Editing Poison (section)

==Management==
* Initial management for all poisonings includes ensuring adequate [[Cardiopulmonary resuscitation|cardiopulmonary function]] and providing treatment for any symptoms such as [[seizures]], [[shock (circulatory)|shock]], and [[pain]].
* Injected poisons (e.g., from the sting of animals) can be treated by binding the affected body part with a [[pressure bandage]] and placing the affected body part in hot water (with a temperature of 50&nbsp;°C). The pressure bandage prevents the poison being pumped throughout the body, and the hot water breaks it down. This treatment, however, only works with poisons composed of protein-molecules.<ref>Complete diving manual by Jack Jackson</ref>
* In the majority of poisonings the mainstay of management is providing supportive care for the patient, i.e., treating the symptoms rather than the poison.

===Decontamination===
* Treatment of a recently ingested poison may involve gastric decontamination to decrease absorption. Gastric decontamination can involve [[activated charcoal]], [[gastric lavage]], [[whole bowel irrigation]], or [[nasogastric aspiration]]. Routine use of emetics ([[syrup of Ipecac]]), [[cathartic]]s or laxatives are no longer recommended.
** [[Activated charcoal]] is the treatment of choice to prevent poison absorption. It is usually administered when the patient is in the emergency room or by a trained emergency healthcare provider such as a Paramedic or EMT. However, charcoal is ineffective against [[metal]]s such as [[sodium]], [[potassium]], and [[lithium]], and [[Alcohol (chemistry)|alcohol]]s and [[glycol]]s; it is also not recommended for ingestion of corrosive chemicals such as [[acid]]s and [[alkali]]s.<ref>{{cite journal |vauthors=Chyka PA, Seger D, Krenzelok EP, Vale JA |title=Position paper: Single-dose activated charcoal |journal=Clin Toxicol |volume=43 |issue=2 |pages=61–87 |year=2005 |pmid=15822758|doi=10.1081/CLT-51867 |s2cid=218856921 }}</ref>
** [[Cathartic]]s were postulated to decrease absorption by increasing the expulsion of the poison from the [[gastrointestinal tract]]. There are two types of cathartics used in poisoned patients; saline cathartics ([[sodium sulfate]], [[magnesium citrate]], [[magnesium sulfate]]) and saccharide cathartics ([[sorbitol]]). They do not appear to improve patient outcome and are no longer recommended.<ref name="jtoxclintox2004-cathartics">{{cite journal | title=Position paper: cathartics | journal=J Toxicol Clin Toxicol | year=2004 | pages=243–253 | volume=42 | issue=3 | pmid=15362590 | doi=10.1081/CLT-120039801 | author=Toxicology, American Academy of Clinical| s2cid=46629852 }}</ref>
** [[Emesis]] (i.e. induced by [[ipecac]]) is no longer recommended in poisoning situations, because vomiting is ineffective at removing poisons.<ref name="jtoxclintox2004-emesis">{{cite journal | title=Position paper: Ipecac syrup | journal=J Toxicol Clin Toxicol | year=2004 | pages=133–143 | volume=42 | issue=2 | pmid=15214617 | doi=10.1081/CLT-120037421 | vauthors=((American Academy of Clinical Toxicology; European Association of Poisons Centres Clinical Toxicologists))| s2cid=218865551 }}</ref>
** [[Gastric lavage]], commonly known as a stomach pump, is the insertion of a tube into the stomach, followed by administration of water or saline down the tube. The liquid is then removed along with the contents of the stomach. Lavage has been used for many years as a common treatment for poisoned patients. However, a recent review of the procedure in poisonings suggests no benefit.<ref name="pmid15641639">{{cite journal | vauthors = Vale JA, Kulig K | title = Position paper: gastric lavage | journal = J Toxicol Clin Toxicol | volume = 42 | issue = 7 | pages = 933–43 | date = 2004 | pmid = 15641639 | doi = 10.1081/clt-200045006 | s2cid=29957973}}</ref> It is still sometimes used if it can be performed within 1 hour of ingestion and the exposure is potentially life-threatening.
** [[Nasogastric aspiration]] involves the placement of a tube via the nose down into the stomach, the stomach contents are then removed by suction. This procedure is mainly used for liquid ingestions where activated charcoal is ineffective, e.g. [[ethylene glycol poisoning]].
** [[Whole bowel irrigation]] cleanses the bowel. This is achieved by giving the patient large amounts of a [[polyethylene glycol]] solution. The osmotically balanced polyethylene glycol solution is not absorbed into the body, having the effect of flushing out the entire [[gastrointestinal tract]]. Its major uses are to treat ingestion of sustained release drugs, toxins not absorbed by activated charcoal (e.g., [[lithium]], [[iron]]), and for removal of ingested drug packets ([[body packing]]/smuggling).<ref name="jtoxclintox2004-wbi">{{cite journal | title=Position paper: whole bowel irrigation | journal=J Toxicol Clin Toxicol | year=2004 | pages=843–854 | volume=42 | issue=6 | pmid=15533024 | doi=10.1081/CLT-200035932| s2cid=800595 }}</ref>

===Enhanced excretion===
* In some situations elimination of the poison can be enhanced using [[Forced diuresis|diuresis]], [[hemodialysis]], [[hemoperfusion]], [[hyperbaric medicine]], [[peritoneal dialysis]], [[exchange transfusion]] or [[chelation]]. However, this may actually worsen the poisoning in some cases, so it should always be verified based on what substances are involved.