Text and Photos by Charmaine A. Lingdas

To raise awareness about venoms, poisons, and their prevention and first aid treatment, the UP-PGH National Poison Management and Control Center celebrated National Poison Prevention Week under the theme ‘Community and Collaboration, Uniting to Prevent Poisoning.’ As part of the commemoration, UP Tox TV aired a special episode titled ‘Who You Gonna Call? Toxbusters,’ on June 24, 2024. The episode featured three renowned toxicologists who shared their expertise on common poisons and offered valuable tips for prevention and management.

Snakebites and Animal Toxins

Dr. John David Comandante began the episode by discussing snakebites and animal toxins. He explained the difference between envenomation and poisoning. Envenomation occurs when venom is injected through the bite or sting of a venomous animal, while poisoning involves the accidental or purposeful ingestion, inhalation, or injection of a toxin, leading to potentially life-threatening consequences.

Dr. Comandante noted that snakes in urban areas like Metro Manila are mostly nonvenomous, but in rural areas with human-wildlife conflict, venomous snakes are more commonly encountered. While many snake bites are not immediately dangerous, it is crucial to seek medical attention if systemic symptoms such as difficulty breathing, or severe swelling occur. He emphasized the importance of having antivenom readily available, noting that the Philippines currently only has antivenom for the Philippine cobra (Naja philippinensis), produced by the RITM.

Regarding the timing of antivenom administration after a snake bite, Dr. Comandante explained that this area is still under study. According to international guidelines, the golden period is six hours. “Pero siyempre napakakakaiba po ang mga ahas po natin dito sa Pilipinas at mas makamandag pa compared sa ibang cobra counterparts natin sa Southeast Asia, lalo na yung Naja philippinensis. May pag-aaral po ang RITM na within five minutes po nagkakaroon na ng tinatawag na respiratory paralysis.” He pointed out that there is currently a shortage in antivenom production but stressed its critical role; emergency stabilization is equally vital. He advocated that healthcare providers should follow Department of Health (DOH) protocols and be empowered to deliver prompt critical care, including ventilatory support, crucial for effectively managing snakebites.

Dr. Comandante shared first aid tips for snake bites:

• Clean the wound or bite area.
• Bandage the affected limb to immobilize it and slow down the spread of venom; do not use a tourniquet.
• Avoid cutting the wound or attempting to suck out the venom, as these methods can cause more harm.
• Seek immediate medical attention even if the symptoms appear mild.

Box Jellyfish Stings

Dr. Comandante also addressed the dangers of box jellyfish (Salabay) stings. He explained that box jellyfish are found in shallow waters with slow currents. Their tentacles can reach a meter in length and are venomous, potentially causing death within minutes. Due to climate change, sightings of box jellyfish have become year-round, with peak sightings in June. 

He advised that vinegar is the most effective first aid treatment for box jellyfish stings in the Indo-Pacific region since it inactivates the nematocysts injecting venom.

The following are his first aid tips for box jellyfish stings:

• Rinse the affected area with vinegar to neutralize the venom.
• Do not use fresh or tap water, as it can trigger more venom release.
• Do not scrape or rub with sand, and do not pour alcohol or urine.
• Remove the jellyfish tentacles carefully using a stick or tweezers, not bare hands. Do not put pressure on the area.
• Immerse the area in hot water for pain relief.
• Seek immediate medical help, especially if the sting covers a large area or if the victim shows signs of severe allergic reactions.

Toxic Alcohols

Dr. Joanna Khris Biag, a toxicologist and pediatrician, joined the discussion to talk about toxic alcohols. “Ang toxic alcohol ay isang uri ng alcohol na kapag pumasok sa katawan ng tao ay maaaring makalason at magdulot ng kamatayan kung hindi agad naagapan,” she explained. She listed ethylene glycol, isopropyl alcohol, and denatured alcohol as common toxic alcohols found in household products like antifreeze, disinfectants, and lacquer thinner.

Dr. Biag stated the signs and symptoms of toxic alcohol poisoning such as abdominal pain, vomiting, dizziness, chest tightness, and difficulty breathing. She warned that toxic alcohol poisoning can lead to kidney failure, impaired vision, convulsions, seizures, and death. Immediate medical attention is crucial.

She also highlighted the dangers of homemade alcohols, such as lambanog, which may contain methanol. She advised consumers to purchase FDA-approved lambanog to ensure it contains only a small percentage of methanol. She added that symptoms of methanol poisoning may arise 12 to 24 hours after ingestion.

Some of her recommended preventive measures to avoid toxic alcohol poisoning are:

• Store toxic alcohols in their original containers and never transfer them to food or drink containers.
• Read labels carefully.
• Keep these substances out of reach of children, preferably in locked cabinets.
• Educate family members about the dangers of toxic alcohols and ensure they understand the importance of proper usage and storage.

Common Household Poisons

Dr. Charmaine Micu-Oblefias discussed common household poisons, identifying disinfecting and cleaning agents, kerosene, and certain self-care products and cosmetics without FDA approval as potential hazards. She also urged the audience to be aware of poisonous plants such as Dieffenbachia and Tuba-tuba (Jatropha).

She emphasized the importance of following several preventive measures to avoid household poisoning, such as storing all chemicals and medications in their original containers and never transferring them to food or drink containers. When handling household cleaning agents, it is crucial to use gloves and masks and to read and follow the instructions on the labels carefully before use. Identifying and keeping potentially poisonous plants out of reach of children and pets is also essential. 

Dr. Micu-Oblefias recommended disposing of expired or unused medications properly by adhering to local disposal guidelines. Additionally, she stressed not using prescribed drugs from other individuals and avoiding referring to medicines as “candy” to children.

“The first step in managing poisoning is what we call decontamination. Kailangan lang itong banlawan para matanggal ang mga particles sa bibig. Huwag ninyong ipapasukahin. Kung ang lason ay dumikit sa balat, kailangan itong hugasan. Kung naging sanhi ito ng inhalesyon, ilayo ito kung saan naganap ang pangyayari,” said Dr. Micu-Oblefias as she shared the simple steps to perform first aid in poisoning at home.

She introduced a simple, yet effective mnemonic device called L-A-S-O-N, serving as a guideline for preventing poison incidents at home and in the community.

• L – Laging itago ang mga kemikal: Store all poisonous substances out of reach of children and pets. Preferably, these items should be kept in locked cabinets. Ensure that medications, cleaning products, and other hazardous materials are securely stored to prevent accidental access.
• A – Alamin ang mga palatandaan ng pagkalason: Know the signs and symptoms of poisoning such as stomach ache, dizziness, and vomiting.
• S – Siguraduhin basahin ang etiketa ng produkto: Make sure to read the label of household chemicals and medications. This helps prevent accidental ingestion and misuse.
• O – Obserbahan ang mga bata: Supervise the use of potentially toxic substances, especially when children are present. Be mindful of what children are doing and where they are exploring to prevent accidental poisonings.
• N – Numero: Always have the emergency number for the National Poison Management and Control Center easily accessible. In the event of a poisoning incident, call +63 2 8524 1078 for immediate assistance and advice. #

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