Poisoning occurs when any substance—solid, liquid, or gas—interferes with normal body chemistry, causing structural damage or functional disturbance. In the Nigerian context, presentations range from accidental kerosene ingestion in toddlers to traditional herbal preparation overdoses and agricultural pesticide exposure. A poison acts by altering cellular function, blocking enzyme pathways, or depriving tissues of essential oxygen. Nurses must recognize that toxicity depends heavily on the dose, route of entry, chemical stability of the agent, and individual patient factors like age and weight.
Initial evaluation follows the standard ABCDE framework. Airway patency is the absolute priority, especially if corrosive substances caused laryngeal edema or the patient has a depressed level of consciousness. Assess breathing depth and rate, check circulation including peripheral pulses and capillary refill, evaluate neurological status using the AVPU scale or Glasgow Coma Scale, and expose the patient to check for hidden skin burns or patch test marks. Obtain a rapid history from relatives or bystanders regarding what substance was taken, the estimated quantity, and the exact time of exposure.
Stopping ongoing toxin entry into the systemic circulation is critical during early presentation. For ingested poisons, activated charcoal may be administered if the patient is fully conscious with a protected airway and the ingestion occurred within an hour. Avoid traditional methods like forcing palm oil or salt water down a patient's throat, as these induce dangerous aspiration pneumonia. For surface contamination, flush the skin or eyes continuously with clean running water for at least fifteen minutes. Remove contaminated clothing immediately while wearing gloves to protect healthcare staff from secondary exposure.
Continuous monitoring forms the bedrock of supportive care. Record vital signs every fifteen minutes until the patient stabilizes. Maintain accurate intake and output charts, catheterizing the patient if urinary retention or precise renal tracking is required. Administer specific antidotes promptly when ordered, such as naloxone for opioid overdoses or atropine for organophosphates. Provide a calm, secure environment because patients recovering from intentional self-harm require close observation and psychiatric referral once physical recovery is underway.
Severe poisoning can lead to multi-organ failure, aspiration pneumonitis, permanent neurological deficits, or cardiac arrest. Preventive education remains the most effective long-term intervention. Nurses must counsel families to store household chemicals, detergents, and medications in original containers, well out of the reach of children. Never store kerosene in empty soft drink bottles, which is a leading cause of accidental pediatric ingestion in local communities. Public health campaigns should continually emphasize safe pesticide handling and secure chemical storage in homes and farms.