PERTOLONGAN PERTAMA PADA KERACUNAN

DEFINISI :Adalah kejadian dimana organisme hidup kontak dengan zat beracun dan mempengaruhi fungsi organisme mahluk hidup tsb.Toxicology: Ilmu yang mempelajari efek yang kurang baik dari racun pada mahluk hidup/organisme hidupWhat is a Poison?All substances are poisons;there is none that is not a poison. The right dose differentiates a poison and a remedy.

Paracelsus (1493-1541)KERACUNAN

The study of the adverse effects of a toxicant on living organismsAdverse effectsany change from an organisms normal statedependent upon the concentration of active compound at the target site for a sufficient time.Toxicant (Poison)any agent capable of producing a deleterious response in a biological systemLiving organisma sac of water with target sites, storage depots and enzymes

DoseThe amount of chemical entering the bodyThis is usually given as mg of chemical/kg of body weight = mg/kgThe dose is dependent uponThe environmental concentrationThe properties of the toxicantThe frequency of exposureThe length of exposureThe exposure pathway

Exposure: PathwaysRoutes and Sites of ExposureIngestion (Gastrointestinal Tract)Inhalation (Lungs)Dermal/Topical (Skin)Injection intravenous, intramuscular, intraperitoneal

Typical Effectiveness of Route of Exposure

iv > inhale > ip > im > ingest > topical

Exposure: DurationAcute < 24hr usually 1 exposureSubacute1 monthrepeated dosesSubchronic1-3morepeated dosesChronic> 3morepeated doses

Over time, the amount of chemical in the body can build up, it can redistribute, or it can overwhelm repair and removal mechanisms

7 Langkah Penatalaksanaan Keracunan :Resusitasi dan stabilisasi .Evaluasi klinis dan difinitiv diagnosa.Dekontaminasi.Absorbsi racun dengan eleminasi.Antidotum.Perawatan suportif.Disposisi.

RESUSITASI DAN STABILISASI.AirwayBreathingCirculation

EVALUASI KLINIS DAN DEFINITIF DIAGNOSA.ANAMNESA : BAGAIMANA RACUN MASUK TUBUH : JUMLAH RACUN YANG MASUK. SUDAH BERAPA LAMA KONTAK. PERTOLONGAN PERTAMA YANG SUDAH DIBERIKAN. PROFIL PSYKOLOGI PENDERITA. GEJALA YANG TELAH DIALAMI PENDERITA.

Common Physical Signs in Toxicology

Physical signsLikely Causative agentComa; drowsinessAlcohol, antidepressants, antihistamines, antipsychotics, barbiturates and other sedatives, narcotics, salicylatesBreath odourAlcoholic breath: EthanolSmell of garlic: Arsenic, organophosphates, phosphorusOdour of bitter almonds: CyanidesSmell of acetone: Isopropanol, nail polish remover, salicylatesPungent odour: EthchlorvynolFragrance of violets: TurpentinneSmell of oil of Wintergreen: Methylsalicylate linimentPearl-like odour: Chloral hydrateMiscellaneous typical odours: Ammonia, kerosene, petrol, petroleum distillates, phenolEyesPupils: Constricted (miosis) Dilated (mydriasis)Nystagmus Visual disturbanceVisual hallucinationsMushrooms (muscarinic properties), narcotics, organophosphatesAmphetamines, antihistamines, atropine, barbiturates, cocaine, glutethamide, Lysergic acid Diethylamide (LSD), methanol, opiate withdrawal, tricyclic antidepressants Barbiturates, PCP, phenytoin, sedativesBotulism, digoxin, methanol, organophosphatesAlcohol, cocaine, LSD, mescaline, PCP

Mouth:DrySalivationGum discolorationAmphetamines, antihistamines, atropine, narcoticsArsenic, corrosives, mercury, mushrooms, organophosphates, strychnine. Lead, other heavy metalsRespiration:Rate increased(>20/min)Rate decreased (

Skin:BullaeCyanosisJaundiceNeedle marksPurpuraRedness and flushing of skinSweatinessBarbiturates, carbon monoxideCarbon monoxide, nitrites, strychnineArsenic, carbon tetrachloride, castor bean, mushroom (delayed effect), paracetamol (delayed effect) Amphetamines, narcotics, PCPSalicylates, snake bites, spider bitesAlcohol, antihistamines, atropine, boric acid, carbon monoxide, cyanideAmphetaminess, barbiturates, cocaine, LSD, mushrooms, organophosphatesNeuromuscular:Fasciculations/ convulsionsParalysisAtaxiaAlcohol, amphetamines, antihistamines, barbiturate withdrawal, chlorinated hydrocarbons, cyanide, isoniazid, lead, methaquolone, organophosphates, phenothiazines, plants (a number of), salicylates, strychnine, tricyclic antidepressantsBotulism, heavy metalsAlcohol, barbiturates, bromides, hallucinogens, heavy metals, organic solvents, phenytoin

DEKONTAMINASI :DEKONTAMINASI MATA DAN KULIT.DEKONTIMASI PERNAFASAN.DEKONTAMINASI GIT

Dekontaminasi.

DEKONTAMINASI MATA DAN KULIT.

PERLINDUNGAN PENOLONG.

LATEX GLOVE , PASTIC GOGLE, MASKER, SCORT.

. PROSEDURE : - PINDAHKAN KORBAN DARI TKP. - SEMPROT/CUCI MATA DAN SELURUH TUBUH DENGAN AIR BERSIH SELAMA 2 5 MENIT. - UNTUK MATA DITERUSKAN SAMPAI 10 15 MENIT. - SEMUA PAKAIAN HARUS DILEPAS DAN SELURUH PERMUKAAN KULIT HARUS DICUCI DENGAN SABUN SELAMA 10 15 MENIT. - JIKA SUDAH ADAD LEPUHAN KULIT/BLISTER, DITABURI DENGAN FULLERS EARTH / ATTAPULGITTE, BILAS DENGAN AIR 10 MENIT. - JIKA TANGAN PX IKUT TERKONTAMINASI , KUKU AGAR DISIKAT SECARA HALUS. - JIKA PROSEDUR DIATAS SELESAI , BERI PAKAIAN KERING..

TreatmentFor clinical purposesall toxic agents two classes : 1. specific treatment or antidote 2. no specific treatment supportive therapy is the mainstay of the treatment of drug poisoning "Treat the patient, not the poison," the most basic and important principle of clinical toxicology symptomatic medical care that supports vital functions is the only strategyGoal of treatment1.to maintain the vital functions if their impairment is imminent 2.to keep the concentration of poison in the crucial tissues as low as possible by : -preventing absorption -enhancing elimination 3.to combat the pharmacological and toxicological effects at the effector sites.

PERTOLONGAN PERTAMAPoisoning.

Bite and Sting

Do no harm

Human bites first aidIf you sustain a human bite that breaks the skin:

Stop the bleeding by applying pressure.

Wash the wound thoroughly with soap and water.

Apply an antibiotic cream to prevent infection.

Apply a clean bandage.

When?5.Get emergency medical care

Domestic pets first aidIf you or your child is bitten by an animal, follow these guidelines: 1-If the bite barely breaks the skin, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover it with a clean bandage.

2-If the bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure to stop the bleeding and see your doctor. . When ? * If you notice signs of infection such as swelling, redness, increased pain or oozing, see your doctor immediately. * If you suspect the bite was caused by an animal that might harbor rabies any unprovoked bite from a wild or domestic animal of unknown immunization status see your doctor immediately. Doctors recommend you get a tetanus shot every 10 years. If your last one was more than 5 years ago and your wound is deep or dirty, your doctor may recommend a booster. You should have the booster within 48 hours of the injury.

Snake bites

Ular berbisa

Ular yang tidak berbisa

SNIKE BITE first aid-CUCI DAERAH/TEMPAT YANG TERGIGIT DENGAN SABUN / DETERGENT

Terbaru BEBAT TEKAN Sarankan pasien tetap tenang dan hindari gerakan yang

tidak perlu

Ptrotap negara australiaQuickly tie a light restricting band both above and below the bite area a few inches away from the puncture/bite marks.

Apply a broad pressure bandage over the bite site as soon as possible. Keep the limb still. The bandage should be as tight as you would bind a sprained ankle. Extend the bandage down to the fingers or toes then up the leg as high as possible. (For a bite on the hand or forearm bind up to the elbow). Apply a splint if possible, to immobilise the limb.

5. Bind it firmly to as much of the limb as possible. (Use a sling for an arm injury).

Scorpion sting first aidWash bite with soap and water and remove all jewelry. Apply cool compresses. Acetaminophen (Tylenol) 1-2 tablets every 4 hours may be given for pain.

Bee stringHoney bee < warp < hornet : first aid For mild reactions:

Move to a safe area to avoid more stings.

Try to remove the stinger by scraping or brushing it off with a firm edge, such as a credit card. Swab the site with disinfectant.

To reduce pain and swelling, apply ice or a cold pack.

Apply 0.5 percent or 1 percent hydrocortisone cream, calamine lotion or a baking soda paste to the bite or sting several times a day until your symptoms subside.

Take an antihistamine such as diphenhydramine (Benadryl, Tylenol Severe Allergy) or chlorpheniramine maleate (Chlor-Trimeton, Teldrin).

For severe reactions:

Severe reactions may progress rapidly. Dial *** or call for emergency medical assistance if you experience any of the following signs or symptoms: Difficulty breathing

Swelling of the lips or throat

Faintness

Confusion

Rapid heartbeat

Hives

Nausea, cramps and vomiting

first aidWhile waiting for emergency transportation:

Have the person lie down. If unconscious and breathing, lay the person on his or her side to allow drainage from the mouth.

If there is no breathing, movement or response to touch, begin cardiopulmonary resuscitation.

Check to see if the person is carrying an allergy kit containing epinephrine. Follow instructions on the kit.

Jelly fish first aidRemove the victim from the water.Rinse the affected area with salt water or dont rinse it at all. Do not rinse the involved area of skin with fresh water, because it will further activate nematocysts and worsen the reaction.Using protective gloves or forceps, remove any tentacles still in contact with the victim.Apply acetic acid 5% (white vinegar). This will inactivate undischarged nematocysts and the toxin and will help to decrease symptoms.Use over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to control pain symptoms. Immobilize the area that was poisoned to prevent further spread. For example, if a foot was stung, encourage the victim to keep the area still with as little movement as possible.

Prevention PoisonSting & bites

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