First Aid for Mushroom Poisoning

Emergency Numbers

CIAV is the Poison Information Centre at INEM (Portugal’s National Emergency Medical Institute). CIAV specialists can help identify the type of poisoning and provide recommendations before the ambulance arrives.

Action Plan

Step 1: Call for help

1. Call 112 — request an ambulance
2. Call CIAV (800 250 250) — report:
   • What was eaten (species, if known)
   • When it was eaten (exact time)
   • How much was eaten
   • When symptoms appeared
   • What symptoms are present
   • Age and weight of the patient
   • Chronic conditions (if any)

Step 2: Preserve samples

• Leftover cooked food — do not throw away
• Raw mushrooms from the same batch — if available
• Vomit — as unpleasant as it sounds, it helps with diagnosis
• Peelings, trimmings — anything related to preparation

Place samples in a paper bag (not plastic) and store in the refrigerator.

Step 3: What NOT to do

Step 4: While waiting for the ambulance

• Place the patient in a comfortable position
• If vomiting — turn their head to the side (to prevent choking)
• Give small sips of water (not milk, not tea)
• Record all symptoms and the time they appeared
• If multiple people ate the mushrooms — everyone should seek medical attention, even without symptoms

Types of Poisoning

The time of symptom onset is the most important diagnostic indicator.

Early-onset poisoning (under 6 hours)

Symptoms appear 30 minutes to 6 hours after consumption.

Late-onset poisoning (over 6 hours)

The treachery of the death cap

Amanita phalloides poisoning progresses in three phases:

1. Phase 1 (6–24 hours after eating): severe vomiting, watery diarrhoea, abdominal pain
2. Phase 2 (Day 1–2): “apparent improvement” — symptoms subside, the patient feels better. This is the most dangerous moment — many people decide the danger has passed
3. Phase 3 (Day 3–5): acute liver failure, jaundice, bleeding. Without a liver transplant — often fatal

It is precisely because of this “apparent improvement” phase that it is critically important to seek medical attention at the first symptoms, rather than waiting.

Special Situations

Child poisoning

• Children are more sensitive to mushroom toxins due to their lower body weight
• Even a small amount of a poisonous mushroom can be fatal
• At the slightest suspicion — take them to hospital immediately

Multiple people affected

• If several people ate the mushrooms — everyone must seek medical attention
• Symptoms may appear at different times and with different intensity
• The dish may have contained different species

Foreigners in Portugal

• Many poisoning cases involve visitors who confuse local species with similar ones from their home country
• Portugal’s flora differs from Central and Eastern Europe — a familiar-looking mushroom may be a different species entirely

Prevention

The best first aid is preventing poisoning. Follow the basic safety rules and study the deadly species of Portugal.

Sources

1. CIAV — Centro de Informação Antivenenos, INEM Portugal
2. Direcção-Geral de Saúde — Intoxicações por cogumelos: orientações clínicas
3. Brandão J.L. et al. — Mushroom poisoning in Portugal // Clinical Toxicology
4. European Association of Poisons Centres and Clinical Toxicologists (EAPCCT)
5. Berger K.J., Guss D.A. — Mycotoxins revisited: Part I // Journal of Emergency Medicine

Disclaimer: Identifying mushrooms from descriptions and photographs on the internet is not a substitute for consulting an experienced mycologist. The authors assume no responsibility for the consequences of collecting and consuming mushrooms.