Prepared by Aktif International Hospital Editorial Board .

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Table of Contents

What is poisoning? When should you go to the emergency department?

Let us begin with a general explanation of poisoning. Poisoning occurs when a medication, cleaning chemical, toxic gas, or spoiled food enters the body and disrupts organ function. Harmful substances that may cause poisoning can enter the system not only through ingestion but also through inhalation or contact with the skin or eyes.

It is important to act quickly when such a situation occurs. In particular, if life-threatening symptoms of poisoning such as difficulty breathing, loss of consciousness, seizures, or bluish discolouration are observed, contacting the 112 Emergency Call Centre without delay is the first potentially life-saving step.

What is the most critical clinical mistake that can be made at this stage? The answer is waiting for the symptoms to become more severe before seeking emergency medical care.

Because some toxins may not cause visible organ damage until several hours later, professional medical advice should be obtained even if the patient appears well, especially in children or in cases of suspected chemical exposure. If the patient appears stable, the 114 National Poison Consultation Centre (UZEM) may be contacted for an assessment of the situation.

In this article, you can find answers to questions about the different types of poisoning, critical first-aid mistakes, treatment processes, and warnings from specialist doctors.

What are the types of poisoning?

Cases of poisoning differ according to the type of toxic substance, the dose taken, and the route through which it enters the body. As mentioned in the introduction, harmful substances do not enter the system only through the digestive tract, and exposure to a substance may involve more than one route. For example, a pesticide may enter the bloodstream both through inhalation and absorption through the skin. For this reason, during clinical assessment, it is essential to know not only what the substance is but also how and for how long the person was exposed.

How can food, medication, and chemical poisoning be recognised?

The causes and patterns of symptom onset differ considerably among these three types of poisoning, which are the ones most commonly encountered in daily life:

Food poisoning: This develops due to bacteria or viruses in spoiled or unhygienic food, or toxins produced in food by these microorganisms. Similar symptoms developing in several people who have eaten the same food are among the clearest indications of foodborne poisoning.
Medication poisoning: This occurs when prescription or non-prescription medications are taken above the recommended dose, accidentally mixed, or accessed and consumed by children out of curiosity. Because age, weight, and organ function can alter the effects of medication on the body, an overdose requires immediate medical assessment even if the person appears well at the time.
Chemical poisoning: This may occur when cleaning products such as bleach, hydrochloric acid, or limescale remover are accidentally swallowed, or when fumes produced by mixing these substances in an enclosed area are inhaled.

Why are carbon monoxide, mushroom, and contact poisoning more dangerous?

Some types of poisoning pose a serious threat to life because they do not produce immediate symptoms or progress silently. Some of these include:

Carbon monoxide poisoning: Carbon monoxide is almost impossible to detect because it is colourless and odourless. Headache, dizziness, and nausea caused by leaks from stoves, water heaters, or vehicle exhaust fumes are often mistaken for influenza. Several people or pets in the same household becoming unwell at the same time is one of the most critical warning signs.
Mushroom poisoning: Mushroom poisoning is also relatively common because of misconceptions such as believing that boiling removes the poison or that cooking makes mushrooms safe. Toxins in dangerous wild mushrooms may not cause organ damage until 6 to 24 hours later. Therefore, the absence of symptoms during the first few hours does not mean that the danger has passed.
Skin and eye contact: This type of poisoning develops when chemical cleaners, solvents, or pesticides come into contact with the skin or eyes. The substance may not only cause irritation or burns in the affected area but may also be absorbed through the skin and enter the bloodstream. In such cases, the affected area should be rinsed immediately with plenty of water.

Regardless of the type of poisoning, it is first necessary to recognise the warning signals produced by the body in order to provide correct and timely first aid.

What are the symptoms of poisoning? When do they appear?

One of the most important questions for people who suspect poisoning is how many hours it takes for symptoms to appear. However, there is no single time range that applies to every case.

Depending on the type and amount of the substance entering the body, symptoms may sometimes develop within the first few minutes, within 6 to 24 hours, or even several days later in cases involving toxins that cause delayed organ damage.

Poisoning may affect the entire body, from the digestive system to the nervous system. Because its symptoms may resemble common conditions such as influenza or a stomach infection, they must be monitored carefully.

Some commonly observed symptoms include:

Severe nausea
Uncontrollable vomiting
Abdominal cramps and diarrhoea accompanied by cramping
Sudden dizziness
Confusion
Loss of balance
Unusual drowsiness and difficulty waking the person
Shortness of breath
A feeling of tightness in the chest
Palpitations or an excessively slow pulse
Sudden bluish discolouration of the skin
Excessive sweating
Abnormally enlarged or constricted pupils

When is emergency intervention required?

Situations requiring emergency intervention include:

Loss of consciousness or failure to respond to stimulation
Noticeably difficult, wheezing, or absent breathing
Bluish discolouration of the lips, face, or nail beds
Convulsive seizures
Signs of chemical burns around the mouth or throat
Suspected intentional ingestion of a high dose of medication or a chemical substance

Correctly recognising the symptoms can undoubtedly save lives. However, incorrect interventions performed at home may make the condition even more severe. The correct first-aid methods and actions that must never be taken in cases of poisoning are explained in the following sections.

How should first aid be provided in poisoning? Is it right to induce vomiting or give milk?

The panic experienced when poisoning is suspected often leads to dangerous first-aid mistakes based on hearsay. Two of the most common misconceptions are attempting to make the patient vomit and giving the patient milk. These well-intentioned actions may cause further irritation of the oesophagus or result in the poison being absorbed more rapidly by the body. Therefore, the fundamental rule of first aid is to avoid unverified methods that may cause more harm than good.

When corrosive chemicals such as bleach or drain cleaner are vomited, they burn the tissues of the oesophagus and mouth for a second time. Volatile substances such as petrol or paint thinner may enter the lungs during vomiting and cause life-threatening irritation.

Similarly, milk, yoghurt, and lemon water are not universal antidotes. On the contrary, they may accelerate the absorption of certain toxic substances or increase gastric reactions and trigger involuntary vomiting. Unless specifically instructed by healthcare professionals, the patient should not be given anything by mouth, including water.

The primary aim when responding to poisoning is to stop the exposure safely. The correct steps depend on how the substance entered the body:

In cases of ingestion: If the patient is conscious, ask them to spit out any remaining substance in their mouth and rinse their mouth with water. Keep the product packaging or container to show the doctor.
In cases of inhalation exposure involving gas or smoke: Without putting your own safety at risk, move the patient into fresh air as quickly as possible, loosen tight clothing, and ventilate the area.
In cases of skin contact: Remove clothing contaminated with the chemical. Brush away powdered substances with a dry cloth before applying water, and then rinse the area under plenty of running water for at least 15 to 20 minutes.
In cases of eye contact: Remove contact lenses, if present, and rinse the eye with clean running water for at least 15 minutes. Avoid rubbing the eye.

The fundamental rule of first aid is to ensure your own safety first. If the patient is not breathing and you have received first-aid training, begin basic life support. If the person is unconscious but breathing, place them in the recovery position.

If severe poisoning symptoms such as loss of consciousness, seizures, difficulty breathing, or bluish discolouration are present, the 112 Emergency Call Centre must be contacted immediately. If the patient appears stable, you may call the 114 National Poison Consultation Centre (UZEM) and provide the name and approximate amount of the substance to receive product-specific advice.

How is poisoning diagnosed? How can I tell if I have been poisoned?

A diagnosis of poisoning is made by determining what the patient was exposed to and how much exposure occurred, followed by a combined assessment of physical examination findings and any laboratory tests considered necessary by the doctor.

Symptoms such as nausea, dizziness, or light-headedness are not specific to poisoning. They may occur in many conditions, ranging from an ordinary stomach infection to low blood sugar. Therefore, the clearest answer to the question “Have I been poisoned?” depends less on the symptoms themselves and more on whether there is a history of unusual contact or exposure.

Consequently, the person should go to the emergency department without waiting for symptoms to develop if they do not know what they have taken, if a child has come into contact with medication or a chemical product, if more than the recommended dose of a medication has been taken, or if exposure to mushrooms, pesticides, or toxic gases is suspected.

During the medical assessment, the doctor examines the patient’s consciousness, breathing, blood pressure, pupillary response to light, and skin reactions. Depending on the circumstances, an electrocardiogram, liver and kidney function tests, and targeted toxicology screening may be requested.

The most important consideration is that routine laboratory screening does not cover every toxic substance. Therefore, a normal test result does not completely rule out poisoning, and clinical monitoring by the doctor remains essential.

How is poisoning treated? Is gastric lavage always necessary?

Treatment methods used in cases of poisoning are planned individually according to the type of substance that entered the body, the dose taken, the route of exposure, and the time that has passed since the exposure.

The primary purpose of medical intervention is to prevent the toxic substance from damaging the organs and to support vital functions while the body eliminates the toxin. The main treatment methods used in the emergency department include the following:

Contrary to popular belief, supportive treatment is the most effective approach in most poisoning cases. Keeping the patient’s airway open, providing intravenous fluids, administering oxygen, and monitoring heart rhythm and blood pressure help protect the organs.
Although it is commonly believed that every poison has a single miraculous antidote, specific antidotes are clinically available only for certain substances. An antidote does not exist for every case. Therefore, if an appropriate antidote is available for the type of poisoning involved, it may be administered.
In suitable cases, activated charcoal may be used, generally within the first one to two hours, to bind toxins like a sponge and reduce their absorption from the digestive system into the bloodstream.

In these cases, patients and their families often expect the stomach to be washed out. However, this expectation does not reflect medical reality. Gastric lavage is a procedure in which stomach contents are removed through a tube. It does not remove all of the poison from the stomach. In particular, it provides no benefit once the substance has moved into the intestines or entered the bloodstream.

Gastric lavage is considered only in very limited circumstances, under the supervision of a specialist doctor, when a life-threatening amount of a substance has been ingested and only a very short time has passed since the event.

Warnings and recommendations from the emergency department doctors at Aktif International Hospital

Two of the most critical mistakes we encounter in our emergency department are incorrect interventions performed at home in a state of panic and patients ending the recommended observation period early because they begin to feel better after the initial emergency treatment.

It should be remembered that in life-threatening situations such as loss of consciousness or shortness of breath, the patient must be taken directly to the emergency department without delay. Bringing the medication or chemical container to the hospital, or showing the doctor a clear photograph of its label when the container cannot be brought, allows the appropriate treatment to be started more quickly.

In cases involving mushrooms, gas, or high doses of medication, the patient may appear well during the first few hours. However, the condition may suddenly become severe several hours later. Patients should therefore not leave the hospital before completing the emergency observation period determined by their doctor.

Another important issue is safety. A patient whose consciousness has been affected should not be allowed to drive themselves to the hospital. When gas exposure is suspected, everyone in the household should be medically examined, even if they have no symptoms.

What precautions should be taken to prevent poisoning at home?

Almost all poisoning incidents occurring at home are preventable accidents. They frequently develop because dangerous products are easily accessible, have been removed from their original packaging, or are left unattended for only a few seconds.

The risk applies not only to curious young children but also to older people who may experience forgetfulness and adults who regularly take several medications. The main precautions required to make the home environment safer can be listed as follows:

Store prescription medications, vitamins, and food supplements in locked cupboards that children cannot see or reach. Never describe medication to children as sweets or treats.
Never pour cleaning products such as bleach, hydrochloric acid, or detergent into plastic drinks bottles, juice cartons, or drinking glasses. A colourless chemical being mistaken for water and swallowed is one of the most common scenarios involving children and older patients presenting to emergency departments.
Mixing bleach with hydrochloric acid, ammonia, or limescale remover in an attempt to achieve stronger cleaning results is extremely dangerous. These mixtures release potentially fatal chlorine gas, which can severely damage the respiratory tract.
Arrange annual maintenance for stoves, boilers, water heaters, and chimneys. Carbon monoxide is colourless and odourless, which means it cannot be detected by smell. Never operate equipment such as generators or charcoal barbecues inside a house, garage, enclosed balcony, or any other closed area.
It is impossible to determine whether wild mushrooms collected from nature are poisonous by cooking, boiling, or examining their appearance. Choose only packaged cultivated mushrooms that have been officially inspected and approved.
Household accidents frequently occur during brief moments of distraction, such as when the doorbell or telephone rings during cleaning, or when a medication container is left on the worktop after use. Instead of intending to put dangerous substances away later, make it a habit to return them to a locked storage area immediately after every use.

These small precautions can be among the most effective ways to protect the lives of your loved ones. However, despite every precaution, if a suspicious exposure occurs, the safest step is always to remain calm and contact the 114 National Poison Consultation Centre for advice or go to the nearest emergency department rather than losing valuable time at home.