Scene Safety and Identification
Make sure the scene is safe before entering, especially for unknown gas exposures. Identify the substance, amount, time, and route, and bring containers to the hospital. Contact poison control early for guidance.
Supportive Care
Airway, breathing, and circulation come first. Many poisoning deaths result from respiratory failure or aspiration, so manage the airway proactively. Activated charcoal is no longer routine and is used only when specifically directed.
Specific Antidotes
Naloxone reverses opioids, and atropine with pralidoxime treats organophosphate poisoning. Hydroxocobalamin treats cyanide toxicity, and high-flow oxygen treats carbon monoxide. Know the toxidromes so you can anticipate which antidote may help.