Poisoning First Aid: What to Do and Who to Call

Most poisonings in Australia happen at home, to children under five, with something that was never meant to be dangerous — dishwasher tablets, a handbag left on the floor, a decanted bottle of something under the sink. And most of them are handled badly in the first two minutes, because the folk remedies are so persistent.

There is no salt water. No milk. No making them sick. There is a phone number.

Which number do you call?

The Poisons Information Centre is free, staffed 24 hours, and covers the whole country on one number. It is the single most useful thing to have in your phone if you have small children, and almost nobody does.

If someone has swallowed a poison

1. Check for danger first. If there are fumes or spilled chemicals, do not walk into them.
2. Sit them still and stay with them.
3. Get them to spit out anything still in their mouth.
4. Rinse the mouth with water and wash any substance off the mouth and face.
5. Call 13 11 26, or 000 if any of the emergency signs above are present.
6. Find the container. The centre will want to know what it was, roughly how much, and when. Take a photo of the label, and keep the bottle or packet to send with them to hospital.
7. If they become unresponsive but are breathing normally, roll them into the recovery position. If they are not breathing normally, start CPR and follow DRSABCD.

What never to do

• Do not give anything to neutralise it. No milk for acid, no vinegar or lemon for alkali. Australian guidance says not to attempt neutralisation of acids or alkalis, swallowed or on skin — the reaction itself produces heat and makes the injury worse.
• Do not wait to see what happens. Many poisons have a delay before symptoms appear. Call while the person still looks fine.
• Do not give food or drink beyond rinsing the mouth, unless the Poisons Information Centre tells you to.
• Do not put yourself in it. Fumes and spills take out rescuers regularly.

Poison that was not swallowed

Inhaled

• Get them to fresh air immediately — without putting yourself at risk. If you would have to breathe the fumes to reach them, wait for people with breathing apparatus.
• Open doors and windows if you can do it safely from outside the space.
• Avoid switching electrical appliances on or off if flammable gas may be present.

On the skin

• Remove contaminated clothing carefully, protecting your own hands.
• Flood the skin with running water, and keep the person warm while you do it.
• Then wash gently with soap and water.
• Do not try to neutralise it. See also chemical burns in our burns guide.

In the eye

• Flood the eye with saline, contact lens solution or cold water for 15 minutes, holding the eyelids open.
• Have them look up, down and sideways so the fluid reaches everywhere.
• Then call 13 11 26 and get it assessed.

Button batteries and small children

Button and coin batteries deserve their own warning because they do not behave like other swallowed objects. Lodged in the oesophagus, a battery generates an electrical current that burns through tissue in under two hours, whether or not the child looks unwell.

• Call 13 11 26 straight away, and 000 if there is bleeding or breathing difficulty.
• Do not wait for symptoms, do not give food or drink, and do not induce vomiting.
• Watch for coughing, drooling, chest or abdominal pain, vomiting, trouble swallowing or refusing food — but remember there may be no symptoms at all.

If the battery is stuck in the airway rather than swallowed, that is choking and needs back blows and chest thrusts.

Medication overdose

An overdose — accidental or deliberate — is a poisoning. The same rules apply: do not induce vomiting, call for help early, and take the packets with you.

• Paracetamol is the one people underestimate. It can seriously damage the liver with very few early symptoms, and treatment works far better when it starts early. Never wait to see whether someone becomes unwell.
• Count what is missing from the packet if you can, and note the time.
• Take every container with you to hospital, including anything else they might have taken.
• If it may have been deliberate, stay with them and call 000. You can also call Lifeline on 13 11 14.

Poisoning symptoms to watch for

Symptoms depend entirely on the substance, which is exactly why the phone call matters more than the checklist. Things that should prompt a call to 000:

• Drowsiness or confusion, or difficulty rousing them
• Difficulty breathing, or noisy breathing
• Persistent vomiting
• Seizures
• Burns or blistering around the mouth or lips
• Collapse or loss of consciousness
• Unusual drooling, or refusing to swallow

Preventing poisoning at home

• Save 13 11 26 in your phone now, under Poisons. That is the whole preparation.
• Store chemicals and medicines up high and latched — above adult eye level, not under the sink.
• Never decant anything into a drink bottle. This is how the worst cases happen.
• Keep everything in its original labelled container, so the centre can identify it instantly.
• Check for button batteries in remotes, scales, car keys, thermometers, toys and novelty cards, and tape the compartments shut.
• Handbags and visitors’ bags go up high. Grandparents’ medications are a very common source.

Related reading: choking first aid, burns and scalds first aid, and what to say when you call an ambulance. If you or your child takes regular medication, a responder needs to know before they treat — you can create your emergency profile in a few minutes.

Poisoning FAQs

Sources

• ANZCOR Guideline 9.5.1 — First aid management of poisoning — not inducing vomiting, not neutralising acids or alkalis, inhaled poisons and rescuer safety, eye irrigation for 15 minutes, skin decontamination, positioning, and the Poisons Information Centre numbers.
• healthdirect — Poisoning — sitting the person still, spitting out what remains, and when to call an ambulance rather than the Poisons Information Centre.
• NSW Poisons Information Centre — the service behind 13 11 26, and what it can advise on.
• Royal Children’s Hospital — Poisoning prevention for children — household sources and prevention.
• Sydney Children’s Hospitals Network — Button battery safety — the under-two-hour burn risk and what not to do.
• Poisons Information Centre, 13 11 26 — 24 hours, anywhere in Australia. Lifeline 13 11 14.

Disclaimer: This article is general first aid information, not medical advice or a substitute for accredited first aid training. In an emergency, always call Triple Zero (000), or the Poisons Information Centre on 13 11 26. For non-urgent health advice, call healthdirect on 1800 022 222 (NURSE-ON-CALL 1300 60 60 24 in Victoria, 13 HEALTH 13 43 25 84 in Queensland) or speak with your GP. Never start, stop or change a medication on the basis of a web page. MedibandPlus stores and provides access to a member’s own medical information; it does not assess, diagnose or treat any condition.

More first aid guides

• Choking first aid for adults, children and babies
• Burns and scalds first aid
• How to stop severe bleeding
• The recovery position, step by step
• DRSABCD: the first aid action plan explained
• Calling an ambulance in Australia