Poisoning First Response: What to Do and What NOT to Do

A child swallows kerosene. An elderly parent takes double doses of medicine by mistake. An adolescent takes an intentional overdose. Poisoning cases in India span from accidental ingestion in toddlers to insecticide self-harm. The specific response depends on what was ingested, but several general principles apply — and several common home remedies are actively harmful.

The immediate steps

• Call poison control or ambulance immediately.
• India: National Poisons Information Centre 011-2658-9391 (AIIMS Delhi).
• Regional centres exist in many states.
• Do NOT induce vomiting unless specifically instructed.
• Do NOT give milk or salt water unless specifically instructed.
• Bring the container / substance to hospital if possible.
• Note the time of ingestion and estimated amount.
• If person is unresponsive: recovery position, monitor breathing.

What NOT to do — common mistakes

• Do NOT induce vomiting with salt water (dangerous).
• Do NOT force water or milk in unconscious patient (aspiration risk).
• Do NOT try to counteract with home remedies (turmeric water, jaggery).
• Do NOT wait to see if symptoms develop.
• Do NOT assume 'small amount is fine' — call to confirm.

Categories that need specific response

• Category: Petroleum products · Common items: Kerosene, petrol, cleaning solvents · Specific response: Do NOT induce vomiting — aspiration into lungs worse
• Category: Corrosives · Common items: Bleach, drain cleaner, strong acids/bases · Specific response: Do NOT induce vomiting — burns oesophagus again; milk may help; hospital immediately
• Category: Medications overdose · Common items: Any prescription or OTC · Specific response: Call poison control; bring container
• Category: Insecticides/pesticides · Common items: Organophosphates common in rural India · Specific response: Emergency — atropine treatment
• Category: Rat poison · Common items: Warfarin-type, aluminium phosphide · Specific response: Emergency — different treatments by type
• Category: Snake bites · Common items: Various in India · Specific response: Immobilise, don't cut, don't suck — hospital
• Category: Food poisoning bacterial · Common items: Restaurant meal, spoiled food · Specific response: Fluid replacement, medical assessment if severe
• Category: Alcohol overdose · Common items: Especially in adolescents · Specific response: Recovery position, hospital if unresponsive

Specific paediatric considerations

• Toddlers taste-test everything — common ingestions: household cleaners, medicines, batteries, plants.
• Button batteries — emergency because they burn oesophagus fast.
• Iron tablets look like candy — can be fatal in small child.
• Adult medicines in small amounts can be dangerous in children.
• Store all medicines in locked cabinets.
• Never call medicine 'candy' to convince a child to take it.

Specific insecticide considerations (rural India)

• Organophosphate poisoning is common cause of Indian rural admissions.
• Symptoms: excessive salivation, small pupils, breathing difficulty, muscle weakness.
• Emergency treatment with atropine at hospital.
• Do NOT wait — mortality is high without prompt treatment.
• Move person away from contaminated area, remove contaminated clothing.
• Wash exposed skin with plenty of water.

Specific snake bite considerations

• India has 4 major venomous species: cobra, krait, Russell's viper, saw-scaled viper.
• Do NOT cut the wound or try to suck out venom.
• Do NOT apply tight tourniquet (can cause more damage).
• Immobilise the bitten limb — like a splint.
• Remove any tight items (rings, watches) from affected limb.
• Keep the person calm and still — activity spreads venom.
• Get to hospital with antivenom capability urgently.
• Photograph the snake if safe to do so (helps identify species and antivenom).

The information to gather quickly

• What was ingested (specific product/medicine name).
• How much (as accurately as possible).
• When (exact time or best estimate).
• How (swallowed, splashed on skin, inhaled).
• Symptoms already present.
• Person's age, weight, chronic conditions.
• Current medications on.
• Any known allergies.

Bring to hospital

• The container / product package.
• Any vomit sample (for identification).
• List of current medications.
• Health record showing chronic conditions and allergies.
• Insurance card.

Prevention — the home audit

• All medicines in locked, child-inaccessible location.
• Original containers with labels intact — never transfer to food containers.
• Household cleaners in labelled, secured storage.
• Old medications disposed properly.
• Insecticides stored well away from food, water, children.
• Emergency numbers posted visibly.
• Poison control number saved in phone.

The single most useful preparation is having poison control number ready and knowing the specific rules — no salt water, no forced vomiting, get to hospital fast. Time and correct action matter equally.

References

• NPIC — National Poisons Information Centre AIIMS
• WHO — poisoning management
• PMC — poisoning epidemiology India