How should you respond to suspected poisoning in the field?

• A. Identify potential substance, support airway/breathing/circulation, contact poison control, and transport
• B. Induce vomiting and administer activated charcoal to all
• C. Ignore until EMS arrives
• D. Administer broad-spectrum antidotes

Answer: (A)

The key idea is to prioritize surviving the poisoning by managing the patient’s immediate risks first while obtaining expert guidance for decontamination and specific treatments. In suspected poisoning, you must secure the airway and support breathing and circulation right away. If the patient’s status is compromised or uncertain, provide airway support, oxygen, and rapid assessment of breathing and circulation, and be ready to intervene as needed. At the same time, try to identify what was ingested or inhaled, when it occurred, and how much, because this information helps poison control and hospital staff tailor the next steps.

Then contact poison control for instructions. They have up-to-date knowledge on what substances require specific decontamination, antidotes, or other field actions. Their guidance helps determine whether any decontamination is appropriate, what to withhold or administer, and how urgently the patient needs transport. Transport promptly to an appropriate facility for definitive care, bringing any packaging, labeling, or witness information that can aid in treatment.

Why the other approaches aren’t appropriate in the field: inducing vomiting and giving activated charcoal to everyone isn’t safe or indicated for all poisons and can cause harm, especially with caustic, oily, or unconscious patients or if vomiting risks aspiration. Ignoring the patient until EMS arrives delays critical care. Administering broad-spectrum antidotes in the field isn’t appropriate without specific direction, as many antidotes require dosing, monitoring, and confirmation of the toxin involved.