Unknown Toxin - Wanna Sniff?

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mcdonl

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Hi there, I wanted to ask you all your opinions on "smelling" things in the field... I went on a call for a pt who drank an unknown substance (Indicated someone put something in her soda bottle...) and was experiencing burning in her throat, esophagus and stomach.

When I got there, I asked PD and the FR where the bottle was, and if anyone took a sniff... they looked at me like I have a third arm or something. The EMT who was the first responder said "I don't smell stuff...." - Ok, fair enough. But, I wanted to know if I could readily identify what the substance was... you know, if it were bleach, or some other odor that I could use as a description... So, I uncapped the bottle and took a sniff... (P F'in U) is all I have to say...

Best I could do to describe the smell to poison control was "Something industrial smelling, but not a cleaning agent...." and I did not care for it at all.

I have been taught to use all of my senses, and I felt like I was doing the right thing.

Would you take a sniff?
 
mcdonl said:
Hi there, I wanted to ask you all your opinions on "smelling" things in the field... I went on a call for a pt who drank an unknown substance (Indicated someone put something in her soda bottle...) and was experiencing burning in her throat, esophagus and stomach.

When I got there, I asked PD and the FR where the bottle was, and if anyone took a sniff... they looked at me like I have a third arm or something. The EMT who was the first responder said "I don't smell stuff...." - Ok, fair enough. But, I wanted to know if I could readily identify what the substance was... you know, if it were bleach, or some other odor that I could use as a description... So, I uncapped the bottle and took a sniff... (P F'in U) is all I have to say...

Best I could do to describe the smell to poison control was "Something industrial smelling, but not a cleaning agent...." and I did not care for it at all.

I have been taught to use all of my senses, and I felt like I was doing the right thing.

Would you take a sniff?
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If it could potentially help the patient, then yes I probably would. Granted, the only way one should take a sniff would be to use the hand technique (that is, waving my hand over the bottle and sniffing that, not sniffing it directly).
 
The technical term for that would be wafting...(giggles at "the hand technique")
 
i dunno i was always taught "scene safety" what if it could have hurt you...just saying lol
 
I'd use wafting if I sniffed at all. I've sat in one too many chemistry labs where I inhaled too close to the hood and ended up with burning membranes of my own LOL.
 
At this point identifying the substance is a low priority. treat the signs and symptoms of the patient and transport them to the hospital. Secure the substance (as simple as putting a cap on the bottle) and bring it with you to the hospital.

But, no I would not smell anything. Even by wafting.
 
although knowing me i probably would take a "waft" to see if i could ID the substance its probably not a good idea. You (the EMT/FR) dont know if the substance is harmful as a vapor or a liquid and could potentially cause you harm. Its possible the pt is down b/c they inhaled it (like old school sniffing glue or butane ...idk...ive seen one too many rescue 911 episodes). Best bet like any OD/poisoning call, secure the substance safely and transport it with the pt and let med control know so they can contact poison control center if necessary.
 
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I have a very poor sense of smell. It's a sense I never depended on. I can't recall ever missing anything because of its absence...wait, that's not true; partners have busted me for B.O.!
 
I suspected I was in the "wrong" - I knew though that she drank it, not sniffed it and my thoughts were... if she drank it and is not feeling well I should be able to get away with a sniff. I will think twice the next time. I am not saying I would not sniff it again, but I will give it some though. Maybe I will use the wafting technique... like I was taught to do...
 
Well, I may be in the minority here, but I would not smell nuffin. You never know what is there. And I've burned my nose too many times between accidentally getting a whiff of purple primer to trying to strip paint in a badly ventilated shop.

Besides, I don't really need to know what is there and, even if I did want to smell it, I'm not going to be able to tell the differance between this and that. I might be able to tell if it is turpintine or miricle grow, but what if it is HCl? I take a sniff of that, I'm screwed. Might not kill me, but it can be pretty bad for me.

Best thing to do? Cap it up and take it with you. Let somebody else figure out what is mixed with the drink.
 
So y'all are in agreement that you would put unknown noxious and possibly deadly chemicals in your ambulance for transport?
 
jjesusfreak01 said:
So y'all are in agreement that you would put unknown noxious and possibly deadly chemicals in your ambulance for transport?
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I at least "secured" it in an outside container.

AND... Let's not overlook the fact I didn't taste it! :)
 
Sensible answers all

Yeah, I used a 1952 Gilbert Science chem set I got from an older cousin to make HCl and sniffed it. Very bad idea.

Remember the woman who drank organophsphate insecticide and offgassed into the ER, causing an evac?

1. If you smell it, chart it.
2. Maybe LE should secure and retreive it, it is evidence to r/o attempted homicide versus accident versus (attempted} sucide (pushed, fell or jumped as they used to say). If no LE, double bag it and put it in an outside compartment?
3. Look for collapsed firefighters or LE on approach from upwind.
4. Know how to quickly ventilate your treatment compartment enroute.
 
I would not be sniffing anything up close. Maybe wafting it after some thought.
Did you smell it or anything on her breath?
 
Isn't this why we have canaries?


Aka some other form of "first responder."


The chief taste testing the tanker was actually on a fire training safety video of real people doing what you shouldn't.

It is a very old video so something "newer" and "more advanced" might have replaced it.
 
mycrofft said:
Yeah, I used a 1952 Gilbert Science chem set I got from an older cousin to make HCl and sniffed it. Very bad idea.

Remember the woman who drank organophsphate insecticide and offgassed into the ER, causing an evac?

1. If you smell it, chart it.
2. Maybe LE should secure and retreive it, it is evidence to r/o attempted homicide versus accident versus (attempted} sucide (pushed, fell or jumped as they used to say). If no LE, double bag it and put it in an outside compartment?
3. Look for collapsed firefighters or LE on approach from upwind.
4. Know how to quickly ventilate your treatment compartment enroute.
Click to expand...

EMS Law, never pass the first body.
 
mcdonl said:
I at least "secured" it in an outside container.

AND... Let's not overlook the fact I didn't taste it! :)
Click to expand...

Not all ambulances have a lot of outside space. I know some don't have more than the backboard compartment and the small one beside it where the c-collars are kept. The rest open to the inside and outside. You risk contaminating your gear if you put chemicals in the truck. I would probably have fire try to figure out what it was, since they are the hazmat specialists, at which time they can radio me or the hospital to let them know. If fire can't figure it out, it is unlikely the hospital will be able to.
 
mycrofft said:
Yeah, I used a 1952 Gilbert Science chem set I got from an older cousin to make HCl and sniffed it. Very bad idea.
Click to expand...


What was I just saying. Did it feel good.



1. If you smell it, chart it.
Click to expand...

So they know what killed you too, right?:P
3. Look for collapsed firefighters or LE on approach from upwind.
Click to expand...
lol! Like fma says: never pass the first body.
 
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