Management Presentation

It is helpful to stage chemical injuries as mild, moderate, and severe based on symptoms and signs. Mild poisonings demonstrate few symptoms and normal vital signs. Moderate poisonings demonstrate more severe symptoms, objective signs, and normal vital signs. Severe poisonings demonstrate multiple complaints, objective signs, and unstable (or abnormal) vital signs.

Mild and moderate poisonings can usually be evaluated on an outpatient basis. Once patients have been removed from exposure and decontaminated, they rarely require treatment other than an antiemetic for nausea and vomiting or topical steroids for a rash (1,8).

Severe poisonings usually require hospitalization and intensive physiological support. Decontamination may include gastrointestinal lavage for accidental or deliberate ingestion. In cases of suicide or homicide, one or more poisons may be involved (2,12).

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