November 16, 2008
Posted by Jim Macdonald at 07:40 PM * 239 comments
What cheerful thing shall we talk about today? How about poison!
Razors pain you;— Dorothy Parker
Rivers are damp;
Acids stain you;
And drugs cause cramp.
Guns aren’t lawful;
Nooses give;
Gas smells awful;
You might as well live.
Two, maybe three, of those things can be classified as poisons. (For the others: direct pressure, high volume oxygen, treatment for shock, and rapid transport to the closest appropriate facility are the keys. Your friends at 9-1-1 are waiting to hear from you!)
We remember poison from Altered Level of Consciousness, when O=Overdose was one of the items in our mnemonic. You might think of any poisoning episode as an overdose. What’s the recommended dose of hydrogen cyanide? Zero? Did someone get more than that? Woo! Overdose!
If you suspect poisoning, call the National Poison Control Center at 1-800-222-1222. That’s a toll-free call. If you can’t get to them, call 9-1-1.
NOTE: If the patient collapses, or stops breathing, or starts convulsing, or you can’t wake him/her up … skip Poison Control. Save a couple of minutes. Go directly to 9-1-1.
Okay, so. Let’s classify acute poisoning, then see what to do about it.
There are four basic kinds of poisons:
- Ingested poisons
- Inhaled poisons
- Injected poisons
- Absorbed poisons
The best treatment for all kinds of poisoning is prevention. Please don’t put the bleach into an old Pepsi bottle and store it where Junior can get at it. Please put a carbon monoxide detector in your bedroom. Please don’t leave the chicken lying out on the kitchen counter at room temperature for a couple of hours. If you’re an artist working with arsenic-based pigments, don’t put the brush in your mouth. Y’know. All that simple stuff.
Okay, ingested poisons. Stuff that you swallow. Deliberately or by accident. This can be medicines (your classic is a nice young lady who breaks up with her boyfriend, swallows every Tylenol in the house, pukes, decides the boyfriend wasn’t worth it, and dies a month later of liver failure), or rat poison, or lye, or what may have you.
Here’s what the nice folks at the Poison Control Center, or at 9-1-1, or the nice EMTs who come to your house, or the nice nurse at the ED, will want to know:
- What was it?
- This is your starting point. We can figure a lot of things out … ringing in the ears, think aspirin … but it’s nice if we don’t have to play Sherlock Holmes. You should be aware that lots of drug names sound similar (e.g. Xanax vs. Zantac). If it’s possible, and it’s safe to do so, take the original packaging with you.
In a work environment you’ll find information on every substance in the place in the MSDS (Material Safety Data Sheets) that are stored at some known and accessible location (e.g. by the front door, in the custodian’s office, in the supervisor’s desk). They’re required by OSHA. Know where the MSDS for your workplace are stored.
- When did the patient ingest the substance?
- Two minutes ago, an hour ago, a week ago … what (if anything) we can do about the situation can be time-critical. If you don’t know the exact time, a range (e.g. sometime after 2:00 pm but before 4:00 pm) is the next best thing, and is often the only thing you’ll know if it was a toddler getting into the cardiac meds in Granny’s purse.
- How much was ingested?
- Count the number of pills left in the bottle, or see how much lye was in the bottle, or your best guesstimate. What’s the most it could have been? That’s the number we’re going with.
- What was the time-frame?
- Chronic exposure? Eating paint chips vs. drinking the bottle labeled “Drink Me.”
- What are the signs and symptoms?
- Practically everything has nausea and vomiting. What else? Slurred speech? Jaundice? Slow pulse? Rapid pulse? Sweating? Diarrhea? Drowsiness? Hyperactivity? Don’t forget to check for things like burns around the mouth and unusual odors.
- How much does the patient weigh?
- For figuring out doses of both poisons and antidotes. The same amount of substance ingested by a 20 kg patient and a 100 kg patient can have a very different prognosis.
- What treatments have already been given?
- Did anyone already do any first aid? What? With what results?
Let’s talk about the possible first aid now. Beyond maintaining an open airway and treating for shock, I personally wouldn’t do anything without talking to the Poison Control Center. There are millions of substances out there; the treatments are changing all the time based on research. You can’t possibly memorize them all. The nice folks at the Poison Control Center have a huge database with all the most recent information. Use them!
Having said that, what are the possibilities? First, doing nothing may be the best course. Second, you may be advised to give the patient some activated charcoal to drink. Activated charcoal absorbs various substances so that they aren’t available to pass through the wall of the patient’s intestines and into their body. You may want to have a bottle of activated charcoal (it’s a slurry of charcoal and water) around the house, so that if the Poison Control Center tells you to administer it, you’ll have it. Activated Charcoal comes both with and without Sorbitol (a laxative) mixed with it. The usual dose is 12.5 to 25 grams for children and 25 to 50 grams for adults.
Activated charcoal is contraindicated and/or useless in some cases:
- Heavy metals
- Caustics (strong acids or bases)
- Hydrocarbons (e.g. gasoline)
- Narcotics
- Alcohol
Oh yeah — if the patient is unconscious or otherwise unable to swallow (say he’s convulsing), don’t give anything by mouth, okay? The guy’s already poisoned—you don’t need to fill his lungs with charcoal.
Activated charcoal is nasty. It tastes horrible, it’s thick and has grotesque mouth-feel. Someone who downs a glass of the stuff is pretty likely to vomit. So: before you give ‘em the charcoal, take a big plastic garbage bag, cut a slit along one top edge, and put it around the patient’s head like a big lobster bib. That way, when they hurl, you just open the bag, they barf into it, and your clean-up situation is greatly eased.
Please don’t add anything to the charcoal before the patient drinks it. Mixing in chocolate syrup, for example, won’t make it taste any better. What will happen is that the charcoal will absorb the chocolate, leaving less charcoal to absorb whatever nasty the patient ate or drank.
Next stuff that Poison Control may tell you to do is give the patient milk or water to drink. “The solution to pollution is dilution,” as the saying goes. The usual dose is one-half to one glass of milk or water for children, one to two glasses of milk or water for adults.
Okay, how about Syrup of Ipecac?
If you have any in your house, get rid of it. Really. Flush it down the toilet. Yeah, I know it’s sold all over, and you can get it in commercial Poison Kits and Babysitter Kits and whatnot. Dump it.
Here’s why. First, the purpose of Syrup of Ipecac is to induce vomiting. When you get that vomiting going, you’re inducing the chance of aspirating fluids into the lungs. Second, it takes about 20 minutes for the stuff to work. So all that time the ingested poison is sitting there, moving down into the intestines where vomiting won’t touch it. But in 20 minutes the patient could be in the ED, where the correct treatment might involve charcoal (which the patient will promptly vomit all over the nice nurses), or the treatment might involve an oral antidote (the treatment for Tylenol ingestion is NAC (N-acetylcysteine) (which smells so bad that it can clear out an entire ED)) which the patient swallows, then promptly barfs up, meaning that the patient doesn’t get treated. Oh, yeah—the other thing about Syrup of Ipecac: At its best it only evacuates about one-third of the stomach contents, so why bother?
One more note about ingested poisons: If you find yourself in a situation where you have to give artificial respiration to an ingested poison patient, you’d better be using a pocket face mask. You don’t want to get whatever it was into your own mouth.
Now let’s look at inhaled poisons.
The first and most important thing is to stay safe yourself. You breathe. Stuff in the air can jump out and get you too. So that may require you to wait for properly trained and equipped people to come and haul the patient out of where-ever he/she was lying.
Signs and symptoms of inhaled poisons may include headache, dizziness, shortness of breath, nausea and vomiting, or cyanosis (blue tinge to the lips or nail beds). Be aware of the situation! Be alert for unusual smells (e.g. rotten eggs, new-mown hay, almonds, fruit, where those items aren’t present).
Some examples of inhaled poisons include carbon monoxide (you do have a CO detector, right?), various other by-products of combustion, paints and thinners (when the label says “Use only in a well-ventilated space” freakin’ believe it). Your various war gasses mostly fall into this area. The treatment for accidental, deliberate, and terrorist-based inhaled poisoning is the same: Get the patient away from the source of the gas, provide high-volume oxygen if you have it, keep the airway open, provide artificial respiration if necessary, and transport to an appropriate facility. If you ever lose your place, drop back to airway, breathing, circulation. Your friends at 9-1-1 are waiting to hear from you. Again, you’ll want to know what the material is; if there’s any way of finding out (bottles or cans present; MSDS) the ED will want to know.
Information you’ll want to gather, for Poison Control, 9-1-1 and ED staff:
- What was the exact substance?
- When did the exposure take place (earliest and latest possible times)?
- How long were they breathing it?
- What are the signs and symptoms?
If a fire was involved, you may have burns in the airway. The world has just started to suck. Get professional help, right now.
Now we come to injected poisons. These move through a break in the skin. One of your classics is the bee sting. Or, the snake bite. Or, recreational drugs. (Overdose of insulin … diabetic shock … is covered elsewhere. Short version: oral or IV sugar.)
A swarm of bees may make the scene unsafe for you. Keep your eyes open. Same for snakes in the grass. The situations where you come on an injected narcotic overdose may be generally unsafe for reasons other than the poison itself.
Here’s what to do with bee stings. First, remove the stinger. When a bee stings you, the stinger (which is barbed) remains in the skin, with the little poison sac attached, pumping more formic acid into you. This is painful (and for people who are allergic, potentially fatal). Here’s how to remove the stinger: Don’t try to use your fingers or a tweezers. All you’ll do is squeeze the poison sac and put more poison into the patient. What you do is scrape along the skin with a credit card, a drivers’ license, or a knife held perpendicular to the skin. That’ll remove the stinger without squeezing that sac.
Speaking of bee/wasp stings, those are the only kinds of venoms where you’ll want to put ice on the injury site. Don’t ice spider bites or snake bites. What else to do? Put the limb lower than the heart (gravity is your friend!) to keep the poison out of central circulation, and put a constricting band (not a tourniquet) between the site and the heart. A constricting band limits the movement of lymph. When it’s tight enough you can still slip your finger under it. (Don’t be cutting snake bites and trying to suck out the poison. Okay? But it is okay to use a Sawyer Extraction Device on snakebites.)
The treatment for injected narcotics is lots of fun: Narcan. That is, naloxone. This is a narcotic antagonist. It reverses the effects of the narcotic, instantly. You should be very careful with this: The patient may wake up pissed off that you took away the high that he paid good money for. Or, you could induce instant withdrawal. So go slow. (Note: Narcan can be used by just about every route except oral, so the only folks who get to play with it are your EMTs. Sorry, guys, if you want to do this, take the course and join a squad.)
Last we come to absorbed poisons. These are poisons that move through intact skin. Again, use caution when you suspect absorbed poisons. Like inhaled poisons, these too can reach out and nail you. Don’t come into contact with the material yourself.
Some examples include medicines like Duragesic patches, or insecticides like Parathion. You may or may not see skin irritation at the site of the poison contact.
What to do: Call Poison Control. Get 9-1-1 rolling. Support Airway, Breathing, Circulation. Treat for shock. Remove the patient’s clothing, bag it up (staying safe yourself while you’re doing this) and (after consulting with Poison Control) flush the skin with a copious amount of water.
Once more: The people you call for help will want to know…
- The exact name of the substance.
- When did the exposure take place?
- How much substance was involved?
- Over what time period?
- What have you (or anyone else) already done?
- What are the signs and symptoms?
Any time you see sudden-onset similar symptoms in two or more patients, you should start thinking about poisoning.
Stay safe, kids. More than anything else, poisons can hurt you, too.
Copyright © 2008 by James D. Macdonald
I am not a physician. I can neither diagnose nor prescribe. This post is presented for entertainment purposes only. Nothing here is meant to be advice for your particular condition or situation.
Poison: It Isn’t Just For Breakfast Any More by
James D. Macdonald is licensed under a
Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.
(Attribution URL: http://nielsenhayden.com/makinglight/archives/010798.html)
Index to Medical Posts
Yummy... save some for me!
Seriously though... The Poison Control folks are wonderful... If you're in a large metro area, the line will answered by local people. I can't count how often I have used them to identify random pills found in a patient's pocket. When someone is too drunk to tell you if and what else they may have taken, a quick consult with the P.C. hotline will often tell me whether I need to shuffle these guys off to the ER... They are worth their weight in gold...
Good post, Mr. MacMedic! Thank you!
The scariest absorbed toxin I know is dimethylmercury. I didn't like even being in the same room as the stuff. A single drop can kill you... through latex gloves. Doubleplus ungood.
My recommendation for the handling of dimethylmercury is as follows: don't.
You bring up a good point, Edward: Alcohol is an ingested poison.
Please note the whole ingested poison thing works here: What was it? Alcohol. When did they drink it? An hour ago. How much? A fifth of Jack Daniel's. What was the time-frame? Chugging is different from sipping all day. And someone who's been drinking a fifth of JD every day for the past thirty years is going to have a different presentation (and probably outcome) than someone who just turned twenty-one and this is the first time he ever took a drink. What are the signs and symptoms? Nausea, vomiting, altered mental status. How much does the patient weigh? A 120-pound lady and a 300-pound football player are going to have a different response to a fifth of JD. What treatment has already been given? His chums made him drink a pot of black coffee (not so good) or his chums rolled him into the recovery position (better choice).
And -- is the scene safe? Any time you've got a bunch of drunks around, the answer is Probably Not So Much.
After a Dartmouth professor accidentally and fatally poisoned herself with dimethylmercury, MIT's chemistry department held a retraining session on What Gloves To Use (like What Fork To Use, only with higher stakes). My wife, a grad student in chemistry at the time, started using nitrile gloves for just about everything.
(She did pretty well coming out with a Ph.D. and no obvious liver disease. Fires, on the other hand....)
It's funny... When asked how much and when they drank, the answer is nearly always inflated beyond survivability. While they might tell the cop they had the famous "two beers," they will tell us at Detox they polished off a whole gallon just that afternoon...
And Jack Daniels? Maybe for the first week of the month... After that it's Popov and Listerine... Although Dr. Tischner's is now available locally (140 proof mouthwash with peppermint oil... makes for some nasty DT's)...
BTW: We had one last month come from the county hospital who popped a .656 by blood draw (down below .300 when they come to us)... They had one 5 years ago who survived a .680... I'd be so dead. No more nom nom nom...
The first job I had was in electronics assembly. We were using silver (conductive) epoxy, and the solvent of choice for uncured epoxy was TCE. We had small beakers, open, next to our stations. Not only that, but we were using tweezers (style C3), and those were wiped clean by jabbing them into a wad of tissue held in the other hand, which resulted in palms full of tweezer holes (and probably epoxy).
Sometimes I'm surprised I'm still alive and well.
I remember one case where we needed every ambulance in the area: a group of young adults up for a weekend vacation in wintertime who all presented with dizziness, shortness of breath, nausea and vomiting, all staring within about five minutes of each other.
The first suspicion was carbon monoxide since it was winter and the furnace hadn't been used in a while. The fire department got involved, but couldn't detect any unusual gases. Eventually, the story came out: They'd stopped for supper en route, and had all had the same entrée. Food poisoning, it turned out. (An ingested, rather than inhaled, poison.)
Let's say you find Granny out in the garden, with altered mental status, and drooling. What's your thought process? Well, any signs of insecticide around? Because organophosphate insecticides have very distinctive symptoms: SLUDGE.
Salivation
Lacrimation
Urination
Defecation
GI Upset
Emesis
(Sometimes you see the signs and symptoms listed as "The Killer B's": Bronchospasm, Bronchorrhea, Bradycardia, and Blurred vision.)
(Other times you hear 'em listed as DUMBELS: Diaphoresis, Urination, Meiosis, Bradycardia, Excessive Lacrimation, and Salivation.)
You get those both from parathion or malathion and from nerve gas. But the odds are that if I see those, it's because someone was spraying their cranberry bog, not because of bin Laden. Remember, a terrorist attack is just a badly-placarded HAZMAT incident.
What you do about this (after you've made sure you aren't going to get exposed) is to give the patient atropine (IV or IM). (Which probably isn't going to be in your first-aid kit.) So what you really do is call someone who does carry atropine (your friends at 9-1-1 can do this), and in the meantime support airway, breathing, and circulation.
Speaking of atropine, atropine is an anticholinergic, and anticholinergics have their own set of symptoms (in case someone gets all Borgia on you; atropina is otherwise known as Belladonna.).
Blind as a bat
Mad as a hatter
Hot as a hare
Dry as a bone
Red as a beet
That's the signs and symptoms of Jimson Weed, 'mongst other things.
Seth, I wish I knew more about mercury in general. I can remember playing barehanded with the mercury from a broken thermometer when I was a kid. Probably didn't even wash my hands afterward... Since I'm alive and not noticeably impaired, I assume the dimethyl version is lots worse.
It doesn't sound common enough that I'll ever likely run into it... and if I do, I'll have a great resource... The expert quoted in your link (Rob Skoglund) is the brother of a high school acquaintance... Nice to know he made it to the big time!
Metallic mercury isn't good for you, but it's not terribly dangerous, as it's hard to get it into your system where it can screw with your nerves, liver, and kidneys. Methylated mercury will soak right through your skin and kill you right quick. As noted above, it'll go right through latex gloves, too.
I used to work in a silicon fab. Fun chemicals there included hydrofluoric acid, also a skin penetrant. Lethal dose is a couple ounces; I regularly worked with a bucket full of the stuff. The real entertaining one was the bottle of arsine gas: lethal levels are something like 6 parts per million and the level of detectability is 10 ppm.
I learned all kinds of entertaining stuff. Proper treatment for inhalation of sulfur hexafluoride gas? It's non-toxic, but heavier than air, so someone who breathes it in won't be able to breathe it back out once it settles to the bottom of their lungs. So what you do is drape them over a railing so the heavy gas flows out of them again....
Another nasty absorbed toxin is fluoride ion. It doesn't go through any of the usual glove materials, but it's readily absorbed through skin, and of course you can get HF gas by acidifying a fluoride solution. No symptoms, I'm told, until that tingling sensation tells you that your nervous system is having problems due to calcium being glommed onto. (This is distinct from fluorine gas, which rots your lungs like chlorine gas only much worse, and then does the fluoride ion thing. You're not likely to encounter fluorine gas outside of a chemistry lab which deals with moderately exotic reactions, mind you. I spent one summer in such a lab, and we had a tiny leak one day. Prompt evacuation. Fluorine smells similar to chlorine, FYI.)
I mention this because there's recently been a rash of graffiti/vandalism in Ottawa which involves people using glass-etching cream to leave their marks on windows. These creams are usually fluoride-based -- they react with the silica. The etchants present a hazard to the vandals and to anyone who touches the graffiti before the remaining etchant is removed.
BigHank53: re: sulfur hexafluoride: gases mix easily; there's very little tendency for them to remain separate based on density except briefly in the absence of any turbulence. A few breaths of normal air would flush a lungful of SF6.
There was a local family here who had jimsonweed poisoning after a large extended family dinner. Apparently the jimsonweed invaded their mint garden and the older person who harvested the mint wasn't paying attention or was unable to tell the difference.
When a younger person at this big family dinner who didn't have the affected dish (a potato stew) noticed that almost everyone else including the older people were acting "like they were high on pot" thought something amiss and called 9-1-1. Everyone recovered in a few days, but they had to be hospitalized.
The Australian guidelines on snakebite go a bit further with bandaging, though the rationale of preventing lymph flow and the NO TOURNIQUETS advice are the same. The recommendation is to apply local pressure to the site and then bandage towards the heart if you have more bandage left, and to immobilize with a splint or sling. The same advice is applied to other critters with neurotoxic venom: funnelweb spiders, blue-ringed octopus, cone shells.
Of course, it makes sense to get local advice if you are venturing into the outdoors: the first-aid for venom from tropical fish is quite different from that for rattlesnakes.
A very appropriate post on the 30th anniversary of Jonestown.
Some veterinary medications are toxic to humans, although certainly not in dimethymercury-levels. There's a drug called M99 (etorphine) that is used to capture large game or zoo animals; it's essentially an extremely potent form of morphine. It's so hazardous that personnel must draw up the antidote before drawing up the anesthetic agent.
A couple friends of mine have been going through a CO scare-- they wake up with headaches, and when I described CO poisoning as 'the worst hangover ever', not my own description, one of them said, "That's exactly it!" The fire department, once called, did not find anything, nor did the energy folks. I am skeptical, but they've done what there is to do.
One thing many people who don't work in labs forget about gloves is that just about everything will go through gloves eventually. Nitrile gloves hold things off a little faster, but the idea is to a) keep you from touching your face, gnawing your fingers, scrubbing your eyes (I fail at this) and b) give you time to rip the glove off before whatever you've spilled all over your hand goes through.
Again, not my own experience, but I have been told that you never take off any glove as fast as the one that's on fire.
#10
I remember the Dire Warnings in chemstry and physics labs about hydrofluoric acid and hydrogen fluoride. One of them was that they act in some way as an anesthetic, so you can be pretty badly hurt without feeling it.
#13
Jimsonweed and mint don't look anything alike.
(The poisoning I read about was someone who was using jimsonweed as rootstock for tomatoes, and the toxic substances were migrating up the stem into the tomato part of the plant.)
regarding Narcan: If you're really determined to get your hands on it, but don't want to take EMT courses, you could move to Vancouver and go to a harm-reduction overdose prevention course. According to this article they will hook you up with a Narcan kit after a brief training session.
A friend of mine posted elsenet some months ago that she was having a great deal of trouble finding activated charcoal for her first aid kit. This was in the Boston area. Is this some specific-to-Massachusetts thing, or is it no longer a readily available drugstore item? And if so, where should we be looking?
#17 When I was with the Nortel Emergency Response Team, the asserted symptoms of HF included intense pain. The claim was that the stuff has a very high affinity for calcium ion. Calcium is key to making your nerves work normally, but loss of it causes irritability. The first antidote is calcium gluconate gel, applied topically.
We also got training for cyanide exposures. The cyanide kits were in multiple parts - amyl nitrate ampules for part one, and an additional package to go to the hospital with the patient for part two. Someone in the training asked about the hazards of the antidote; I think I embarassed the trainer by remarking that they were a sought-after recreational drug in some circles.
I see that the UK has new recommendations on cyanide treatments.
The only call I ever took from the chemical facilities was "difficulty breathing" - very scary, of course. It turned out to be a peanut butter allergy, though - a different ingested poison.
***
Back in university, when we were using HCN, they showed us the solutions A & B antidote - nasty looking stuff - and assured us that we'd vomit out everything we'd ever ingested, back to mother's milk. That turns out to be
"ferrous sulphate dissolved in aqueous citric acid, and aqueous sodium carbonate".
One of our comp. sci labs had a mysterious cupboard - when we opened it, we found a kit of "poison antidotes" with last inspection dates in the 1940's. They were in classic ground-glass stoppered bottles, and there were still liquids in them.
***
I'll dispose of the ipecac - I've been keeping it on hand for years.
Diatryma @ 16: I'd expect there to be a simple blood test for CO poisoning. The toxic effect is that the CO binds strongly to hemoglobin, forming bright-red carboxyhemoglobin, inhibiting the usual transport of oxygen -- a usual symptom of serious CO poisoning is that the victim appears flushed. Your friends might want to consult a doctor. There are probably other environmental problems that could also produce chronic headaches.
I take colchicine, which is toxic in very small amounts. I'm very careful to take it as prescribed. And before there were good inhalers, I used atropine in my nebulizer. The atropine came in glass ampoules and I had to buy accountant rubber-fingertips to keep from cutting myself by opening them. Now I use the rubber-fingertips for pulling needles through beads.
Another classic absorbed toxin: nicotine.
My cousin's research involves administering drugs to flies. When she got her lab safety training, they told her this about the nicotine solution: "If you get any of it on yourself, wash and have someone call 911. Then sit down, and relax, try to stay as calm as possible. You don't want to have a heart attack before the ambulance arrives."
I once took a couple of quarts of liquid mercury -- neatly sealed in glass canning jars -- to a hazardous waste disposal day. The reaction from the workers was pretty dramatic: they called their supervisor who called his supervisor. They did, however, accept it, after interrogating me for a bit.
My grandfather was a prospector in the 1960's, and used mercury for recovering placer gold. When Gramma passed away several years ago, we found his mercury in a cupboard.
I suspect Gramma was the one who canned the mercury.
In no particular order:
Poison Control will also (once you explain why you want to know[0]) help you to understand what to keep around the house, and how much to worry about plants in your garden.
Carbon monoxide poisoning is nasty. I'm very, very, very glad that I still have parents[1], and that one parent "smelled something funny"[2]. I hadn't known until then that (sensibly) they use the same treatment as you would for divers -- a hyperbaric chamber.
If you don't have carbon monoxide detectors... get them. It's a cheap investment at the price. CO detectors -DO EXPIRE-, so check them often, and be sure there's a (working) battery backup if yours is mains powered.
[0] I've grown Atropa Belladonna on-and-off for years, when I've had an appropriate garden area, but only had it fruit once. At that point, despite the garden being in a fenced back yard, it seemed wise to find out what a problem dose would be; the fruit look rather appetizing to anybody that doesn't know better (and some that should).
[1] It's a tad disconcerting when the emergency department explains that your parent shouldn't have survived with that CO level, let alone having survived with no immediate damage.
[2] More likely "has been a research chemist, and didn't smell anything, but recognized that there was something wrong", and remembered "smelling something"
Diatryma @ #16, Joel @ #21, one of those headache-like presentations might be sleeping in a room for extended periods with furniture made of particle board. There's formaldehyde used in the processing of that stuff, and we've called the State Health Dept. to ask about it. They suggest replacing the furniture if you can, but at least ventilate the room if you can't do the first.
Reason we called is that I'm waking up with the occasional headache and the dresser is a 5-foot piece of furniture made of that material. My windows are wide open.
Ahh, old familiar grounds here. I used to work in a neuropharmacology lab. Our MSDS files read like something out of an ED's nightmare. LSD, cocaine, PCP, digitoxin, picrotoxin, barbiturates - you name the dangerous, sometimes voluntarily used substance, we had it (and the five metric tonnes of required paperwork to go with it).
And just to add to the fun, the protocol we were working with required the mixing of these substances with DMSO. Whee! From ingested to contact poisons in one easy step.
The MSDS's could be entertaining. The MSDS for sucose was good - nothing like five pages of warnings attached to a 100g can of something you can buy in 5 lb. lots at the grocery store - but it was not quite as good as the one that got sent us for books. (Hazards: Impact, falling, paper cuts)
Way back before I got sensible and left inorganic chemistry, the scary one around our lab was nickel carbonyl. This is essentially a nickel atom cozying up with 4 carbon monoxide molecules. Boils at 43C, extremely easy to absorb through the skin, and with a nice high vapor pressure.
It has the wonderful feature of giving you heavy metal poisoning and carbon monoxide poisoning in one handy package. Plus the vapor is so heavy that regular fume hoods are very, very bad at containing it. Thank heaven I never even had to think about using it.
Now I'm scared- where out of garages, factories, and labs do you get CO poisoning, and how? And why didn't anyone tell me about it before?
Raphael @ 29 ...
Generally anywhere there's combustion and insufficient ventilation, there's an opportunity for CO poisoning.
I'm a tad surprised that you haven't heard about it before -- in most schools these days, it'll come up from kindergarten onwards, as a part of "safety & fire" related days/talks.
Xeger, thank you, good to know. I've learned about CO poisoning, but pretty much entirely in connection with cars and other ICE powered stuff. What about city apartments along busy streets with open windows?
Somewhere around here* I've still got a transparent green plastic capsule with about an 8mm-diameter blob of mercury in it. I got it from my dentist when I was 10 or 11 years old, and thought it was the coolest thing since sliced bread. I don't think I ever took it out -- just rolled it from one end of the capsule to the other, feeling the weight of it and watching it be a very dense liquid.
* Actually, I'm pretty sure I know where it is -- in the dresser drawer that stores a lot of "I've had this forever" sort of tchotchkes that I never use but don't want to throw away.
Raphael @ 31 ...
In general, as long as the air supply isn't excessively constrained, you should be fine -- open windows along a city street are likely to be stinky, but there's also a very large (planet sized, in fact) amount of 'air' involved, so you'd have to have some pretty impressive amounts of CO for any effect (although my recollection says that in some unusual circumstances, like volcanic eruptions, huge amounts of CO can be pushed into the local area... of course, if you're sitting around a volcanic eruption, there are likely other issues...).
Closed environments are a problem (but note that "closed" means that whatever's producing the CO is doing so at a rate faster than the closed environment can refresh -- ergo advice to not do things like use your propane BBQ for indoor heating during a power outage...).
Raphael-
Mainly houses with bad furnaces.
Ginger @ 15
I sometimes give a lecture to final-year veterinary students on remote anaesthesia. Half the lecture is safety such as making sure you've got the Narcan, double-checking whether the vial you're about to draw drug from is the Immobilon (etorphine plus ACP) or Revivon, preferably not using highly potent opioids without someone else there who knows how to inject the Narcan - and ALWAYS ASSUME THE DART GUN IS LOADED. Just because there's one tale of a guy who managed to inject himself with M99 out in the middle of nowhere in Africa then drove back to the hospital, injecting himself with Narcan every 10 minutes or so on the way and survived to tell the tale, doesn't mean this is a good thing to try.
Also, don't clean around the needle cuff of a loaded, pressurised dart wihtout depressurising it. I got a face full of ketamine and xylazine once and, while running to a sink where I could wash it off, was trying to calculate how much might have got into my eyes and mouth (and therefore been absorbed) and whether the dose rate would be high enough to cause physical symptoms (it wasn't).
On the CO problem, I'm going to ask along the same lines as Raphael did: in a reasonably modern apartment building (erected at some point in the last five years or so) there shouldn't be any real risk of carbon monoxide poisoning, should there? We tend to have the windows open much of the time, and the only combustion happening in the apartment is that we cook with gas (and that happens in the livingroom/kitchen, where there usually is a half-opened window as well, nevermind the door to the balcony being opened once an hour when my roommate goes outside to administer personal carbon monoxide poisoning to his lungs). CO poisoning doesn't sound like something I realistically need to worry about, right?
Massachusetts requires CO detectors in all rental units. I've got one.
If you're worried about CO, Amazon sells a First Alert detector for $19.88. I hear they make great Giftmas presents.
Another poison-injection-opportunity I remember from my OSHA training: getting cut with broken glass from a poison container.
I saw hydroflouric acid baths in a factory once, and they terrified me. Half of our OSHA training was horror stories about what chemicals will do to you if you don't watch out, and the hydroflouric acid stories were especially terrifying. (The other half was dangling from wires, looking at the dents in the ceiling from when the instructors chopped the top of that compressed air bottle, and all that good stuff.)
@#7: I'd worry more about the TCE than about the silver epoxy. TCE is nasty stuff.
I talked a lot more about carbon monoxide in Stop, Drop, and Roll.
If you're cooking with gas, rather than just a CO detector, get one of the combined CO and explosive gas detectors. It'll probably never go off. If it does, call the fire department ... from across the street. Think of it as very cheap insurance.
Our CO monitor went off after a bird thought our clothes dryer exhaust vent made a dandy winter house and I did a week's laundry in one day. I've heard that lint buildup in the exhaust vent is a CO hazard as well as a fire hazard.
Back in high school, in the 1980s, our chemistry teacher told us about the old-style health-and-safety measures they'd used when dealing with nasty chemicals when she was working in industry: working person sits in a laboratory with a rope round their waist. Someone else watches through a glass window. If the chemist falls over, haul them out the room using the rope... I think things have moved on a bit since then.
G. Jules: Massachusetts requires CO detectors in all rental units. I've got one.
(curious) -- What's the usual mode of heating and cooking there?
It has been over 20 years since I lived in a place that even had a furnace or a gas stove.
Carbon monoxide poisoning can come from a variety of sources, but they all involve combustion; it's a byproduct of burning fuel. One of the most common causes of CO poisoning is when someone uses a propane gas grill inside the house while the electricity is out. Or, hooking up an emergency generator inside the garage instead of outdoors. Running your car in a garage, even with the door open, can elevate the CO levels in the building and it can seep into your house. Bad furnaces will do it too.
A few years ago we had a woman in our office call in sick; she had been working outside the day before in her yard, and that evening found a plethora of red welts all over her skin, and she felt terrible. The doctor looked at the welts with a magnifying glass, asked her some questions, and said "well, they aren't insect stings". When she asked how he knew that, he said "because each one of these welts has TWO punctures".
After some tests, he diagnosed her illness as being caused by tiny little black widow spiders that had just hatched and fallen on her when she was working under one of her trees. Being newly hatched, they were only the size of a pinhead, but they --were-- black widow spiders, and their venom was full strength, only in minuscule quantities.
inge, while it's a toss-up whether any apartment or house in Massachusetts would have a gas or an electric stove, furnaces are pretty much standard - either gas or home heating oil. I can't think of anywhere I've lived in New England that's relied entirely on electric heat.
I remember some years ago walking into my workplace after a few days off and encountering a staff member on the way to the office who complained that she and all our colleagues had been suffering from headaches. This was at a time when the heating in the building wasn't working and they'd been given a paraffin (kerosene) stove.
When I went into the office proper, I reeled back and then rushed around opening windows. The stink of paraffin fumes was incredible. It's one thing to keep warm, quite another to sit there poisoning yourself and wondering why your body is complaining....
I've had CO poisoning. Not Fun.
A second on "where the heck do you get activated charcoal?" When my daughter was born & I took all those baby first-aid classes, I kept looking for it but could never find any. (For the record, the classes have been anti-ipecac for at least 6 years, but you can still get that in drugstores!)
The new tankless water heaters can also be culprits, since they often have higher combustion requirements.
Get your activated charcoal over at Moore Medical.
Re #23:
If "nicotine solution" is an absorbed poision, is this only a special preparation, or is there risk from, say, cleaning up nicotine stains off of walls and fabrics, from nicotine in the water used to clean?
Other on-line sources of activated charcoal.
The brand name of the stuff we carry is "Actidose," so that's a good search term.
What Rikibeth said.
My apartment is in a converted Victorian house and has natural gas heat delivered via radiators, an electric stove, and electric hot water. Heating here generally is probably 50-50 natural gas to #2 fuel oil. Some newer apartment complexes do have electric, but it's not common; our winters are cold enough that baseboard electric heat isn't all that cost-effective, and AFAIK heat pumps can't really handle this kind of cold.
I'm originally from Maine, which is where you start finding kerosene (Monitor heaters) and wood as heating methods.
Nicotine is a vegetable alkaloid, and it can enter the body through the transdermal route.
While I imagine the amounts that you'd find while washing walls and curtains would be small, it wouldn't hurt to wear gloves.
13: Way to make the party go with a bang!
I sometimes give a lecture to final-year veterinary students on remote anaesthesia. Half the lecture is safety such as making sure you've got the Narcan, double-checking whether the vial you're about to draw drug from is the Immobilon (etorphine plus ACP) or Revivon, preferably not using highly potent opioids without someone else there who knows how to inject the Narcan - and ALWAYS ASSUME THE DART GUN IS LOADED.
I would think part of the problem here is that if you give the reviver rather than the sedative, what are you going to do with the leopard?
This reminds me of the time I got sprayed with a veterinary insecticide that came in containers with safety warnings including "in remote areas, keep atropine injector handy". We were wearing our usual outback spacesuits - i.e. jeans, boots, old German Army shirt, hat. I was leery, but there was nowhere else to go. And then the boss - did I mention he had been a full colonel in the Royal Engineers and an NBC specialist of all things? - dropped the spraygun. Sprayed!
I ran like hell to a hose, expecting to become the world champion tap dancer at any instant, and soaked myself from head to foot with H2O, the solution to pollution being dilution.
This queered my reputation instantly, marking me out as a piker. I still wonder if the Colonel knew more about the stuff's effects than the safety authority (he mentioned it was similar to some Soviet war gasses), or whether he was just really, really irresponsible.
In the organometallic lab where I did my doctoral work, I used iron carbonyls a few times -- start with Fe(CO)5, a somewhat volatile liquid, and photolyze to Fe2(CO)9, a flaky orange solid, or react with a strong base to eventually give dark-green crystalline solid Fe3(CO)12. Though I did what I could to minimize exposure, I sometimes caught a whiff of the stuff. They had a distinctive strong musty odour.
A couple of my colleagues sometimes used CO from a cylinder in their work. Again, though they were as careful as they could be, a couple of times a tiny amount of the gas got out. Same musty smell. I've sometimes wondered if the CO, under pressure in the cylinder, might have been reacting to give traces of iron carbonyls. The cylinder should have been constructed of materials that wouldn't react with the gas, but...
This isn't work I particularly care to repeat.
I'm sure it's time to check (probably to replace) my CO detector. I expect I'll find an expiration date on it somewhere.
Do the new ones have an actual readout that show the level before it gets high enough to issue a warning? My old one does, and has never shown a number other than 0.0 (and it keeps track of the max recorded). I actually wish it were *very slightly* higher, as pure perfect 0.0 leaves me wondering a bit.
Down here in tobacco-growing country, hospitals regularly see outbreaks of nicotine poisoning when it's time to harvest the stuff--the only way to harvest tobacco is by hand*, and some people regularly ignore any warnings they've received about wearing gloves and long-sleeved shirts, because it's usually hot weather, and thus they collect enough nicotine from the plants on their bare, sweaty skin that they end up feeling quite unwell. I haven't heard of anyone dying as a result, but then, I haven't gone looking for the data either. As far as I know, most people are treated and kept for observation, and then sent home with reminders to be more careful next time.
Why, yes, farming is one of the more interestingly dangerous occupations in the US.
*In case you were wondering, because it requires so much hand-tending (you have to keep plucking off buds so the plant won't flower and go to seed to early, plus there's the tobacco worm issue--these are traditionally pulled off the plant by hand, and droopped in a jar of kerosene or gasoline), besides the picking, tobacco is generally grown in small plots. To harvest it, someone goes down the rows with a big muckin' knife, cutting off the plant close to the ground. They're followed by someone else who picks up the plant, and jams it (near the base of the plant) onto a long stick. When the stick is full, you get another one, and at the end of the day, the sticks are hung up in the rafters of the tobacco barn to cure, either by slow-drying or, in the case of dark-fired tobacco, by means of slow smoking via a smouldering fire of hardwood chips and sawdust. There are also a lot of complaints of shoulder pain from the people hanging the sticks as the harvest wears on, and then there are the folks who need stitches, as they weren't as careful as they should have been with their big muckin' knives.
#17 - belatedly - the tomatoes-on-jimsonweed-rootstock is from one of Berton Roueche's excellent medical/epidemiology essays, and I'm pretty sure it's one of the ones which was reprinted in the later re-collection The Medical Detectives. If you're fascinated by these EMT posts (and their subsequent comments) as I am, you want this book, and any of his other collections (the original ones, such as Eleven Blue Men, are now hard to find) that you can locate.
Diatryma (16): I've taken off a glove that was on fire more than once, and I was quick about it, but not spectacularly so. They were very thick gloves with high-temperature insulation, designed for reaching into a ceramic furnace. I think my fastest glove-removal ever was when I was up to my wrists in biohazards, and I heard my friend in the other room make that beginning-of-seizure-noise and *thump*.
Speaking of Duragesic patches, Jim mentioned them as being absorbed through the skin. That's the way they're supposed to be used. It's possible for a person to overdose that way. Heat makes the drug release faster, and people in a lot of pain tend not to account for fevers or even hot tubs.
When a person deliberately abuses Duragesic, trying to extract 3 days worth of narcotic (or the residual narcotic in a used patch) for an immediate high, they sometimes put the patch in their mouth. The narcotic is absorbed through mucous membranes faster than through other kinds of skin. A friend of mine is an EMT in an area rather like Jim's (rural Vermont), where Duragesic abuse was starting to become popular, and she told me about the problem of using Narcan in those cases. It's easy to miss a bit of plastic under the tongue when checking the airway, but the person still tends to aspirate it during the initial WTF! response to Narcan.
Farming is hazardous. Farming is why I run into a lot of trauma, environmental, and poisoning emergencies. The only thing worse than farming is logging ... and I'm living in a logging area. Keeps us busy.
In Ontario, part of the required home study before they'll let you adopt a child is checking for CO and smoke detectors in the kitchen, near the furnace, and in the bedrooms. So CO poisoning is definitely part of people's consciousness here. Whereas a little to the south ...
In Mexico City, about ten years ago, the air got unusually bad one summer - bad even for Mexico City that is - and then one of the local volcanoes started belching CO among other gases. Mexico City is very high up so there's not a lot of O2 in the air anyway. A friend of mine was quite seriously hurt when, as she was driving along on the Periferica, a pigeon fainted in mid-air and hit her windshield on its way down, because there wasn't enough oxygen to keep a pigeon conscious in the air five meters about her head. Bystanders told her that the pigeon got up and flew away again, apparently unharmed. When the medics got there they told her they were seeing a lot of falling-bird-related injuries.
Rikibeth, G. Jules: The places I lived in lately had heat from local CHP plants. With several apartment blocks and a university campus close together, it's more energy efficient than to have one boiler rooom in every house's basement.
Columbina @ #56, yep, the jimsonweed/tomato story is in The Medical Detectives, a book notable for the number of episodes in the first season of "House" it spawned (and for the fact that often the real story is more interesting than the TV version).
@15: Mmm, etorphine. Binds to opiate receptors with something like 4500 times the affinity of morphine, if I remember my pharmacology lectures properly. Dose is as for diamorphine, only in micrograms rather than milligrams. Not used on human beings; generally used for sedating large animals (from elephants and rhinos on up to whales).
On fluourine ions and related stuff: one of the substances I least want to ever come within a mile of is chlorine trifluoride. As oxidizing agents go, it seems to be the halide equivalent of hydrogen peroxide. There's a wonderful chapter in John D. Clarke's book "Ignition: An informal history of liquid rocket fuels" in which he describes ClF3 as "hypergolic with everything, including rocket scientists" and describes the most essential handling equipment: "a good pair of running shoes".
Yes, I gather this stuff is used in semiconductor production.
Farming also gives you access to odd ways of poisoning yourself, and sufficient lack of funds that you'll try things that suburbanites wouldn't. When I was a boy, a family, friends of mine, got very very sick with organophosphate poisoning. They (like my family, and a lot of others of our acquaintance) had, on the advice of the local vet, been using horse wormer to worm themselves; a perfectly safe enterprise if you use the right wormer and the right dose, but they'd gotten the nearly-same-named wormer that also kills bots. (Brandname vs Brandname-B). Bots are tough, and not helminths, and the usual anti-bot agent is an ACE inhibitor--in this case, triclorofon.
And NEVER go into an enclosed area where one person has collapsed without a rope and a guard. These people and I had mutual friends. Methane is a suffocant, not a poison per se, but it can still kill you, as can CO2.
Charlie, you should read up on the fuel used in the Messerschmitt Me163 Komet. Elementary safety principle, the first - keep the T-Stoff truck one kilometre away from the C-Stoff truck at all times. The second - wash down aircraft and hardstanding with fire engine after loading either fuel.
The third - don't volunteer to fly the fucking thing, as in the event of a forced landing, the T-Stoff had been known to leak into the cockpit and dissolve the pilot alive. In that event, the fuel tank exploding was actually the best thing that could happen. And all Me163 landings were glide approaches. But you couldn't be certain there wasn't some left in the tank...
Come to think of it, I don't know what the procedure was in the event you had to de-fuel one. I wouldn't be surprised if you just set fire to it.
Oh yeah, farms are hazardous areas everywhere you look. Every year when I was growing up there was always a news story about how someone sent into a silo suffocated from the buildup of CO2 trapped in the bottom of the silo from decomposing grain.
Often the rescue team would find out too late that what they thought was a falling injury was a suffocation, when they realized they were breathing but it wasn't doing them any good at all. But, that's why they were TEAMS; someone could pull them out when they fainted, unlike the farm worker who had already expired.
Then there's the tractors and their engines in the barn (more CO), fertilizers in both liquid and solid form that release noxious and hazardous fumes, nails in the cow manure (quick trip to the doctor for a tetanus shot, yeah, been there done that), washing down the milking areas with bleach and then realizing the cows were about to URINATE there too (not fun with chlorine gas being liberated around big animals), etc, etc.
Re: livestock wormer ...
Pour-on ivermectin is absorbed through the skin, rather efficiently, as the name would suggest. I know someone who made themselves fairly sick when they spilled a large dose on themselves while worming cattle. However, it's safe to say that they're free of worms.
I also discovered I was allergic to penicillin via a needle stick while treating a goat. And then discovered I was allergic to sulfa when washing out poultry waterers after I had put a sulfa drug in the water.
I carry epinephrine now.
Re: #67: when some of the mice here at work got pinworms and they were putting ivermectin in their water to clear that up, the guy mixing it up was just doing it in a bucket, arms wet to the elbows, because no one thought about the danger or mentioned it to him. Then he had his one and only bout of Bell's Palsy...
For happier news, the last time I called poison control was when I was mowing the back yard and got poked by the pineapple-shaped palm tree, which eh, but then there was the feeling of blood running down my arm inside my sweatshirt... Went inside to wash it off and saw that the arm had swollen up like crazy. Was googling for a local poison control phone number, since I seemed to remember from childhood that poison control was a local thing... No luck whatsoever, terribly aggravating. Eventually found a number for poison control for the whole state of California, and the lady was reassuring that there was no info on poisonous palm trees, or allergies to palm trees... It was just "mechanical insult" which was an amusing way of putting it. Basically, the goddamned skewer went deeper than I thought, pissed off a lot of blood vessels, but had such a tiny entry wound that it clotted without letting the released blood flow out. Those things are menaces. Like growing a rapier tree.
Anyway, now I've got the poison control number in my cellphone.
Alex @65, T-Stoff was merely stabilized high-test hydrogen peroxide -- nasty stuff, but not remotely as unpleasant as chlorine trifluouride. C-Stoff (the fuel) was hydrazine and methanol -- not nice stuff either, and the two in combination were hypergolic, but again, mild in comparison to things like monomethyl hydrazine.
The USAF were considering the use of ClF3 as an oxidizer during the 1950s. After messing around with it in small (less than 1000 Kg) quantities, they decided to stick to relatively safe oxidizers, like red fuming nitric acid and liquid oxygen. This stuff is evil.
(Drip water into a tank of ClF3: the water will burn. Drip ClF3 onto concrete, or glass, or stainless steel: it'll catch fire. Drip ClF3 onto rocket scientists: they burn good, too. Doesn't work too well in rocket motors, because rocket nozzles are combustible too, if you get them hot enough -- like, above 4000 degrees. Oh, and when it burns, it gives off hydrochloric and hydrofluoric acid.)
Actually, Charlie, if I remember the sci.space posts correctly, some of those experiments were -- rocketry worshipping the god Performance -- with Chlorine Pentafluoride. Which is even worse...
I have so far been very lucky with toxins, and I really hope I manage to stay that way.
I now suspect I may have had CO poisoning that time I left work in an ambulance. I had been waiting to cross the street at a traffic jam outside Port Authority in NYC: many idling buses. I got to work and got sicker and sicker: barfed out of an empty stomach, had such a headache I was going blind.
I was feeling better by the time the ambulance arrived, but the guy still said I had very little pulse and no blood pressure to speak of; at that point I started getting oxygen and feeling much, much better.
I had a headache for three days. I thought I'd accidentally double-dosed my Verapamil, or was it Atenolol back then? But the symptoms sound a lot like CO poisoning.
@#72: New-mown hay is phosgene, I think.
@#61: Central heating plants in the States are generally only found at colleges or in the city centers of older cities. (I know Boston, NYC, and Philadelphia have steam available in some areas as a utility; not sure about other cities.)
Otherwise, you don't really see CHPs in the states. Even a fair number of the multi-building apartment complexes in the US tend to use individual heating units for each apartment. It's too bad, because a CHP would be much more efficient.
Ariella @ 72: the "canonical" smell of new-mown hay is from coumarin. (SF geeks may recall this from Asimov's reply to a comment from John W. Campbell about a submitted story, something like "CH3CH2CH2CH2SH", i.e., butyl mercaptan, i.e., "it stinks".)
Please don’t leave the chicken lying out on the kitchen counter at room temperature for a couple of hours.OK, so how else do you defrost the bloody things? (Well, you can leave them in the fridge for about four days, if you have four days...)
I'm perversely amused that the first commenter on the thread shares a name with a famously poisonous plant. Oleander's nasty stuff, and I'm boggled at how common it is around here (southern CA) as an ornamental.
In a work environment you’ll find information on every substance in the place in the MSDS (Material Safety Data Sheets) that are stored at some known and accessible location (e.g. by the front door, in the custodian’s office, in the supervisor’s desk).It is to laugh. In the UK at least this is only true if you happen to work in a biomedical facility (e.g. when I was working at the NIBSC fifteen years ago even the laser printers had an MSDS for toner stuck to them). Elsewhere? I found to my surprise that the City firm where I'm now working had MSDSes... once. After much research I found from a retired ex-colleague that they were last seen two takeovers ago in a storage facility in Birmingham, since sold off by our ex-owners.
I would be staggered if anywhere that didn't regularly deal with hazardous substances as a matter of course had such things anywhere accessible.
#76
Lorax, we're also taught from childhood that oleanders are poisonous. (I can't say that I've ever been tempted to try it: the leaves and seed pods look tough and dry, and the flowers aren't that tasty looking.)
Nix - I defrost mine in cool water, same as fast-defrosting a turkey. It only takes a half-hour to an hour. Having said that, I feel obligated to report that my RN husband (of the famously poisonous plant, above) defrosts it on the counter all the time, and he hasn't poisoned me yet (that I know). When carped at about that habit, he only repeats his tiresome "do as I say, not as I do". Almost as much of a saw with him as the "if it hurts, I'm not doing you any good."
*sigh* "If it doesn't hurt..." of course.
This American Life has a ghosts and poisoning story.
Nix 75: I believe it's when the meat is at room temperature for hours that the problems occur. If you use it as soon as it's thawed, that will be well before the danger point.
Jim, correct this if I misinterpret it.
One thing that looks toxic but isn't - Vaseline. While my daughter was a master at putting anything in her mouth until she was about three, we managed to keep her away from poisons. Somehow. Then, there was the time she climbed up a bureau and threw herself onto a high window-ledge where we'd put babywipes and Vaseline. She wandered out into the living room a few minutes later, her mouth covered with Vaseline. I called poison control (expecting we'd have to take her somewhere).
"Is she breathing?"
"Yes."
"Just wipe out her mouth. Vaseline can suffocate, but it isn't poisonous."
Good to know!
I'm glad syrup of Ipecac is no longer recommended. I remember my mother had some on hand and it smelled dreadful.
Jim 8: What you do about this (after you've made sure you aren't going to get exposed) is to give the patient atropine (IV or IM). (Which probably isn't going to be in your first-aid kit.)
That's interesting; Witches used to make something called Flying Ointment, which was made from belladonna berries, extracted with spirits of wine. There's a famous story about Bernadette Devlin (I think it was) using denatured alcohol instead of spirits of wine for the extraction, and it came out three orders of magnitude stronger than it was supposed to be, and she nearly died just from what she got under her fingernails in the process of making the ointment.
The point is, though, that the way flying ointment was used was to spread it on unbroken skin, and in some period of time the user would feel like s/he was flying (the signature hallucination of atropine).
Reputedly. I'm not a fan of hallucinating generally, and that one in particular sounds like it could lead to dangerous behavior. I've never made flying ointment, and I suspect the drug culture of the 60s and 70s may have been its primary home, more than the traditions of Wicca.
The reason I bring this up, Jim, is that I wonder if it might be useful stuff to have around in case of insecticide poisoning. I'm sure not as much would be absorbed as with an IM injection, but as a first aid kind of thing while we wait for you guys to arrive? I mean, of course, the traditional formulation, not the Devlin version!
Xopher #82: I believe it's when the meat is at room temperature for hours that the problems occur.
Quite right. (And watch the potato salad too, please.)
You should be aware that both E. coli and S. aureus produce heat-stable toxins. While cooking destroys the bacteria, the toxins may well remain.
(Picking the wrong kind of mushroom is a whole 'nother problem.)
Xopher, I personally wouldn't mess around with home-made atropine. If I frequently used organophosphates, I might see about getting an atropine autoinjector (much like the Epi-Pens that folks with anaphyactic reactions to assorted stuff carry) which has the chemically pure stuff in a measured dose.
Any time you're working with insecticides you have to be scrupulously careful to avoid self-contamination. Prevention really is key to poisoning emergencies.
Nix, #75: Put it in the sink, or in a big stewpot, and run water to cover. This will defrost the meat much faster, which limits the potential growth time for nasty bacteria. Note: don't use the defrosting water for cooking! Also, as Xopher notes, use the meat as soon as it's thawed.
You can also thaw frozen meat in the microwave if you have one, but that tends to give uneven results.
#69, #70: What the heck do you store these exotic oxidizers in, if they eat glass and stainless steel?
Zack @88: you need to use very high grade stainless steel, with a very fine finish and take extreme care, if you're storing liquid ClF3. It's such a strong fluorinating agent that it fluorinates the exposed surface of the steel vessel on contact and hopefully renders it inert. However, if there are any scratches or flaws in the welding, you can end up with a metal-halide fire (burns at a few thousand degrees, melts more of the metal so that it flows into contact with the oxidizer, so it propagates like crazy and makes thermite look like a refrigerating agent).
Lee, Jim et al, thanks for the advice. The water trick is one I keep learning about and keep forgetting... and, no, using defrosting water for cooking strikes me as unutterably disgusting.
Regarding the heat-stable toxin stuff, that's interesting: I guess they're non-protein-based, whatever they are.
Zack: you store these things in an alembic made of frozen Universal Solvent, of course. (Downside: Universal Solvent freezes at -1K.)
dcb@ 35: I know a veterinarian who was accidentally injected with ketamine (she was holding cat, cat moved, student injected her instead of cat). Her description of the subsequent trip was very funny.
I also know a veterinarian (former, perhaps I should say) who gave his kids xylazine in fruit juice when he was supposed to be giving them back to the wife at the end of the visit. He's in prison somewhere in Louisiana.
I'm very grateful that the most toxic stuff I ever worked with was just picric acid.
Re. Chicken: here in the UK, caterers managed to take out most of a police force with Christmas dinner - they cooked the turkeys well, then put them back into their original bags to "keep them clean" while they were cooling down. The salmonellae thought that was great!
Alex @ 52: I was once sent to get some more Revivon. Driving along with the vial on the passenger seat, thinking how much more careful I'd be if it was Immobilon rather than revivon. Stopped the car, picked it up. Immobilon. Clearly labelled, colour coded (Immobilon is yellow/orange; Revivon is colured blue). I'd STILL managed to pick up the wrong bottle.It really made me think.
Charlie Stross @ 63: Etorphine is great for elephants - knock one down with about 2 mL. Needs about 8 mL to take down a yak. Don't ask me why.
Ginger @ 91
I had fun trying to work out if my rapid heart rate was due to the ketamine or just the fright - probably the latter. After washing and gargling I did tell someone what had happened and that if I fell of the chair/fell asleep they should call the hospital and tell them what I'd contaminated myself with. Luckily only a wallaby dose, and probably only a small fraction got absorbed through my eyes/mouth.
The reason you do not defrost stuff at room temperature is that the outer bits can be at dangerously warm temperature for dangerous amounts of time while the middle bits are still frozen. For example, you could get e-coli growing on the warm end of a turkey leg while the breast was still frozen like a rock.
Another scary faux poison: Give the kid a glass of grapejuice just after dosing her with milk-of-magnesia. Scary green goo ensues.
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