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Substance identification

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The substance taken may be elicited by the patient, but this should be corroborated, especially in serious suicidal attempts. Fellow household members, relatives, neighbours, ambulance personnel, and the police may all be useful as sources of third-party evidence.

Where possible, ascertain:

  • time of ingestion
  • associated alcohol consumption
  • past and current medical history
  • symptoms noted since ingestion

Useful clues may be present by examining the:

  • eyes:
    • dilated pupils - tricyclics, cocaine, amphetamine
    • pinpoint pupils - opiates - rapidly reversed by naloxone; organophosphates
    • nystagmus - alcohol, benzodiazepines, phenytoin
  • breath - bitter almond smell of cyanide; alcohol; organic solvents
  • burns around the mouth - corrosive substances such as paraquat, glue sniffers
  • hyperventilation - salicylates
  • needlemarks - 'recreational' drug abuse

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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