What is the general field approach to suspected toxic ingestion?

• A. Identify substance if possible; do not induce vomiting; provide supportive care; contact medical control or poison control for guidance
• B. Induce vomiting to expel poison
• C. Give activated charcoal without contacting control
• D. Wait and see; there is no urgent need for guidance

Answer: (B)

In suspected toxic ingestion, the focus in the field is on stabilizing the patient, gathering information, and getting expert guidance rather than trying to remove the toxin yourself by vomiting. Start with airway, breathing, and circulation, provide oxygen if needed, protect the airway, monitor for deterioration, and treat any seizures or arrhythmias while preparing for transport. Gather critical details: what was ingested, how much, and how long ago; try to obtain packaging or labeling and note any known medical conditions or medications.

Vomiting induction is not the standard field approach because it can cause aspiration, esophageal or gastric injury, and can spread caustic or harmful agents. Instead, contact medical control or poison control for instructions on decontamination and antidotes. Activated charcoal may be considered only if directed by medical control and when appropriate (time since ingestion, type of substance, and airway protection), not as a routine step. The emphasis is on informed guidance and supportive care, with prompt transport when indicated.