Examples of corrosive agents and sources of contact are listed in table 5-3.

When providing treatment for the above poisons, DO NOT INDUCE VOMITING. The damage to the mouth and esophagus will be compounded. In addition, the threat of aspiration during vomiting is too great. Gastric lavage could cause perforation of the esophagus or stomach. Therefore, use it only on a doctor's order. First aid consists of diluting the corrosive and keeping alert for airway potency and shock. If spontaneous vomiting occurs, administer an antiemetic.

Irritants
Substances such as automatic dishwasher detergent, diluted ammonia, and chlorine bleach can produce local irritation to the mucous membranes and potentially cause mild chemical burns. The pH of irritants may be slightly acidic or basic. If a person has ingested an irritant, direct the patient to spit the product out and rinse the mouth repeatedly with water. Spit the rinse water out also. Do NOT administer anything other than water unless directed by a PCC or medical officer.

Petroleum Distillates or Hydrocarbons
Volatile petroleum products (such as kerosene, gasoline, turpentine, and related petroleum products like red furniture polish) usually cause severe chemical pneumonia as well as other toxic effects in the body. Symptoms include abdominal pain, choking, gasping, vomiting, and fever. Often these products may be identified by their characteristic odor. Mineral oil and motor oil are not as serious since they usually do nothing more than cause diarrhea.

When providing treatment for the ingestion of petroleum distillates, DO NOT INDUCE VOMITING unless told to do so by a physician or poison control center. Vomiting may cause additional poison to enter the lungs. However, the quantity of poison swallowed or special petroleum additives may make gastric lavage or the use of cathartics advisable. If a physician or poison control center cannot be reached, give the victim 30 to 60 ml of vegetable oil. Transport the victim immediately to a medical treatment facility.

Food Poisoning
Food poisoning can occur from ingesting animal or plant materials, or even from the chemicals that are used in raising, processing, or preserving crops and livestock. Although illness associated with a contaminated water supply could be considered a type of food poisoning, this issue will not be addressed.

Most bacterial and viral food poisonings appear within 8 hours of ingesting food. The signs and symptoms of poisoning include nausea, vomiting, diarrhea, muscle aches, and low-grade fever. The general treatment is supportive and directed at preventing dehydration through the administration of fluids. If diarrhea persists more than 24 hours, or if the patient is unable to keep fluids down, further definitive medical care is necessary. Food poisoning can also occur from ingestion of parasites.

Marine food-borne illnesses from ingesting fish and shellfish is a concern especially when traveling to new destinations. Wherever you are in the world, you should learn which local seafood is known to be safe and which present the potential for harm. Table 5-4 lists some of toxins found in fish and shellfish and their potential sources.

Mussels, clams, oysters, and other shellfish often become contaminated with bacteria during the warm months of March through November (in the northern hemisphere). Numerous varieties of shellfish should not be eaten at all. Therefore, wherever you are in the world, you should learn which local seafoods are known to be safe and which present the potential for harm.

Table 5-3.-Examples of Common Acids, Alkalies, and Phenols, with Possible Sources of Contact

Most fish poisonings occur from eating fish that normally are considered to be safe to eat. However, style="mso-spacerun: yes"> fish can become poisonous at different times of the year because of their consumption of poisonous algae and plankton (red tide) that occur in certain locations. The signs and symptoms of red tide paralytic shellfish poisoning are tingling and numbness of the face and mouth, muscular weakness, nausea and vomiting, increased salivation, difficulty in swallowing, and respiratory failure. Primary treatment is directed at evacuating the stomach contents as soon as possible. If the patient has not vomited, select the appropriate method to remove the stomach contents by either syrup of Ipecac or gastric lavage. If respiratory failure develops, support ventilation and other life-sustaining systems as needed.

Examples of fish that are known to be poisonous AT ALL TIMES are shown in figure 5-1.

The symptoms of shellfish and fish poisoning are tingling and numbness of the face and mouth, muscular weakness, nausea and vomiting, increased salivation, difficulty in swallowing, and respiratory failure.

Primary treatment is directed toward evacuating the stomach contents. If the victim has not vomited, cause him to do so. Use syrup of Ipecac, gastric lavage, or manual stimulation; then administer a cathartic. If respiratory failure develops, give artificial ventilation and treat for shock.