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Anticoagulant rodenticides poisoning

Definition

Anticoagulant rodenticides are poisons used to kill rats. Rodenticide means rodent killer. An anticoagulant is a blood thinner.

Anticoagulant rodenticide poisoning occurs when someone swallows a product containing these chemicals.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Alternative Names

Rat killer poisoning; Rodenticide poisoning

Poisonous Ingredient

  • 2-isovaleryl-1,3-indandione
  • 2-pivaloyl-1,3-indandione
  • Brodifacoum
  • Chlorophacinone
  • Coumachlor
  • Difenacoum
  • Diphacinone
  • Warfarin

Note: This list may not be all-inclusive.

Where Found

  • D-Con Mouse Prufe II, Talon (brodifacoum)
  • Ramik, Diphacin (diphacinone)

Note: This list may not be all-inclusive.

Symptoms

  • Blood in the urine
  • Bloody stools
  • Bruising and bleeding under the skin
  • Confusion, lethargy, or altered mental status from bleeding in the brain
  • Low blood pressure
  • Nosebleed
  • Pale skin
  • Shock
  • Vomiting blood

Home Care

Do NOT make a person throw up unless told to do so by poison control or a health care professional.

Before Calling Emergency

Determine the following information:

  • Person's age, weight, and condition
  • The name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • How much was swallowed

Poison Control

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. The person may receive:

  • Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent the person from breathing in blood.
  • Blood transfusion, including clotting factors (which help your blood clot) and red blood cells
  • Chest x-ray
  • EKG (electrocardiogram, or heart tracing)
  • Endoscopy -- a camera down the throat to see the esophagus and stomach
  • Fluids through a vein (IV)
  • Medicines to treat symptoms
  • Medicine (activated charcoal) to absorb any remaining poison and laxatives to move it quickly through the body
  • Medicine (antidote) such as vitamin K to reverse the effect of the poison

Outlook (Prognosis)

Death may occur as late as 2 weeks after the poisoning as a result of bleeding. However, getting the right treatment usually prevents serious complications. If blood loss has damaged the heart or other vital organs, recovery may take longer and the person may not fully recover.

References

Cannon RD, Ruha AM. Insecticides, herbicides, and rodenticides. In: Adams JG, ed. Emergency Medicine Clinical Essentials. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 146.

Janz TG, Hamilton GC, Eckstein M, Henderson SO. Disorders of hemostasis. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 122.


Review Date: 11/2/2014
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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