First Aid for Poison Sumac Poisoning

First Aid for Poison Sumac Poisoning

Article
Allergy
Ear, Nose, & Throat (ENT)
+5
Contributed byKrish Tangella MD, MBANov 04, 2021

What is Poison Sumac Poisoning?

  • The poison sumac (botanical name Toxicodendron vernix) is a wild plant that can grow to be about 20 feet tall. It has a bright red color leaf stalk/stem that contains between 5 to 13 pointed leaves. The plant has small and distinctly spaced berries that are green when unripe and white when ripe
  • Poison sumacs belong to the same family as poison ivies. Like the poison ivy, touching the poison sumac plant results in itchy and painful skin rashes due to an allergic reaction of the body. The plant is found in many parts of America, particularly along the Mississippi river
  • Poison Sumac Poisoning is often the accidental exposure to poison sumac leaves or other plant parts usually via physical contact. The condition is often seen among farmers, gardeners, forest workers, campers, landscape personnel, and painters
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Poison Sumac Poisoning may be also referred to as Poison Sumac Toxicity or Poisonous Sumac.

What are the Causes of Poison Sumac Poisoning?

  • Poison Sumac Poisoning is caused by touching poison sumac plant or plant parts. It can also be the result of eating plant parts (leaves or berries), or inhaling smoke from burning dead/dry plants
  • The exposure could be accidental, or in some cases intentional, to bring self-harm. It is reported that a vast majority of the individuals exposed to poison sumac develop an allergic rash
  • The plant contains a toxin called urushiol, a strong allergic organic oil, which is found in all plant parts (especially in the leaves). Even touching any toxin-contaminated items, such as gardening tools or pet fur, may cause rash formation
  • Burning the plant can also cause release of the toxin in smoke, resulting in associated symptoms. Even burning dead leaves or dried plant can result in symptoms

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Poison Sumac Poisoning?

The signs and symptoms can vary from one individual to another. It may be mild in some and severe in others based on the degree of exposure and the specific allergic reaction of the individual. The signs and symptoms of Poison Sumac Poisoning may include:

  • Itching at the site of skin contact; the itching can be severe to extreme
  • Itching the affected site may cause spread of the oily substance (urushiol) to other body areas, resulting in a larger area to be affected
  • Formation of red skin rashes that present burning, irritation, and pain. This is termed as allergic contact dermatitis
  • The skin rashes are striated or striped in pattern
  • Over time, the rashes may become fluid-filled blisters; some blisters can be large
  • The rashes form only at the sites of exposure to the plant/plant oil; the rashes do not spread, even if the blisters break
  • Eating the plant parts can result in swollen mouth, and injury to the throat, food-pipe and stomach
  • Inhaling smoke from burning poison sumac plants can result in chest pain/tightness and severe respiratory difficulties
  • In some individuals, the exposure may cause a severe allergic reaction, or anaphylaxis, that presents breathing difficulties, weak pulse, and shock

The symptoms are usually seen within 1-3 days (and sometimes, after 5 days) following contact with the poison sumac plant. The severe phase of skin symptoms is typically between days 4 and 7 of exposure.

How is First Aid administered for Poison Sumac Poisoning?

First Aid tips for Poison Sumac Poisoning:

  • Call 911 or your local emergency help number for emergency assistance, if a life-threatening allergic reaction develops
  • Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information on time and extent of exposure, age, weight and general health status of the affected individual
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • Wash the affected skin sites thoroughly with soap and water, immediately on recognition of the exposure (preferably within the first 30 minutes). The affected areas may also be washed using specialized washes (if available), rubbing alcohol, or detergent soap
  • The fingernails should also be scrubbed using a brush and washed with soap and water. Trim fingernails to prevent children from scratching the skin
  • Washing the affected sites should be repeated over the next 6-8 hours
  • Remove or change clothing and footwear (including socks). Since the toxin (plant oil) may be present in the clothing of the exposed individual, these should be thoroughly washed using hot water
  • Use over-the-counter applications, such as calamine lotions, Burow's solution, poison sumac specific creams, or hydrocortisone ointments. Do not apply these on the face or genitals unless advised accordingly by a healthcare expert
  • Avoid applying creams on open wounds or broken blisters unless indicated
  • Staying cool (such as by using cold compresses) can reduce the intensity of itching, while increased sweating can worsen the condition
  • Oatmeal baths in mildly warm water can help improve the symptoms (such as rashes and itching)
  • Take antihistamines to relieve symptoms of an allergy (such as itching), per recommendation of the healthcare provider
  • Seek emergency treatment, if the face and genitals are severely affected, large areas of the body are involved, the symptoms get worse, or an infection develops in the rash
  • Seek emergency medical help if there is a severe allergic reaction to the toxin and the individual has difficulty breathing, chest tightness, swollen tongue or throat, or develops extensive skin redness and swelling
  • Always try to take the plant or plant part to the ER, as safely as you can
  • Children may require pediatric consult

In case of hospitalization, the affected individual may be provided with breathing support, suitable medications to address the symptoms, and fluids by an intravenous drip line, if necessary.

Who should administer First Aid for Poison Sumac Poisoning?

  • Any individual around the victim, or the affected individual himself/herself, can administer first aid for Poison Sumac Poisoning
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions, if necessary

What is the Prognosis of Poison Sumac Poisoning?

  • The prognosis of Poison Sumac Poisoning is dependent on the extent of exposure, severity of the symptoms, as well as general health status of the patient
  • In most cases, the prognosis is good with adequate home care and/or treatment. A complete resolution of the skin rashes usually occurs within 14 to 21 days
  • In case of severe allergic symptoms due to severe exposure/poisoning, it may prolong time of recovery. Occasionally, severe poisoning (from inhalation of burnt plant smoke) may result in obstruction of the airways, necessitating immediate medical attention

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Poison Sumac Poisoning be Prevented?

Poison Sumac Poisoning can be prevented by:

  • Destroying poison sumac plants using suitable weed killers from home gardens or backyards, once the plant has been identified
  • Using adequate protective wear (full-sleeved shirt, gloves, goggles) while handling the plant, or while working or camping outdoors
  • Avoiding burning dry leaves or dead poison sumac plants
  • Washing hands thoroughly to prevent the toxic compound from spreading to other body areas, or even to clothing and other objects (such as to garden tools)
  • Cleaning the fur of pets that are exposed to the plant
  • Avoiding eating wild berries and plants, especially if you have no information about them
  • Following working in the garden or fields, hiking, or camping, always wash hands thoroughly, prior to eating anything
  • Learning to identify poison sumac plant and avoiding them
  • Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

  • Avoiding touching poison sumac plant, once it is identified
  • Do not burn the plant after removing/uprooting it
  • Avoid scratching the skin following contact with the plant
  • Seek medical attention in case of a severe allergic reaction, if the eyes, mouth, or genitals are involved, or if an infection forms in the blister
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Krish Tangella MD, MBA picture
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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