🔴 Life-Threatening Emergency

Poisoning &
Overdose

Every minute counts. South Africa's National Poison Centre is available 24 hours a day — call them first for expert advice on what to do for the specific substance involved.

Poison Centre: 0861 555 777 EMS: 087 183 1129

CRITICAL

Emergency Contacts — South Africa

Call These Numbers Immediately

National Poison Centre

0861 555 777

Tygerberg Poison Information Centre

Available 24 hours / 7 days

Medi Edge EMS

087 183 1129

Emergency Medical Services

Available 24 hours / 7 days

Children's Poison Centre

021 658 5308

Red Cross Children's Hospital, Cape Town

Business hours — paediatric specialist

What to have ready when you call: the exact name of the substance (keep the container), the amount ingested or exposed to, the time of exposure, the patient's age and weight, and any symptoms already present.

Select a Poisoning Type

What Type of Poisoning?

Select the type of exposure for specific recognition signs, step-by-step actions, and critical do's & don'ts.

💊 Medication & Drug Overdose

Includes paracetamol (Panado), opioids, antidepressants, benzodiazepines, sleeping tablets, and recreational drugs. The specific substance determines urgency and treatment.

Recognise It

●Confusion, drowsiness, or loss of consciousness
●Slowed, shallow, or stopped breathing (opioids)
●Very small (pinpoint) or very large pupils
●Empty or disturbed medication packaging found nearby
●Seizures, uncontrollable shaking
●Blue lips or fingertips (cyanosis)
●Nausea, vomiting, abdominal pain (paracetamol/aspirin)

Note on Paracetamol: Overdose may show no symptoms for 24–48 hours, then cause fatal liver failure. Do NOT wait for symptoms — call the Poison Centre immediately even if the person feels fine.

Step-by-Step: What To Do

Call 0861 555 777 (Poison Centre) immediately

Tell them exactly what was taken, how much, and when. They will advise whether emergency services are needed and what specific actions to take for that substance.

Call 087 183 1129 if any serious symptoms are present

Call EMS immediately if: unconscious, not breathing normally, having seizures, lips/skin turning blue, or breathing is very slow.

Keep the packaging — do not guess

Collect the medication box, blister pack, or bottle. Count remaining tablets if possible to estimate how many were taken. This information directly determines treatment decisions.

Position the patient safely

If conscious and alert: keep sitting upright. If drowsy or unresponsive: recovery position (on their side). This prevents choking on vomit. Monitor breathing continuously.

If not breathing — start CPR

If breathing stops, begin CPR: 30 chest compressions (hard and fast, centre of chest) followed by 2 rescue breaths. Continue until EMS arrives. Use the CPR Guide for step-by-step guidance.

Common Examples & Specific Actions

Paracetamol (Panado) Overdose

No immediate symptoms — appears harmless for 24–48 hours before liver failure. Any adult dose above 10g (20 standard tablets) or 150mg/kg in children is potentially lethal. Always call the Poison Centre immediately regardless of how the person feels.

Opioid Overdose (Morphine, Codeine, Tramadol, Heroin)

Hallmark: very slow breathing (fewer than 1 breath every 5 seconds), pinpoint pupils, unconscious. This is immediately life-threatening. Call 087 183 1129, give rescue breathing/CPR if needed. Do NOT leave alone — death is from respiratory arrest.

Antidepressants / Tricyclics (Amitriptyline, Imipramine)

Dangerous even in small amounts. Can cause rapid deterioration: seizures, cardiac arrhythmias. Always treat as high risk — call Poison Centre and EMS even if currently alert.

Benzodiazepines / Sleeping Tablets (Valium, Urbanol, Stilnox)

Usually causes deep sedation rather than immediate death when taken alone. Becomes highly dangerous in combination with alcohol, opioids, or other sedatives. Recovery position is critical — airway protection from vomit.

What NOT To Do

Do NOT induce vomiting

Unless specifically instructed by the Poison Centre. Vomiting can cause aspiration into the lungs or worsen burns from corrosive substances.

Do NOT give milk or food

Unless instructed by the Poison Centre — milk does not "neutralise" most poisons and delays absorption assessment.

Do NOT wait for symptoms to appear

Many dangerous overdoses (paracetamol, iron) show no early symptoms. Call the Poison Centre immediately regardless of how the person appears.

Do NOT leave them alone

Condition can deteriorate rapidly. Stay with the patient and monitor breathing until help arrives.

Do NOT give other medications to "counter" the overdose

Only medical professionals can administer antidotes. Giving other medications can cause dangerous interactions.

SA Poison Centre — 24/7

0861 555 777

Tygerberg Hospital, Cape Town

Call Poison Centre Call EMS: 087 183 1129

Call EMS Immediately If:

●Unconscious or unresponsive
●Breathing is slow, shallow, or stopped
●Seizures occurring
●Lips or skin turning blue
●Deliberate self-harm
●Child with any suspected ingestion

🧴 Household Chemical Poisoning

Includes bleach (sodium hypochlorite), dishwasher tablets/pods, drain cleaners (caustic soda), oven cleaners, paint thinners, turpentine, and pool chemicals. Many are highly corrosive.

Recognise It

●Burns, redness, or blisters around the mouth and lips
●Severe burning pain in the mouth, throat, or stomach
●Drooling, difficulty swallowing
●Hoarse voice or difficulty breathing (throat swelling)
●Nausea and vomiting (may contain blood)
●Eye or skin irritation, redness, or burns
●Strong chemical smell on breath or clothing

Step-by-Step: What To Do

For skin/eye contact — flush immediately with water

Flush affected skin or eyes with large amounts of clean, cool running water for at least 15–20 minutes. Remove contaminated clothing. Wear gloves when helping — protect yourself.

Call 0861 555 777 — keep the product container

The product name and ingredient list is essential. Read the label to the Poison Centre advisor. They will advise whether hospital attendance is required and what specific first aid to give.

For ingestion — small sips of water only if conscious

If conscious and can swallow safely, giving a few small sips of water to rinse the mouth and oesophagus may reduce burning. Do NOT give large amounts or induce vomiting. Wait for Poison Centre guidance.

Call 087 183 1129 for any airway or swallowing symptoms

Hoarse voice, difficulty breathing, or inability to swallow indicates throat/airway swelling. This is immediately life-threatening and requires emergency airway management. Call EMS and do not wait.

Common Household Chemical Examples

Bleach / Jik

Corrosive to mucous membranes. Flush mouth with water. Do NOT induce vomiting. Call Poison Centre.

Dishwasher Pods / Tablets

Extremely concentrated alkaline — very common in children. Can cause severe burns. Call Poison Centre immediately.

Drain Cleaner (Caustic Soda / NaOH)

Highly alkaline — causes severe burns. Immediate EMS and Poison Centre call. Do NOT neutralise with acid at home.

Paint Thinner / Turpentine / Petrol

Inhaled vapours are toxic. Move to fresh air. Do NOT induce vomiting — aspiration into lungs causes severe pneumonia.

What NOT To Do

NEVER induce vomiting for corrosives

Vomiting a corrosive substance burns the oesophagus a second time and risks aspiration into the lungs.

Do NOT try to neutralise

Do not give vinegar for alkalis or bicarbonate of soda for acids — the heat released can worsen burns.

Do NOT mix chemicals

Bleach + ammonia = toxic chloramine gas. Bleach + acid = chlorine gas. Many cleaning products produce toxic gas when combined.

Do NOT rub skin or eye exposure

Rubbing spreads the chemical and increases absorption. Flush with running water only.

SA Poison Centre — 24/7

0861 555 777 Call Poison Centre Call EMS: 087 183 1129

☁️ Carbon Monoxide & Inhalation Poisoning

Carbon monoxide (CO) is odourless and colourless — "the silent killer." Sources include indoor fires, gas heaters without ventilation, generators indoors, and blocked flues. Also includes toxic fume inhalation from chemicals, fires, and gases.

Critical: CO cannot be seen or smelled. Multiple people collapsing in an enclosed space = suspect CO immediately. The scene is dangerous — do not enter without ventilation.

Recognise It

●Headache (most common — "flu without fever")
●Dizziness, confusion, or feeling faint indoors
●Nausea, vomiting
●Cherry-red or flushed skin (severe poisoning)
●Rapid heart rate, chest tightness
●Multiple people in same space feeling unwell simultaneously
●Pets appearing unwell or dying

Step-by-Step: What To Do

Step 1: Get out — do not go in

Move everyone out of the building immediately. Do not re-enter. Do not attempt rescue unless you have breathing apparatus. You will also be incapacitated within seconds in a high CO environment.

Step 2: Call 087 183 1129 immediately

All CO poisoning is a medical emergency. High-flow oxygen is the treatment — it must be given by EMS or hospital. Inform emergency services it may be a CO incident.

Step 3: Fresh air and open windows from outside

Keep all patients in fresh air. Open doors and windows from outside the building if safe. Do not use electrical switches (spark risk if gas leak present).

Step 4: Recovery position and CPR if needed

Unconscious but breathing: recovery position. Not breathing: begin CPR immediately. Symptoms may seem to improve in fresh air but hospital evaluation with oxygen therapy is still essential.

What NOT To Do

Do NOT enter the building

CO incapacitates faster than you can reach a victim. More rescuers die this way.

Do NOT assume symptoms will pass

CO binds to haemoglobin 200x more strongly than oxygen. Hospital oxygen therapy is required to reverse this.

Do NOT use electrical switches or open flames

If a gas leak is involved, electrical sparks can cause explosion.

Do NOT ignore pets collapsing

Small animals are affected faster — a dying pet indoors can warn of CO danger before humans feel it.

Prevention — SA Context

● Never use a paraffin stove, gas braai, or generator indoors
● Never sleep in a closed room with a gas heater burning
● Ensure coal/wood fires have working chimneys
● Install a CO detector — inexpensive and life-saving

Emergency

087 183 1129 Call EMS Now

🌿 Poisonous Plants & Berries

South Africa has many toxic plants. Children are at highest risk as they frequently taste berries and plants. Many toxic plants look attractive or edible.

Common Toxic Plants in South Africa

Syringa / Seringa Berries (Melia azedarach)

Yellow/orange berries on common SA street tree. Causes vomiting, drooling, weakness, and convulsions. Potentially fatal in children.

Oleander (Nerium oleander)

Common garden plant, all parts toxic. Cardiac glycosides cause irregular heartbeat. Even smoke from burning branches is toxic.

Datura / Stinkblad / Malpitte

Causes severe anticholinergic syndrome: fast heart rate, hallucinations, dry mouth, urinary retention, dilated pupils. Often mistakenly used recreationally.

Arum Lily / Varkoor

White-flowered SA native. Contains calcium oxalate crystals. Causes intense burning mouth, throat swelling, drooling, difficulty swallowing.

Dieffenbachia / Dumb Cane

Common indoor plant. Sap causes immediate intense burning in mouth, swelling of tongue and throat. Can cause inability to speak.

Euphorbia / Noors / Melkbos

Milky sap causes severe eye burns and skin irritation. Flush eyes immediately with water for 20 minutes. Always seek medical review for eye exposure.

What To Do

Try to identify the plant — keep a sample or photograph

Take a photo or collect a sample of the plant (leaf, berry, or flower). The plant species determines the treatment and urgency. Do not delay calling while trying to identify it.

Rinse the mouth with water — spit, do not swallow

Rinse the child's (or adult's) mouth out with water and have them spit it out. This removes residual plant material. Do NOT induce vomiting unless specifically instructed by the Poison Centre.

Call 0861 555 777 — all plant ingestion in children is urgent

Even if the child appears well. Many plant toxins have delayed onset. The Poison Centre has a plant toxicology database and can rapidly assess risk from the species involved.

What NOT To Do

Do NOT induce vomiting

Unless specifically told to by the Poison Centre. Many plants (calcium oxalate, corrosives) cause worse burns on the way back up.

Do NOT wait for symptoms

Oleander and other cardiac toxins can cause sudden collapse hours after ingestion. Call early.

Do NOT assume because it is "natural" it is safe

Many of SA's most dangerous poisons are plant-based. Natural ≠ safe.

Poison Centre — 24/7

0861 555 777 Call Now EMS: 087 183 1129

🍶 Alcohol Poisoning

Acute alcohol poisoning occurs when blood alcohol reaches dangerous levels. It is a medical emergency — not "sleeping it off." Also includes ingestion of methanol (methylated spirits, illegal liquor / "papsak" that may be adulterated).

Recognise It

●Unresponsive — cannot be woken (not just "very drunk")
●Slow, irregular, or very shallow breathing
●Pale, blue-tinged, or cold and clammy skin
●Vomiting while unconscious (choke risk)
●Seizures

Methanol Warning: Methanol (found in illegal alcohol, methylated spirits) causes blindness and death. Symptoms: visual disturbances ("snowstorm" vision), severe metabolic acidosis. Call EMS immediately — this is not treatable at home.

What To Do

If unconscious: recovery position immediately

Roll onto their side. Keep them on their left side. Alcohol causes vomiting — the recovery position prevents aspiration (inhaling vomit into the lungs), which can cause death. Do NOT leave face-up.

Call 087 183 1129 if they cannot be woken

If the person cannot be roused, is breathing irregularly, lips are blue, or they are having seizures — call EMS immediately. Do not assume they will sleep it off.

Monitor breathing and stay with them

Check breathing every few minutes. Keep them warm with a blanket. Do not give coffee, food, or cold showers — these do not sober someone up and can cause harm.

Begin CPR if breathing stops

If breathing stops — begin CPR: 30 chest compressions, 2 rescue breaths. Continue until EMS arrives.

What NOT To Do

Do NOT leave them on their back

Aspiration of vomit is the most common cause of death in alcohol poisoning.

Do NOT give coffee or food

Does not accelerate alcohol metabolism. Coffee can cause dehydration.

Do NOT put them in a cold shower

Can cause hypothermia and shock in a drunk person.

Do NOT assume sleep is safe

Blood alcohol can continue to rise even after drinking stops. A person who seems "okay" may become severely affected while asleep.

087 183 1129 Call EMS Now

🌾 Pesticide & Organophosphate Poisoning

Highly prevalent in South Africa's agricultural communities. Organophosphates (OPs) are found in many commercial and agricultural pesticides including parathion, malathion, and dieldrin. Can be absorbed through skin, inhalation, or ingestion.

Protector First: OP pesticides can be absorbed through your skin too. Do NOT touch the patient directly until you have protective gloves. Remove contaminated clothing using gloves.

Recognise It (SLUDGE Mnemonic)

S — Salivation (excessive drooling)

L — Lacrimation (watery eyes)

U — Urination (involuntary)

D — Defecation (involuntary)

G — GI distress (cramps, vomiting)

E — Emesis (vomiting)

Also: muscle tremors, seizures, pinpoint pupils, slow heart rate, difficulty breathing, unconsciousness.

What To Do

Step 1: Protect yourself first

Wear rubber/nitrile gloves before touching the patient. If none available, use plastic bags over hands. Avoid contact with vomit or contaminated clothing.

Step 2: Remove contaminated clothing

Cut off clothing rather than pulling over the head to avoid spreading contamination. Flush exposed skin with large amounts of water and soap for 15–20 minutes.

Step 3: Call 087 183 1129 and 0861 555 777 immediately

OP poisoning requires atropine antidote which can only be given by medical professionals. Tell EMS it may be organophosphate exposure — they will prepare accordingly.

Step 4: Move to fresh air and monitor

For inhalation exposure: move to fresh air. If conscious: recovery position. If not breathing: begin CPR with rescue breaths (ensure own protection from contamination).

What NOT To Do

Do NOT touch with bare hands

Organophosphates absorb through intact skin within minutes. Secondary poisoning of rescuers is common.

Do NOT induce vomiting

Risk of aspiration and spreading contamination.

Do NOT delay calling EMS

The antidote (atropine) must be given by paramedics or in hospital. There is no effective first aid antidote.

Poison Centre — 24/7

0861 555 777 Call Poison Centre EMS: 087 183 1129

🐍 Snakebite Envenomation

South Africa has numerous venomous snakes. Most snakebite deaths result from delayed treatment. Common dangerous species include puff adder, black & green mamba, cobra (spitting and non-spitting), boomslang, and berg adder.

Cytotoxic Venom

Puff adder, gaboon adder. Local swelling, tissue destruction, severe pain.

Neurotoxic Venom

Mamba, cobra (non-spitting). Muscle weakness, ptosis, respiratory failure. Can be rapidly fatal.

Haemotoxic Venom

Boomslang, vine snake. Uncontrolled bleeding, clotting failure. Delayed onset — call Poison Centre even if bite looks minor.

Recognise It

●One or two fang puncture marks at the bite site
●Immediate or delayed pain and swelling at bite site
●Drooping eyelids (ptosis), blurred vision (mamba/cobra)
●Difficulty breathing or swallowing
●Abnormal bleeding from bite site or gums (boomslang)
●Eye pain, redness, and vision disturbance after spitting cobra

What To Do

Move away and keep still

Move the patient and yourself away from the snake. Keep the bitten person as still as possible — movement accelerates venom absorption. Remove watches and rings near the bite (swelling occurs rapidly).

Call 087 183 1129 and 0861 555 777 immediately

Antivenom is the definitive treatment and is only available in hospital. Tell EMS the approximate appearance of the snake if safe to observe. The Poison Centre can advise on specific species management.

Spitting cobra eye exposure — flush immediately

Flush with large amounts of clean water for 15–20 minutes. This is time-critical for vision preservation. Seek medical attention after flushing.

Immobilise the bitten limb below heart level

Keep the bitten limb lower than the heart and immobilised (splint with a stick if needed). Keep the patient calm and lying down. Anxiety increases heart rate and venom spread.

What NOT To Do

Do NOT cut and suck the wound

This is ineffective and dangerous — it can introduce infection, cause tissue damage, and poison the rescuer through mouth sores.

Do NOT apply a tourniquet

Restricting blood flow concentrates venom locally, causing severe tissue destruction. Contraindicated for snakebite.

Do NOT apply ice

Ice can worsen tissue damage from cytotoxic venom.

Do NOT try to catch or kill the snake

Most snakebite victims are bitten a second time trying to kill the snake. A photo from a safe distance is enough for identification.

Do NOT give alcohol

A common folk remedy — alcohol dilates blood vessels and speeds venom absorption.

Poison Centre — 24/7

0861 555 777 Call Poison Centre EMS: 087 183 1129

For All Types of Poisoning

Universal Do's & Don'ts

These rules apply regardless of the type of poison involved.

Always DO These Things

Call 0861 555 777 (Poison Centre) first

Available 24/7 with substance-specific advice — they guide you on exactly what to do for what was ingested.

Keep the container, packaging, or sample

The exact substance determines treatment. Even a photo of the label is better than guessing.

Note the time of exposure and amount

Doctors use this to calculate toxicity and decide whether treatment is needed.

Use the recovery position if drowsy

On their left side — prevents choking on vomit, the most common preventable cause of death in poisoning.

Stay with the person

Condition can change rapidly. Monitor breathing every few minutes until help arrives.

Protect yourself from exposure

Gloves for chemical contact, fresh air for inhalation, do not enter toxic environments.

Never Do These Things

NEVER induce vomiting without Poison Centre instruction

For corrosives: re-burns the oesophagus. For hydrocarbons: aspiration pneumonia. For some toxins: vomiting accelerates absorption.

NEVER give milk to "dilute" or "neutralise"

This is a common misconception. Milk does not neutralise most poisons and can delay or complicate treatment.

NEVER assume "a little bit can't hurt"

A single adult ibuprofen tablet can cause kidney failure in an infant. Dosage is relative to body weight.

NEVER wait for symptoms before calling

Many serious poisons (paracetamol, boomslang venom, iron tablets) have delayed onset with no early warning.

NEVER leave the person alone

Sudden deterioration, seizure, or respiratory arrest can occur with minimal warning.

NEVER enter a toxic environment unprotected

Gas leaks, CO-filled rooms, and chemical spills kill rescuers every year. More people die trying to help than the original victims.

Be Prepared

What to Tell the Poison Centre

Having this information ready saves critical time and allows them to give you accurate, substance-specific advice immediately.

💊

Exact Substance Name

Read the product name, active ingredient, and concentration from the label. For unknown substances, describe appearance, smell, and container type.

📏

Amount Ingested or Exposed

Count remaining tablets, estimate volume of liquid, or estimate skin area exposed. Best guess is better than no information.

⏱️

Time of Exposure

The exact time (or best estimate) determines which treatments are still effective and how urgently the patient needs to be seen.

👤

Patient Age & Weight

Toxicity is calculated per kilogram of body weight. A dose that is minor in an adult may be lethal in a child of the same weight.

🩺

Current Symptoms

Describe exactly what you observe: level of consciousness, breathing, skin colour, vomiting, pain, unusual behaviour.

💉

Other Medications

List any other medications or substances the patient regularly takes. Drug interactions can dramatically change the severity of an overdose.

National Poison Information Centre (Tygerberg)

0861 555 777

Available 24 hours a day, 7 days a week — including public holidays

Safety

Poisoning Prevention

The majority of childhood poisonings and many adult incidents are preventable with simple precautions.

🔒

Lock Away Medications & Chemicals

Store all medications, cleaning products, and chemicals in locked or child-proof cupboards above child reach. The kitchen and bathroom are the highest risk areas.

🏷️

Never Repackage Products

Do not store cleaning chemicals in food or drink containers — a fatal number of adults and children die each year from mistakenly drinking chemicals stored in cool drink bottles.

🌿

Know Your Garden Plants

Identify toxic plants in your garden. Oleander, syringa, datura, and arum lily are common in South African gardens. Teach children never to eat any plant, berry, or seed without adult permission.

☁️

CO Safety Indoors

Never use gas heaters, paraffin stoves, coal fires, or generators in closed rooms. Install a CO detector. Ensure all flued appliances are regularly serviced.

💊

Medication Safety

Dispose of old medications safely. Do not share prescriptions. Keep medications in original child-proof containers. Never refer to medicine as "sweets" to encourage children to take it.

📞

Save the Poison Centre Number

Save 0861 555 777 in every household member's phone now — before an emergency. Also save 087 183 1129 for Medi Edge EMS.

Suspected Poisoning? Call Now.

Do not search online. Do not guess. Call the Poison Centre — they have substance-specific databases and will tell you exactly what to do within seconds.

Poison Centre: 0861 555 777 EMS: 087 183 1129

WhatsApp EMS

Medical Disclaimer: This page is provided for public educational purposes only and does not constitute medical advice. Information is general in nature — specific treatment for any poisoning depends on the exact substance, amount, and individual patient factors. Always follow the guidance of the National Poison Information Centre (0861 555 777) and qualified emergency medical personnel. View First Aid Training →

Poisoning & Overdose

Call These Numbers Immediately

What Type of Poisoning?

💊 Medication & Drug Overdose

Recognise It

Step-by-Step: What To Do

Common Examples & Specific Actions

What NOT To Do

Call EMS Immediately If:

🧴 Household Chemical Poisoning

Recognise It

Step-by-Step: What To Do

Common Household Chemical Examples

What NOT To Do

☁️ Carbon Monoxide & Inhalation Poisoning

Recognise It

Step-by-Step: What To Do

What NOT To Do

🌿 Poisonous Plants & Berries

Common Toxic Plants in South Africa

What To Do

What NOT To Do

🍶 Alcohol Poisoning

Recognise It

What To Do

What NOT To Do

🌾 Pesticide & Organophosphate Poisoning

Recognise It (SLUDGE Mnemonic)

What To Do

What NOT To Do

🐍 Snakebite Envenomation

Recognise It

What To Do

What NOT To Do

Universal Do's & Don'ts

Always DO These Things

Never Do These Things

What to Tell the Poison Centre

Exact Substance Name

Amount Ingested or Exposed

Time of Exposure

Patient Age & Weight

Current Symptoms

Other Medications

Poisoning Prevention

Lock Away Medications & Chemicals

Never Repackage Products

Know Your Garden Plants

CO Safety Indoors

Medication Safety

Save the Poison Centre Number

Suspected Poisoning? Call Now.

Poisoning &
Overdose