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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 22

Toxicology

Learning objectives (14)

  1. Define toxicology, poison, toxin, and overdose — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  2. Demonstrate how to administer activated charcoal — Knowledge/skills objective (printed page 822); confirm wording in your course copy.
  3. Demonstrate how to assess and treat a patient with a suspected overdose — Knowledge/skills objective (printed page 822); confirm wording in your course copy.
  4. Demonstrate how to assess and treat a patient with a suspected poisoning — Knowledge/skills objective (printed page 822); confirm wording in your course copy.
  5. Describe how poisons and toxins can enter the body — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  6. Describe the assessment and treatment of a patient with a suspected overdose — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  7. Describe the assessment and treatment of a patient with a suspected poisoning or toxic exposure — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  8. Describe the assessment and treatment of a patient with suspected food poisoning — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  9. Describe the assessment and treatment of a patient with suspected plant poisoning — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  10. Discuss how to manage a patient who has overdosed on an opioid or opiate and who has gone into cardiac or respiratory arrest — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  11. Discuss scene safety considerations for working at a scene with a potentially hazardous material or violent patient — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  12. Explain the use of activated charcoal, including indications, contraindications, and the need to obtain approval from medical control before administration — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  13. Identify the common signs and symptoms of poisoning or toxic exposure — Knowledge/skills objective (printed page 821); confirm wording in your course copy.
  14. Understand the role of airway management in a patient suffering from poisoning or overdose — Knowledge/skills objective (printed page 821); confirm wording in your course copy.

Vocabulary (13)

Toxin (poison)
Any substance that, in sufficient quantity, produces harmful effects on the body.
Ingested poison
A poison taken in by mouth — the most common route of exposure in the United States.
Inhaled poison
A poison absorbed through the lungs — examples include carbon monoxide, smoke, and chlorine gas.
Absorbed poison
A poison that crosses the skin or mucous membranes — pesticides and some chemicals.
Injected poison
A poison delivered through the skin barrier — including snake or insect envenomation and IV drug overdoses.
Activated charcoal
An oral adsorbent that binds many ingested toxins in the gut to limit systemic absorption; used selectively and within scope.
Naloxone (Narcan)
An opioid antagonist that reverses respiratory depression caused by opioids; commonly given 0.4–2 mg intranasal or intramuscular.
Opioid
A class of drugs — natural and synthetic — that act on opioid receptors; includes heroin, morphine, oxycodone, and fentanyl.
Opioid toxidrome (triad)
The classic triad of opioid overdose — pinpoint pupils, depressed respirations, and decreased mental status.
Sympathomimetic toxidrome
A pattern of stimulant overdose — tachycardia, hypertension, hyperthermia, dilated pupils, agitation — from drugs like cocaine or methamphetamine.
Carbon monoxide poisoning
A toxic exposure to colorless, odorless CO gas that binds hemoglobin and prevents oxygen delivery; presents with headache, confusion, and nausea.
Poison Control Center
A 24-hour resource available at 1-800-222-1222 in the U.S. that provides expert guidance on poisoning emergencies.
Withdrawal syndrome
A characteristic set of signs and symptoms that occur after sudden cessation or reduction of a substance to which the body has adapted.

Sequence practice (2 puzzles on Quiz Me)

Field response to a suspected opioid overdose

Order EMT actions for an unresponsive patient with the opioid triad.

  1. Ensure scene safety; consider environmental hazards
  2. Open airway and assess breathing; assist with BVM as needed
  3. Recognize the opioid triad — pinpoint pupils, depressed respirations, decreased mental status
  4. Administer naloxone intranasal or intramuscular per protocol
  5. Continue ventilation; repeat naloxone if no response after 2–3 minutes
  6. Monitor for recurrence of respiratory depression and transport
Toxicologic history — what the EMT asks

Order the focused questions when poisoning is suspected.

  1. What substance was taken or to which was the patient exposed?
  2. How much (dose, container size)?
  3. When did the exposure occur?
  4. By what route — ingested, inhaled, absorbed, injected?
  5. Has the patient vomited or taken any antidote?

Quick fire sample (13 of 13 on Quiz Me)

Any substance that, in sufficient quantity, produces harmful effects on the body.
  1. Opioid toxidrome (triad)
  2. Toxin (poison)
  3. Sympathomimetic toxidrome
  4. Poison Control Center
A poison taken in by mouth — the most common route of exposure in the United States.
  1. Sympathomimetic toxidrome
  2. Poison Control Center
  3. Ingested poison
  4. Opioid toxidrome (triad)
A poison absorbed through the lungs — examples include carbon monoxide, smoke, and chlorine gas.
  1. Inhaled poison
  2. Sympathomimetic toxidrome
  3. Naloxone (Narcan)
  4. Withdrawal syndrome
A poison that crosses the skin or mucous membranes — pesticides and some chemicals.
  1. Withdrawal syndrome
  2. Absorbed poison
  3. Inhaled poison
  4. Opioid toxidrome (triad)
A poison delivered through the skin barrier — including snake or insect envenomation and IV drug overdoses.
  1. Injected poison
  2. Ingested poison
  3. Withdrawal syndrome
  4. Sympathomimetic toxidrome
An oral adsorbent that binds many ingested toxins in the gut to limit systemic absorption; used selectively and within scope.
  1. Activated charcoal
  2. Ingested poison
  3. Opioid toxidrome (triad)
  4. Poison Control Center
An opioid antagonist that reverses respiratory depression caused by opioids; commonly given 0.4–2 mg intranasal or intramuscular.
  1. Absorbed poison
  2. Toxin (poison)
  3. Naloxone (Narcan)
  4. Sympathomimetic toxidrome
A class of drugs — natural and synthetic — that act on opioid receptors; includes heroin, morphine, oxycodone, and fentanyl.
  1. Withdrawal syndrome
  2. Inhaled poison
  3. Opioid
  4. Carbon monoxide poisoning
The classic triad of opioid overdose — pinpoint pupils, depressed respirations, and decreased mental status.
  1. Opioid
  2. Inhaled poison
  3. Opioid toxidrome (triad)
  4. Toxin (poison)
A pattern of stimulant overdose — tachycardia, hypertension, hyperthermia, dilated pupils, agitation — from drugs like cocaine or methamphetamine.
  1. Ingested poison
  2. Sympathomimetic toxidrome
  3. Opioid toxidrome (triad)
  4. Poison Control Center
A toxic exposure to colorless, odorless CO gas that binds hemoglobin and prevents oxygen delivery; presents with headache, confusion, and nausea.
  1. Toxin (poison)
  2. Inhaled poison
  3. Carbon monoxide poisoning
  4. Opioid
A 24-hour resource available at 1-800-222-1222 in the U.S. that provides expert guidance on poisoning emergencies.
  1. Poison Control Center
  2. Injected poison
  3. Carbon monoxide poisoning
  4. Absorbed poison
A characteristic set of signs and symptoms that occur after sudden cessation or reduction of a substance to which the body has adapted.
  1. Opioid toxidrome (triad)
  2. Sympathomimetic toxidrome
  3. Withdrawal syndrome
  4. Activated charcoal

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/22/print/. Answers are not marked on this sheet.