Poisoning & Overdose
Whether accidental in a child or deliberate in an adult, the priority is the same: get to hospital fast, take the container with you, and do not make them vomit.
When to call an ambulance immediately
- Drowsiness, confusion, or unresponsiveness
- Difficulty breathing, or very slow or shallow breathing
- Seizures
- Burns, blistering or staining around the mouth and lips
- Vomiting blood, or severe abdominal pain
- Any known ingestion of pesticide, rat poison, kerosene, acid, or a handful of tablets
- Pinpoint pupils with slow breathing, or excessive salivation, sweating and tears
What to do
Work through these in order. If you are alone, put your phone on speaker so the 108 call handler can guide you while your hands stay free.
- 1
Make the scene safe first
With pesticide, gas or fumes, protect yourself before approaching. Ventilate the area. Do not become a second casualty, which happens more often than people expect with organophosphate exposure.
- 2
Call 108 immediately
Say what was taken, roughly how much, when, and the person's age and weight if known. Treatment for many poisons is time-sensitive and specific.
- 3
Take the container with you
Bring the bottle, the tablet strip, the pesticide packet, the plant, or a photograph of it. Identifying the exact agent is often the difference between targeted treatment and guesswork.
- 4
For skin or eye exposure, irrigate
Remove contaminated clothing carefully and wash the skin with plenty of running water. For the eyes, rinse continuously with clean water for at least twenty minutes, holding the eyelids open.
- 5
Keep the airway safe
If they are drowsy but breathing, put them in the recovery position so vomit drains away. Never leave them lying on their back unattended.
- 6
Do not leave them alone
Where the overdose may have been deliberate, stay with the person, remove any remaining medicines or chemicals from reach, and be gentle. Getting them to hospital is the priority, and judgement helps nobody.
Never do these
Most of these are well-intentioned and widely believed. All of them make the situation worse.
- Never make the person vomit, by salt water, by finger, or by any other means. With acids, alkalis, kerosene and petroleum products it causes a second burn on the way back up, and it risks the lungs.
- Never give milk, ghee, or any home antidote. There is no universal antidote, and milk speeds absorption of some poisons.
- Never give activated charcoal at home without instruction from a doctor.
- Never wait for symptoms to appear. Paracetamol overdose in particular causes almost no symptoms in the first day and can still destroy the liver. The antidote works best early.
- Never assume a small amount is safe for a child. A single tablet of some adult cardiac and diabetes medicines can be lethal to a toddler.
Once the immediate danger has passed
- Store all medicines and chemicals in locked, high cupboards, and never decant pesticide or kerosene into a soft-drink bottle. That single habit causes a substantial number of paediatric poisonings.
- After a deliberate overdose, ask for a mental health assessment before discharge. It is part of proper care, not an add-on.
Frequently asked
My child swallowed something an hour ago but seems completely fine. Do we still go?
Yes. Many serious poisonings, including paracetamol, iron and certain cardiac drugs, have a silent early phase. Being well now says very little about the next twelve hours.
What about a button battery?
That is an immediate emergency. A swallowed button battery can burn through the oesophagus within two hours. Go to an emergency department straight away and do not wait, do not give food or drink.
Reviewed and written by
Dr. Poonam Sekhon Chahal, MBBS, MEM
Senior Emergency Physician, Manipal Hospital, Patiala · Certified in ACLS, ATLS, PALS and PoCUS