Inhaled poisoning is a medical emergency that demands immediate and decisive action to minimize harm to the victim. Toxic gases, fumes, or vapors, such as carbon monoxide or chlorine, rapidly enter the bloodstream through the lungs, causing systemic damage or asphyxiation. Rapid intervention is paramount, as even brief exposure to a high concentration of a toxin can lead to severe injury or death. This guide provides a structured, step-by-step approach for a lay responder to manage this crisis until professional medical help arrives.
Prioritizing Scene Safety and Removing the Victim
The first priority in any inhaled poisoning scenario is ensuring the safety of the rescuer, following the principle of “Do not become a second victim.” Before approaching the person, assess the environment for the source of the fumes, noting strange odors, visible vapors, or signs of poor ventilation. If the air is visibly contaminated or the poison source is active, do not enter the area without specialized protective equipment.
If it is safe to enter, or if the toxic source can be quickly eliminated (e.g., turning off a stove), the immediate goal is to move the victim to uncontaminated, fresh air. Moving the person even a short distance can dramatically reduce their exposure and stop the poisoning process. If the poisoning occurred indoors, open windows and doors to ventilate the area, but this should not delay moving the victim outside.
If the environment is clearly hazardous, such as a smoke-filled room or near a chemical spill, the responder must wait for fire or hazardous materials (Hazmat) professionals to secure the scene. Attempting a rescue in a toxic environment without proper breathing apparatus risks the rescuer collapsing. Once the victim is safely in an open-air environment, the focus shifts to activating the emergency response.
Emergency Response Activation and Primary Assessment
Once the person is in a safe location with fresh air, immediately activate the professional emergency response system. Call the local emergency number (e.g., 911) to request medical assistance. Simultaneously, call the national Poison Help hotline (1-800-222-1222), which connects to a local Poison Control Center.
Immediately after calling, perform a rapid primary assessment of the victim’s vital functions. Check for responsiveness by speaking to the victim and gently shaking them, and check if they are breathing normally. If the person is unresponsive and not breathing, or only gasping, initiate cardiopulmonary resuscitation (CPR) if trained, and instruct emergency services to dispatch an ambulance.
If the person is breathing but unconscious, or conscious with symptoms like confusion or difficulty breathing, clearly relay this information to both the emergency dispatcher and the Poison Control specialist. This dual activation mobilizes both medical transport and specialized toxicology advice quickly. Rapid transport is a priority, especially for suspected inhaled poisoning like carbon monoxide, where high-flow oxygen is a standard treatment.
Supportive Care While Awaiting Medical Help
Provide supportive care until medical help arrives, ensuring the primary assessment remains stable. If the victim is conscious but struggling to breathe, help them into a comfortable sitting position to ease respiration. If the person is unconscious but breathing normally, gently roll them onto their side into the recovery position.
Monitor the victim’s condition continuously, watching for changes in consciousness, skin color (such as bluish lips indicating cyanosis), and breathing rate. Keep the person calm, still, and warm, as anxiety and physical exertion increase the body’s demand for oxygen. Loosen restrictive clothing around the neck and chest to ensure unrestricted airflow.
Do not attempt to counteract the poison with unprescribed substances. Do not give the victim anything to eat or drink, including water or milk, unless specifically instructed by Poison Control or a medical professional. Such interventions can complicate the medical assessment or cause aspiration if the person’s mental status changes.
Information Gathering and Follow-Up
While monitoring the victim, gather all relevant information for the arriving emergency medical services (EMS) crew. This includes details about the source of the fumes, such as the chemical name or product container. Providing the container or substance to the medical team offers immediate clues about the type of poisoning.
Record the estimated duration of the victim’s exposure and a timeline of observed symptoms, such as headache, nausea, or loss of consciousness. This data is crucial for medical personnel to determine appropriate treatment, including the need for specific antidotes or hyperbaric oxygen therapy. The Poison Control specialist will also have used this information to guide the initial first aid advice.
Even if the person recovers quickly after moving to fresh air, medical follow-up is necessary due to the potential for delayed effects. Some inhaled toxins, like phosgene gas, can cause severe pulmonary edema hours after exposure. The victim must be transported to a hospital for a full medical evaluation to ensure no long-term damage or latent complications develop.