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August 1997

Poisoned In Camp?

How to deal with common backpacking substances that are more toxic than three-day-old socks.

Mushroom and plant poisonings: When it comes to eating the wrong plant or mushroom, deadly encounters are rare. Out of 85,556 documented questionable mushroom ingestions reported to the American Association of Poison Control Centers in a recent 11-year period, only 14 resulted in fatalities. Almost all the deaths were in adults who mistakenly gathered bad ‘shrooms for dinner or in hopes of a hallucinogenic high. Children are still the greatest eaters of unidentified mushrooms.

The mushroom most likely to kill? The Amanita species (also known as the Death Cap, Death Angel, and Destroying Angel) is responsible for 90 to 95 percent of all mushroom-related deaths. Typically growing under deciduous trees in the United States, Amanitas have a yellowish to white cap 11/2 to 6 inches in diameter, and a thick stalk 11/2 to 7 inches long with a large bulb at the base. The gills under the cap are usually easily visible and white to green in color. Gastrointestinal distress (severe nausea, vomiting, abdominal cramps, diarrhea) with Amanita, and with all potentially death-causing mushrooms, usually begins within 6 to 12 hours. “As a general rule,” notes the Clinical Toxicology Forum, “if symptoms develop within approximately 2 hours of ingestion, it is unlikely that the mushroom is one of the potentially fatal hepatotoxic [liver destroying] varieties.” In other words, if stomach problems surface soon after mushroom munching, the chance of dying is slim.

If you suspect someone has eaten a bad ‘shroom, or ingested anything poisonous, start treatment quickly. Even if you’re in doubt, treat. Don’t wait because each moment that passes means more poison is absorbed into the system.

If the person is still conscious, your goal is to limit the absorption of the poison from the gastrointestinal tract. There are two ways to do this in the wilderness: induce vomiting or bind the toxin with activated charcoal.

Unfortunately, by the time you realize that the person has eaten a poison, much of it will likely have traveled out of the stomach and into the bloodstream. Even so, vomiting can help get rid of what’s left, especially when done within the first hour of poison consumption. Ideally, your first-aid kit will contain a lightweight emetic (vomit inducer), most likely syrup of ipecac. Anyone older than 10 years should get 2 tablespoons with 8 to 16 ounces of water. Younger people should have 1 tablespoon with the same amount of water. Avoid facing the person because the vomiting tends to be sudden and forceful. If he hasn’t vomited in 20 minutes, repeat the dose. If you have no ipecac, try 2 tablespoons of mild soap, or the gag reflex. Lean the person forward, gently reach into his mouth with a finger, and tickle the back of his throat.

Examine the vomit. If you can find samples of the plant or mushroom, bag them and some of the vomit and carry to the hospital. If you can’t find the plant, bring the vomit anyway.

Do not induce vomiting if:

  • He’s losing consciousness.
  • He has heart problems or a disorder that leads to seizure.
  • He has swallowed corrosive acids or bases, which can increase damage as they come back up.
  • He has swallowed petroleum products, which can cause pneumonia if even a small amount is breathed into the lungs.

Better even than vomiting is binding the poison with activated charcoal, which can be administered post-vomiting. While it’s not something most campers keep in their first-aid kits, if available the usual dose is 50 to 100 grams (13/4 to 31/2 ounces) for adults, and half that for children. Swallowing the slurry of fine black powder may prove to be a chore, even though it is odorless and tasteless. To help it down, add to flavored fluids like fruit drinks.

If the person is unconscious, you’ll have to immediately evacuate him to a medical facility, during which you’ll want to keep him on his side to maintain an open airway.

In general, if you suspect someone has ingested poison, ask him about nausea and vomiting, abdominal cramps, diarrhea, loss of visual acuity, muscle cramps, or anything else unusual. What has the person put into his mouth in the past 24 hours? When? How much did he eat?

Watch for changes in the level of consciousness. Confusion, irritability, change of personality, or loss of consciousness are indicative of serious poisonings. Vital signs also are important clues indicating the seriousness of the situation, so watch for signs of shock, such as a fast heart rate with a weak pulse; quick, shallow, or labored breathing; skin that’s cool, clammy, and damp; thirst; or nausea.

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