Thursday, July 26, 2018

Chemical Poisoning

Despite taking precautions like labeling poisonous chemicals and keeping them out of the sight and reach of children, chemical poisoning emergencies do arise. Let us prepare ourselves for the quick and decisive action that is called for.
Domestic chemical poisons can be divided into three categories: 1. Corrosives like acids and alkalis. 2. Petroleum products. 3. Pesticides.
There are three ways that poisonous chemicals can get into the human system and wreak their havoc. They may be taken in
  1. through the mouth (ingested)
  2. through the nose (inhaled) or
  3. through the skin (absorbed)
Depending on the concentration dosage and duration of exposure, these poisons (especially corrosives) do the most harm when they are ingested as they impair the mouth, foodpipe (esophagus) and stomach and, if aspirated, even the lungs, thus impairing breathing.
But whatever the chemical, and whether it is ingested or inhaled, if the person is semi-conscious, unconscious or convulsing, do not give any fluids or try to induce vomiting. If he is semi-conscious or unconscious, make him lie on his side so that the fluid drains out and stay by his side. Contact an ambulance service or try to get him to a hospital a soon as possible.
If the person is conscious, look for specific symptoms of chemical poisoning like burn marks or swelling around the mouth, increased salivation, constricted pupils, a pungent smell or spray paint on the face and hands. (Many non-specific symptoms like vomiting, mental confusion, breathlessness, convulsions and even coma may be mistaken for other acute illnesses.)
Though, in most cases, antidotes are indicated by the manufacturer on the packaging of domestic products that can cause poisoning, they are not always accurate or adequate. Nevertheless, locating the container helps in ascertaining the nature of the poisonous chemical so that suitable first aid measures can be taken.
The specific measures depend upon the category in which the chemical falls:
CORROSIVES
ACIDS
Some acids in common domestic use are: hydrochloric acid, bleach (sodium hypochlorite and oxalic acid), toilet bowl cleaner (sulphuric acid), and phenyl (carbolic acid).
Symptoms of acid poisoning: Scalding, and hence a burning pain around the lips and the mouth, palate, the tongue and, most probably, the hands. Acids act on clothes by completely eating them away, giving the impression that holes have been cut out. The person may also cough and get breathless.
How to treat:
DON'T
  • Induce vomiting by pressing a finger down the throat or making the person drink saline water: the convulsive movements of vomiting put a strain on the walls of the stomach and may perforate it. If the stomach gets perforated and the acid leaks into the peritoneal (abdominal) cavity, it could prove fatal. Besides, if vomiting is induced, on its return journey up the esophageal tract, the acid will compound the damage.
  • Give an alkali (like soda bicarb) in the hope of neutralizing the acid. The equally corrosive alkali will aggravate the damage done by the acid. Besides, the chemical reaction that takes place between the two will release carbon dioxide which will bloat the stomach and increase the chances of peroration.
WHAT TO DO:
If the person appears to have difficulty breathing or if he has stopped breathing, give mouth-to-mouth respiration. This is done by positioning the person flat on his back on a hard surface. Kneeling at his side, place one hand under his neck and the other on his forehead and gently tilt his head back so the chin points up. Pinch the nose shut and give four quick breaths at the rate of twelve times a minute or once every five seconds for an adult; and twenty times per minute or once every three seconds for a small child or infant.
If the person begins to vomit, turn his head to one side to allow the vomitus to drain out so that it does not enter the airway.
If the person is convulsing, keep calm and place a padded object such as handkerchief between his teeth to prevent him from biting his tongue or cheek. Don not force his jaw open if he has already clamped it shut. Loosen tight clothing. Once the convulsive movements stop, turn him on his side to allow his tongue to fall forward and excess saliva to drain out of his mouth.
If the person is in shock, the symptoms will include: shallow breathing, weak pulse, nausea and vomiting, shivering, pale, moist skin, dropping eyelids, dilated pupils, mental confusion and even collapse. Keep the victim lying down and elevate his feet by about 12 inches. Maintain normal body temperature. Give nothing by mouth.
If the person is conscious and is not convulsing, quickly give about three tablespoons of vegetable oil, or milk cream, or melted butter or the white of an egg. They partly neutralize the acid and form a protective coating along the lining of the mouth, pharynx, esophagus and stomach to prevent further damage.
If the acid has entered the eyes and the person wears contact lenses, remove the lenses first and flush with plenty of water. If only one eye is contaminated, turn the head so that the injured side is down and flood the inner corner with cool water for at least five minutes. Or, hold the eye under a stream of cold water from a tap, making sure the acid does not wash into the other eye. Cover with clean gauze but not with absorbent cotton (the fibres can get lodged in the eye.)
Similarly, wash off any acid from the skin with plenty of water preferably under a tap or shower.
Remove contaminated clothing. Rush the person to the hospital to minimize late complications like narrowing of the esophagus which involves long-term surgical measures for correction.
Alkalis
In the domestic setting, these may be found in drain cleaners (sodium hydroxide), button batteries (sodium and potassium hydroxide), and products containing ammonia.
Symptoms: Since alkalis are also corrosive, the symptoms will be the same as in the case of acids, only the membranes of the mouth appear white and swollen, instead of scalded.
How to treat:
The action to be taken is also similar, only don't five an acid in the hope of neutralizing the alkali as its corrosive action will worsen the damage.
Button batteries if swallowed are removable with a gastroscope (inserted into the stomach through the mouth) or through surgery.
PETROLEUM PRODUCTS
These include gasoline, kerosene, benzene, lighter fluid, furniture polish and paraffin.
Symptoms: Burning irritation in the throat, coughing, breathlessness and possibly shock.
DON'T
  • Induce vomiting as the poison could enter the lungs via the windpipe on its way up and induce chemical pneumonia.
  • Give water. Petroleum products, because of their low density, float on water, which increases the chances of their entering the lungs and causing chemical pneumonia.
How to treat:
If he has difficulty breathing or has stopped breathing, give mouth-to-mouth respiration.
Treat for shock, if necessary.
Only the absence of the symptoms listed above (an indication that a small quantity has been ingested) should the person be inducted to vomit.
As there is no specific antidote, it's important to take the person to a hospital as soon as possible.
PESTICIDES
These fall into two categories:
  1. Organophosphorus compounds. All cockroach and bug repellents come in this category.
  2. This category includes DDT (an organochlorine insecticide), moth repellent, also called naphthalene balls (hydrocarbons), and rodenticides or rat poison (phosphide).
Symptoms: A strong, pungent smell pre-dominates.
Since the chemical stimulates the parasympathetic nervous system, it brings on a constriction of the pupils and increased salivation. It may also bring on nausea, vomiting, breathlessness, drowsiness, sweating, convulsions and even coma.
How to treat:
If the person has difficulty breathing, give mouth-to-mouth respiration.
Induce vomiting by giving two glasses of water with at least two teaspoonful of common salt stirred into each glass. If the person does not vomit, give more of this solution until he vomits and the vomitus stops smelling of the poison. Children who cannot easily be induced to drink such a solution should be forced to vomit by pressing a finger down their throat.
Collect the vomitus and take it, along with the container of the product, to the hospital.
Do not delay transporting the victim. As the chemical stimulates the parasympathetic nervous system, it brings on increased motility (movements) of the gastrointestinal tract, and if the poison travels from the stomach to the small bowel it will cause further damage.
WHEN POISONS ARE INHALED:
Chemical poisoning can be caused by inhaling gases such as carbon monoxide, volatile liquids like gasoline, turpentine and paints, or the fumes from acids or from pesticides such as cockroach and mosquito repellents or DDT.
Carbon monoxide collects due to incomplete combustion of gasoline in a car, particularly when it is left in a closed garage with its motor running; or when heating equipment, including gas ranges, are used in poorly-ventilated rooms.
Signs and Symptoms: Coughing
Rapid or slow pulse
Irritation or burning of the eyes
A burning sensation in the mouth, nose, throat and chest
A burning or itching in the underarms, groin and other moist areas of the body
Severe headache
Nausea and vomiting
Another helpful indication is the presence of spray paint or other substances on the person's face.
However, it is important to realize that carbon monoxide, being odourless and tasteless, will give rise to practically no symptoms except headache. It may, however, cause the lips and cheeks of a fair-skinned victim to turn red.
How to treat:
Take a gulp of fresh air before entering a dangerously-polluted room.
Get the person away from the contaminated air and into fresh, clean air.
If the person is not breathing, begin mouth-to-mouth respiration promptly.
If he is conscious and breathing, ask him to take deep, slow breaths.
Loosen his clothing, using minimal contact, so as to avoid getting skin burns.
Get the person to a hospital a soon as possible.
WHEN POISONS ARE ABSORBED:
Poisonous chemicals which fall in this category include organophosphorus compounds (cockroach and bug repellents), fungicides, rodent poison, wood preservatives, paints, varnishes, paint thinners, waxes and polishes, motor oil and de-greasers and aerosols (spray insecticides). Absorbed poisons usually irritate or damage the skin. However, if they are highly concentrated and absorbed in large amounts, they can enter the blood-stream via the blood vessels under the skin and bring on the same symptoms as if the poisons were ingested.
Symptoms: Skin reactions from mild irritation to burns.
Itching
Irritation of the eyes
Headache
How to treat:
Carefully brush off any dry chemicals from the skin.
Wash the areas exposed to the poison with plenty of water. Remove all contaminated clothing, shoes and accessories, including jewellery, wrist watch, etc.
Then, once again wash the affected areas with soap and water.
Transport the person to a hospital.


 

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