The unknown poison

This article outlines a rational approach to management of an unknown poisoning. See table in the PDF file. If an unidentified material has been ingested, the safest course of action is to induce vomiting with ipecac if no contraindication exists (Table I). If the product or ingredient is known but there is uncertainty regarding the quantity ingested, tables of toxicity rating (Tables II and III) are offered to help in deciding the necessity for treatment. If signs and symptoms suggesting a potential poisoning are present, the most likely agents may be found in Table IV. Definite toxicologic identification of ingested ingredients requires a great deal of time and special expertise. It is seldom available in time to aid in the treatment. Therapy should be directed toward support of vital functions (Table V). A small number of rapid and easily performed presumptive tests are available and are offered to the practicing physician as an aid to making a more definitive diagnosis.