Poisoning and overdose (adult)

How to respond to suspected poisoning and overdose in adults, focusing on scene safety, airway, breathing and early contact with 999/111, following NHS guidance.

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How to guide

What is poisoning & overdose?

Poisoning occurs when harmful substances are swallowed, inhaled, absorbed through the skin or injected, leading to a wide range of possible effects from mild nausea and dizziness to seizures, coma and cardiac arrest. Common causes include medicines taken in error or overdose, cleaning products, pesticides, alcohol, illicit drugs and carbon monoxide.

First aiders should prioritise their own safety, remove the casualty from ongoing exposure if safe, support airway, breathing and circulation and contact 999 or NHS 111 for specialist advice; they should not induce vomiting, give antidotes or rely on home remedies like milk.

Poisoning, whether accidental or intentional, is a common reason for hospital attendance and can be life-threatening, particularly with certain medicines, household chemicals, alcohol and recreational drugs.

Who needs this skill?

Any setting where medicines, chemicals, alcohol or drugs are present - which includes most homes, workplaces and venues - needs clear poisoning response plans.

Health & Social Care

In health and social care, staff must follow medicines management, safeguarding and mental health policies, particularly in cases of self-harm, polypharmacy and vulnerable adults.

Licensed venues & nightlife

In nightlife and licensed venues, overdose and poisoning may involve alcohol, recreational drugs or adulterated substances; staff should recognise unresponsiveness, breathing problems, agitation, seizures and unusual behaviour as possible signs of toxicity and call 999 promptly.

Schools

Schools must plan for staff and visitor poisoning risks, including cleaning agents, medication errors and substances brought on site; clear procedures reduce hesitation about calling for clinical advice.

Workplaces

In workplaces, poisoning risks vary from cleaning products and solvents to industrial chemicals; employers must provide COSHH information, PPE and emergency protocols, and first aiders should know how to access product safety data and NPIS advice via clinicians.

How to manage poisoning & overdose

These steps outline how to stay safe, support airway and breathing and contact 999 or NHS 111 when you suspect poisoning or overdose.

1

Ensure scene safety and remove further exposure if possible

Check for hazards such as spilled chemicals, gas leaks, needles or aggressive behaviour and do not put yourself at risk; ventilate the area if safe and move the casualty to fresh air away from the source where possible.

Wear gloves and appropriate PPE when dealing with contaminated clothing or surfaces.

2

Assess airway, breathing and circulation and call 999 or 111

If the casualty is unresponsive or not breathing normally, start CPR and call 999 immediately. If they are conscious but unwell, call 999 for severe symptoms or NHS 111 for urgent advice, providing details of substances, amounts and timings.

Do not delay calling while searching for packaging; any information you have can be updated once on the line.

3

Do not induce vomiting or give food, drink or home remedies

Do not try to make the person vomit or give them anything to eat or drink unless specifically advised by medical professionals, as this can cause further harm or aspiration.

Avoid giving milk or other substances in an attempt to 'neutralise' poisons; these can worsen absorption or interact unpredictably.

4

Collect evidence of substances and packaging

Gather any medicine packets, chemical containers, drug paraphernalia or vomit samples and take them to hospital with the casualty to help identify the substance and dose.

Do not handle sharps or unknown powders without appropriate precautions.

5

Monitor and support while waiting for help

Place responsive casualties in a position of comfort, monitoring their breathing and level of consciousness; place unresponsive but breathing casualties in the recovery position and be prepared to start CPR if they deteriorate.

Record times, observed symptoms and changes in condition to support clinical assessment.

This guide is a learning reference only. It does not replace attended, assessed first aid training.

Qualifying courses

These courses introduce poisoning response principles, with clinical programmes covering toxicology in more depth. Choose the course that matches your role, sector, and the level of clinical practice required.

Qualsafe Level 3 Award in First Aid at Work (RQF)

3 days

3 years

Learn More

Qualsafe Level 2 Award in Activity First Aid (RQF)

Covers sudden poisoning in activities

2 days

3 years

Learn More

Common questions

Practical answers for employers, venue managers, and healthcare teams about poisoning & overdose training.

Can't find your answer? Contact us.

B

Should I give activated charcoal as first aid?

Activated charcoal use is a clinical decision with specific indications and timing; first aiders should not administer it unless operating under explicit protocols and training.

B

What if the person has taken an overdose on purpose and refuses help?

Intentional overdose is a mental health emergency and safeguarding concern; you should encourage them to accept help and still call 999 or 111 for advice, explaining the situation. Professionals may need to assess capacity and risks.

B

Are children’s poisoning principles the same as adults’?

Broad principles are similar but thresholds for concern are lower in children, who are more vulnerable to small amounts of many substances; paediatric poisoning guidance should be followed in clinical settings.

B

How can we tell if someone is drunk or poisoned by something else?

Alcohol intoxication can mimic or mask other poisonings; unusual odours, needle marks, tablets, powders, very small amounts of alcohol for the level of impairment, or atypical symptoms such as seizures or severe agitation should prompt suspicion and 999 activation.

B

How can organisations reduce poisoning and overdose risk?

Measures include secure storage of medicines and chemicals, staff training, clear drug and alcohol policies, early welfare checks on unwell individuals and close liaison with local health and substance misuse services.