. Children aged one to four years are the most likely age group to be poisoned, but fortunately, death from poisoning in children is relatively rare. Poisoning in adults The majority of adult poisonings are intentional. Most fatal intentional selfpoisoning events involved carbon monoxide, while most poisoning admissions involved prescription and over-the-counter medicines. Construction workers and people who are exposed on a regular basis to chemicals or harmful dusts in the course of their work are also at high risk of chronic poisoning. Initial assessment Remind all customers to store their medicines out of reach of children, even people without children, as unintentional poisonings are just as likely to happen in the home of a relative or friend. Show concern if you notice that a customer, staff or family member appears depressed. New Zealand has a relatively high rate of suicide – more than 500 people each year take their own lives, with many more attempting suicide. Most people who commit suicide give some warning of their intentions to a friend, family member, or someone they trust. Be willing to listen and take the initiative to ask what is troubling them. Offer to source professional help and reassure them that depression can be treated and problems can be solved. If you suspect a person has ingested something poisonous call the Poisons Centre for professional advice BEFORE administering any first aid: phone 0800 POISON (0800 764 766). Calls to the Poisons Centre take only a couple of minutes, and provide the appropriate course of action, saving time and anxious moments overall. • NEVER induce vomiting unless told to do so by the Poisons Centre since this can cause more damage. • For non-urgent information, phone 03 479 7227 between 9am and 5pm. National Poisons Centre The NZ National Poisons Centre is New Zealand’s only poisons and hazardous information centre and runs a 24-hour, seven-day-a-week hotline all year round – 0800 POISON (0800 764 766). TREATMENT OPTIONS Type of poisoning First aid Poisons that have been swallowed Do NOT make the person vomit unless told to do so by a doctor or the Poisons Centre: 0800 POISON (0800 764 766). Remain calm. Protect yourself from poisoning and seek first-aid advice from the Poisons Centre or call 111 if the person is displaying serious symptoms of poisoning. If the person is unconscious, place in the recovery position and call 111. Bring the product container to the phone if you can. Do not give fluids unless instructed to do so by the Poisons Centre. Fluids may cause a person to vomit. For some toxic substances this can help the substance to be absorbed into the body and cause poisoning or may increase risk of burns to the throat. Do NOT rely on first-aid advice on labels (this is sometimes incorrect or out of date). Wipe the mouth out to clear away any remaining substance. Poisons that have been inhaled or breathed in Poisons that have been splashed in the eye Protect yourself from harm. Ventilate the area and quickly move the person away from the gas or fumes to fresh air if it is safe for you to do so. Check skin and eyes for chemical burns. Flush with water if necessary. Call the Poisons Centre for advice. If the person becomes unconscious, place in the recovery position and call 111. Do not attempt to remove an unconscious person from an area where highly toxic or unknown gas is without proper safety equipment including breathing apparatus. Keep yourself safe at all times. Flush immediately with clean room-temperature water poured from a jug, bottle, or low-pressure tap for at least 15 minutes. Pour water continuously across the eye. Ask a bystander to contact the Poisons Centre for further advice while flushing if possible. Do not use eye baths or solutions since these may react with the chemical. Take to a medical centre or hospital for an eye examination as soon as possible. Poisons that have been splashed onto the skin Poisons that are bites or stings Immediately flush the exposed area with lots of water for 15–20 minutes to remove all traces of the spilled poison. Seek medical attention if the skin is damaged or the person is showing other worrying signs. Treatment varies depending on type of bite or sting (see Bites and Stings for more detailed information), but generally the area should be washed with mild soap and water. See a doctor if there are signs of infection (redness, swelling, blistering, pain) and seek immediate medical attention if the person develops an allergic reaction (eg, rash, temperature, difficulty in breathing, swelling of the face and neck). DO NOT take an analgesic for pain without advice from a doctor unless the sting is from a common non-venomous creature (see Bites and Stings). PharmacyToday A part of your everyday Page 120 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

CONTINUING OTC EDUCATION Every year the centre receives over 30,000 telephone enquiries. The majority of people are able to be treated at home, but approximately 20% will require active treatment or investigation in hospital. The centre maintains TOXINZ (www.toxinz.com), a computerised database listing over 200,000 chemical and medicinal products, plants and hazardous creatures. TOXINZ is designed to be used both in a hospital and pharmacy environment. It contains succint, comprehensive information and delivers clear recommendations on patient management. Information is continually reviewed and updated to accommodate new information. Full access requires an annual subscription. Safety Messages • The Pharmaceutical Schedule (Section G) or the PSNZ Code of Ethics contains information on medicines that should be dispensed with child safety caps. »» Although difficult to open for most children aged under five years, child resistant packaging is not completely childproof, it merely delays access to the medicine or poison. »» Safe storage of medicines and toxic substances, out of reach and sight of children, remains essential. Always store medicines and other toxic substances in their original container and separately from food. Encourage customers to return unwanted medicines. »» Ensure customers know how to open and close safety caps correctly. • Do not keep the dishwasher door open when not in use. »» Children will often get into the dishwasher and eat the powder or tablets before or after the wash cycle. This can result in serious poisoning. • When giving out medication, check the customer understands the medicine instructions and maximum dosages. »» Check the customer has an appropriate medicine measure to use. »» Warn the customer of any potential “double-ups” of the same medicine in different products. • Do not use pesticides or lay baits where children might access them. • Never spray garden chemicals on a windy day and always inform neighbours of your intentions to spray. • Be mindful of any substance that is potentially toxic (eg, antifoul for boats, antifreeze) and take all recommended precautions. In an emergency •• If a child or adult is displaying serious symptoms of poisoning, treat as an emergency and dial 111 for an ambulance. •• For other suspected poisonings, immediately call the National Poisons Centre Urgent Phoneline 24-hours a day, seven-days a week on 0800 POISON (0800 764 766). •• Do NOT assume that first-aid information on the label is correct. •• Do NOT induce vomiting unless told to do so by the Poisons Centre. •• Bring the product container or plant to the phone if you can. •• Save any vomit, containers and labels in case they are needed later to help identify the poison. •• Always protect yourself from the poison. Garden plants Many plants commonly found in New Zealand gardens, parks and recreation areas may not be safe for children or may cause skin irritation if children come into contact with them (eg, arum lillies, black nightshade, daffodils, jonquils, snowflakes, snowdrops, swanplants, poinsettias, rhododendrons). Fortunately, fatalities in New Zealand from eating poisonous plants are extremely rare. Most plants are not tempting for children to eat and usually a child does not eat enough of a poisonous plant to cause serious illness. However, it is important to be aware of what poisonous plants may be present near where young children play and to educate young children about the dangers of eating new plants, particularly ones with fruits or berries, without the supervision of an adult. For more information see www.landcareresearch.co.nz, search term "poisonous plants" for the factsheets Plants in New Zealand Poisonous to Children and Safety in pre-school centres: plants to avoid. SUBSCRIBE • Latest pharmacy headlines • Online learning • Hot retail tips • Prizes & giveaways • Healthcare Handbook 09 488 4286 www.pharmacytoday.co.nz Page 121

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