Box 5

Recovery Position The recovery position is the safest position for an unconscious or drowsy person. It allows the person to breathe easily and will help to prevent choking if vomiting occurs. Hence a victim of poisoning should always be placed in the recovery position (but not when the victim has suffered anaphylactic shock). Recovery position: Place the victim on his or her front with one leg bent and the arm on that side raised. Turn the head to the same side. Tilt the head back so that the chin juts forward. Cover the person with a blanket or clothing for warmth.

Box 6

Induction of Vomiting 1. Sometimes it may be necessary to make a person vomit in order to expel the drug from the stomach. 2. It must be done only if specifically advised. It can be done in the following ways: * By tickling the back of the victim's throat. * By giving the victim plenty of salt water (4 tablespoonfuls of salt to each tumbler of water). * By giving the victim syrup of ipecac, the dose of which should be as follows:   Age Dose Under 18 months 10 ml 18 months to 12 years 15 ml Adults 30 ml 3. DO NOT: * Induce vomiting in an unconscious victim. * Induce vomiting if the suspected poison is a petroleum product or a corrosive such as stony acid/alkali. (Hint to recognise a corrosive poison: Lips and mouth may show greyish white stains.) 4. Ensure * The victim leans well forward to avoid choking or inhalation of vomit. * Clear the victim's mouth of vomit or any other foreign material. This can be done by giving the victim some water to rinse his/her mouth and then spit it out (not swallow it). * Preserve the vomit for detection of poison at the hospital.

Box 7

Dilution of Poison 1. Usually it is advisable not to give anything to the victim by mouth, unless specifically instructed to do so by your doctor. Fluids may hasten absorption of the drug and thus increase the danger. 2. However, sometimes, the doctor may advise you to dilute any poison left in the victims' stomach after vomiting. 3. Dilution of poison can be done in the following ways: a) Ask the victim to drink milk. b) Ask the victim to drink beaten eggs. c) Ask the victim to drink charcoal powder slurry (prepared by dissolving 4 tablespoonfuls of powder in about 400 ml [2 glassful] of water). Half a glass is given to drink every 15 minutes. Charcoal powder slurry prevents absorption of poisons which are toxic in small amounts. It is quite safe but should not be used in case of poisoning due to acids and alkalis. Burnt bread powder can be used if charcoal powder is not available.

Box 8

Artificial Respiration When there is no rise and fall of the chest and you can feel no movement of the exhaled air, it means that the victim is not breathing. Immediately give the victim artificial respiration (mouth to mouth resuscitation) steps include: 1. Lay the victim on his back on a firm surface. Clear the mouth of vomit or any other foreign material that may otherwise block the airways, and remove false teeth. 2. Place one hand under the victim's neck and lift gently to tip the head back and raise his chin while pressing down on his forehead with your other hand. This should allow the mouth to drop open. 3. Pinch the victim's nostrils closed with the fingers of your hand that is placed on his forehead, and use your other hand to grip his chin firmly to keep the mouth open. Take a deep breath seal your mouth over that of the victim and give two quick breaths. Continue to give further breaths every 5 seconds. 4. After each breath, turn to watch the chest falling while you listen for the sound of air leaving the victim's mouth. Continue until medical help arrives or the victim starts breathing on his own.

Box 9

Cardiac Compression If the victim does not start breathing after two breaths of artificial respiration, check the pulse in the neck of the victim. If there is no pulse, start cardiac compression, if you have been trained in this technique. Cardiac compression is used in conjunction with artificial respiration to start a stopped heart beat. The technique involves putting repeated strong pressure on the centre of the chest with the heels of both hands at a rate of 80 compressions per minute. At every 10 compressions, two breaths should be given using artificial respiration. This sequence must be continued until breathing restarts.

Box 10

How to Deal with a Fit? Certain types of drug poisoning may provoke fits. These may occur whether the person is conscious or not. In a fit, the victim usually falls to the ground twitching or making uncontrolled movements of limbs and body. If you have to deal with such a victim of fit, always remember: * Do not try to hold the victim down. * Do not put anything into his mouth. * Try to ensure that the victim does not suffer injury by keeping him away from dangerous objects or furniture. * Once the fit is over, place the victim in the recovery position. (Box 5).

Box 11

How to Deal with an Anaphylactic Shock? Anaphylactic shock occurs as the result of a severe allergic reaction to a drug. It usually occurs within minutes of taking the drug. In an anaphylactic shock, the blood pressure falls drastically and the air-ways may become narrowed. The main symptoms include: pallor, tightness in the chest, breathing difficulty, rash, facial swelling, collapse. If you have to deal with such a victim, always remember: * Check if the victim is breathing or not. If breathing has stopped, give artificial respiration (Box 8) immediately. * Once the victim is breathing normally, lay him down, face upwards with legs raised above the level of the heart to ensure adequate circulation of the blood. Use a footstool, carton or a similar item to support the feet. * Cover the victim with a blanket or articles of clothing while waiting for medical help. Do not try to give anything to the victim by mouth.