Signs of chemical poisoning. What causes chemical poisoning. Symptomatic drug therapy

- this is pathological condition in which the body is affected by various toxic substances. These substances can penetrate into the human body in various ways, which determines the severity of their toxic effect, as well as the clinical picture of poisoning.

A person can get poisoned:

• glue;
• nicotine;
• carbon monoxide (smoke);

• poisonous gases;
• ammonia;
• hydrogen sulfide;
• salts of heavy metals;
• copper sulfate;
• aluminum;
• polonium;
• chemicals;
• pesticides;
• organophosphate compounds ( FOS);
• acids;
• alkalis;
• arsenic;
• freon;
• vapors of paint;
• gray;
• gasoline;
• mercury vapor;
• medicines.

drug poisoning ( spices, cocaine, heroin, opiates, morphine)

However, it should be noted that in addition to positive phenomena ( euphoria), these substances also have a number of negative adverse reactions. They negatively affect the central nervous system, as well as other body systems ( cardiovascular, respiratory, immune and so on), which can contribute to the development of a number of diseases. Negative Effects drugs are especially pronounced in case of poisoning ( overdose), when a person takes too much of the drug at a time.

Damage to the central nervous system and other body systems can be observed in case of poisoning:

• Spice. These are smoking mixtures that cause increased mental activity person. With an overdose of spices, the patient ceases to soberly assess the situation, may behave aggressively, inappropriately, see hallucinations ( something that doesn't really exist) and exhibit other mental abnormalities. Cases have been described when, under the influence of this substance, people inflicted irreparable physical injuries on themselves ( gouged out eyes, cut off body parts and so on). It is also worth noting that spice poisoning causes an increase in blood pressure and heart rate, which can be dangerous for people suffering from heart disease.
• Cocaine. This drug can be introduced into the body different ways (by application to mucous membranes, by inhalation, ingestion or intravenous administration). Poisoning most often occurs with intravenous administration of the drug, since in this case a large dose of a toxic substance quickly enters the systemic circulation. This is manifested by increased neuropsychic arousal, hallucinations, delusions and other behavioral disorders. AT severe cases there may be a slowdown in heart rate ( up to cardiac arrest and death of the patient), which is associated with the inhibitory effect of the drug on the heart muscle.
• Morphine and other opiates. Morphine is a drug opium derivative), which is used medicinally as a powerful pain reliever. In addition to pain relief, morphine can cause a feeling of euphoria, which is why it and other drugs from this group are used by drug addicts. Morphine poisoning can occur as a result of a single intravenous or intramuscular injection large dose of the drug less often - when taken orally). In this case, there may be severe drowsiness and lethargy, as well as respiratory arrest ( morphine inhibits activity respiratory center in the central nervous system, which normally regulates the frequency and depth of breathing), which is most often the cause of death of the patient. With morphine intoxication, constriction of the pupils is also observed ( this effect is due to the action of the drug on the central nervous system), which may help in making a diagnosis.
• heroin. This drug is also used by drug addicts to achieve a feeling of euphoria. After entering the systemic circulation, heroin turns into morphine, which has a toxic effect on the body.

Glue poisoning

Glue poisoning can be observed:

• For employees of enterprises that produce glue- in case of violation of safety regulations and inhalation of vapors of toxic substances.
• For workers who work with glue for a long time– especially when using the adhesive in poorly ventilated areas.
• When using glue inside- for example, for the purpose of suicide or in an accident when children find glue and drink it.
• When using glue for pleasure- the toxic effect of the vapors of some adhesives disrupts the activity of the central nervous system ( CNS), in connection with which a person may experience a kind of euphoria.

• CNS lesion- dizziness, gait disturbance, headaches, increased nervous excitement, which can be replaced by drowsiness, lethargy, loss of consciousness or even coma.
• Damage to the visual analyzer- double vision, darkening of the eyes, the appearance of visual hallucinations ( a person sees images that do not exist in reality).
• Damage to the gastrointestinal system- nausea, vomiting, diarrhea.
• Damage to the cardiovascular systems s - arrhythmias ( increase or decrease in heart rate), an increase or decrease in blood pressure.
• – decrease ( or increase) the frequency and depth of breathing, which can lead to the death of the patient.
• Liver damage- can be observed with frequent poisoning with glue and is manifested by irreversible changes that lead to the development of liver failure.
• Development of malignant tumors- the toxic substances that are part of the adhesives can contribute to the development of cancer, especially when chronic poisoning them.

Acute and chronic nicotine poisoning ( tobacco smoke)

Acute nicotine poisoning can occur in previously non-smokers who immediately inhale a large number of smoke containing nicotine. Initially, they will also experience an increase in heart rate and blood pressure, but then ( with an increase in the concentration of nicotine in the blood) damage to various body systems can be observed.

Acute nicotine poisoning can manifest itself:

• dizziness due to impaired oxygen delivery to the brain.
• cough- due to irritation respiratory tract.
• Nausea, vomiting and diarrhea.
• Paleness of the skin and a decrease in its temperature- due to the narrowing of blood vessels resulting from the release of the hormone adrenaline.
• convulsions- involuntary muscle contractions resulting from damage to the central nervous system with large doses of nicotine.
• Decrease in respiratory rate due to damage to the nervous system.

Chronic nicotine poisoning occurs in heavy smokers who smoke daily for several years or decades in a row. At the same time, lesions of the cardiovascular system, metabolic disorders and other disorders are noted.

Chronic nicotine poisoning can contribute to the development of:

• arterial hypertension- Chronic high blood pressure.
• atherosclerosis- damage to blood vessels arteries), at which they lose their elasticity.
• arrhythmia- violations of the frequency and rhythm of heart contractions.
• myocardial infarction- the death of part of the muscle fibers of the heart muscle, which can cause death of a person.
• Hyperglycemia- an increase in blood sugar levels.
• Oral lesions- characterized by chronic inflammatory processes or sores in the lips, oral mucosa, and so on.
• Malignant tumors including the development of lung cancer.

Smoke poisoning ( carbon monoxide, carbon monoxide)

Carbon monoxide poisoning can manifest itself:

• dizziness;
• throbbing pains in the temples;
• drowsiness and lethargy;
• nausea and vomiting;
• dry, agonizing cough ;
• visual hallucinations ( one sees what is not there);
• auditory hallucinations ( a person hears what is not);
• loss of consciousness;
• convulsions;
• coma;
• involuntary urination;
• respiratory failure;
• violation of the contractile activity of the heart.

Poisoning by toxic gases ( household, carbon dioxide, exhaust gases, nitric oxide, natural gas, methane, phosgene)

Damage to the body can be observed in case of poisoning:

• natural gas ( methane). Natural gas is extracted from the bowels of the earth and consists of a mixture of various gaseous substances, the main of which ( over 80%) is methane. By itself, this gas is not poisonous and has virtually no toxic effect on human body. They can be poisoned only if its concentration in the room is too high ( over 30%). At the same time, it will displace oxygen from the inhaled air, as a result of which a person will begin to show signs of oxygen starvation ( dizziness, blurred vision, increased heart rate and respiratory movements ). If you do not notice these manifestations in time, oxygen starvation can lead to loss of consciousness and death of the patient from suffocation.
• Household gas. Household is called gas, which is used in everyday life for space heating, cooking and other needs. Since the middle of the last century, it has been used as domestic gas natural gas, which consists predominantly of methane ( signs of methane poisoning have been described previously).
• Carbon dioxide. This gas is used in the metallurgical and food industries, and is also regularly produced by the cells of the human body in the course of their life. People working with carbon dioxide can become poisoned by inhaling elevated concentrations of this gas. Also, signs of poisoning can be observed in people who are in hermetically enclosed spaces without good ventilation. In this case, carbon dioxide exhaled through the lungs will gradually accumulate in the air. AT normal conditions concentration carbon dioxide in ambient air should not exceed 0.08%. When it rises to 0.1%, a feeling of weakness, fatigue and drowsiness appears, which is associated with the effect of gas on the central nervous system. With a further increase in the gas concentration ( up to 7 - 9% or more) can be observed pronounced headache, drowsiness, dizziness, visual disturbances, loss of consciousness and death from suffocation, which can occur within 10 to 30 minutes.
• Exhaust gases ( nitric oxide). Exhaust gases are made up of many gaseous substances resulting from the combustion of gasoline or diesel fuel. The most toxic of them is nitrogen monoxide, which accounts for about 0.5 - 0.8% exhaust gas. When released into the bloodstream, this gas attacks red blood cells, causing them to lose their ability to transport oxygen to body tissues. As a result, oxygen starvation develops rapidly at the level of the brain, which can lead to the death of the patient. It should be noted that the composition of exhaust gases includes other toxic substances ( hydrocarbons, carbon dioxide, carbon monoxide, soot and so on), which can also contribute to damage to the central nervous system and other body systems.
• Phosgene. It is an asphyxiant gas that was used during World War I for military purposes ( how chemical weapon ). The action of phosgene is due to damage to the lung tissue, through which, under normal conditions, the blood is enriched with oxygen. As a result of the toxic effect of the gas, oxygen cannot penetrate into the blood, as a result of which the person begins to gradually suffocate. Death occurs in a few hours or days from suffocation.

Ammonia poisoning ( ammonia)

Poisoning with ammonia can be observed when inhaling too high a concentration of solution vapors, which can lead to reflex respiratory arrest for a while. In addition, when the drug is taken orally in the form of a concentrated solution, burns may occur on the mucous membrane of the esophagus and stomach, which will be accompanied by a violation of the processes of swallowing and digestion of food, abdominal pain, and so on. For outdoor use ( i.e. when applied to the skin) solutions of ammonia poisoning do not develop.

Hydrogen sulfide poisoning

Hydrogen sulfide poisoning can occur in people working in close proximity to the gas. At the same time, inhalation of even a small amount of toxin can lead to damage to the central nervous system, which will be manifested by dizziness, headaches, nausea and vomiting, as well as a taste of metal in the mouth ( characteristic sign of poisoning with this substance). When hydrogen sulfide is inhaled in high concentrations, convulsions and loss of consciousness may develop. The person may fall into a coma or even die.

Poisoning with salts of heavy metals ( zinc, chromium, manganese, cadmium, lead)

Heavy metals may include:

• in some medicines;
• in paint and varnish products;
• in petroleum products;
• in electrical appliances;
• in exhaust gases;
• in smoke from industrial enterprises;
• in waste water and so on.

• Through the lungs- inhalation of polluted air.
• Through the gastrointestinal tract- when eating contaminated food.
• With intravenous administration of drugs containing derivatives of heavy metals.

Poisoning with salts of heavy metals can manifest itself:

• The appearance of a metallic taste in the mouth.
• Inflammatory redness and / or ulceration of the mucous membranes of the respiratory tract and oral cavity.
• cough ( sometimes with bleeding).
• Nausea and vomiting.
• Headaches.
• Digestive disorders ( diarrhea or constipation).
• Hearing and/or visual impairment.
• Violation of the functions of internal organs ( liver, hematopoietic system, central nervous system and so on).
• bone damage ( salts of heavy metals can accumulate in them, contributing to bone tissue damage and the occurrence of pathological fractures).

Copper sulphate poisoning

Copper sulphate poisoning can manifest itself:

• pain in the abdomen;
• nausea;
• vomiting ( sometimes with blood);
• diarrhea
• headaches;
• general weakness;
• kidney injury ( the process of urine formation is disturbed);
• jaundice ( due to damage and destruction of red blood cells, as well as due to liver damage and the development of liver failure) and so on.

It should be noted that when hit blue vitriol there are no signs of poisoning on the skin, but the substance should be washed off with water as soon as possible, since it can have a local irritant effect.

aluminum poisoning

Aluminum poisoning can be observed:

• Inhalation of aluminum-contaminated dust- for example, from workers in factories that use or produce this metal.
• When eating foods high in aluminum- this metal is a food additive known as E173.
• When using medicines containing aluminum.

Other signs of chronic aluminum poisoning may include:

• muscle weakness;
• pale skin;
• delay in physical and mental development The child has;
• immunodeficiency ( tendency to develop infectious diseases).

polonium poisoning

Poisoning with polonium can be observed when swallowing it, as well as when inhaling dust contaminated with its particles. After entering the human body, this substance affects the vital organs ( predominantly the liver, kidneys, spleen and red bone marrow, in which blood cells are normally formed), causing their irreversible destruction. Clinical manifestations in this case, they can be varied and depend on the dose of polonium that has entered the body, on the route of penetration ( through the lungs or through the gastrointestinal tract) and many other factors.

Poisoning with polonium can manifest itself:

• pain in the abdomen;
• nausea and vomiting;
• lack of appetite;
• cough with bloody sputum infection through the lungs);
• severe fatigue;
• pale skin ( due to disruption of the hematopoietic process);
• decreased visual acuity;
• mental disorder and so on.

Poisoning with chemicals and poisons ( cyanides, potassium cyanide, chlorine, fluorine, iodine, acetone, benzene, formaldehyde)

To date, several dozen pesticides are used in agriculture. Poisoning by each of them may have its own characteristic features. At the same time, in case of any poisoning, there will be observed general symptoms allowing timely diagnosis.

Pesticide poisoning can manifest itself:

• Gastrointestinal tract injury- nausea, vomiting, diarrhea and abdominal pain, loss of appetite, gastrointestinal bleeding ( excretion of blood in feces or vomit).
• Damage to the central nervous system- headaches, impaired vision or hearing, impaired consciousness, convulsions, coma.
• Kidney damage- Absence of urine for 24 hours or more.
• Damage to the blood system- violation of oxygen transport and the development of oxygen starvation.
• Damage to the cardiovascular system- a drop in blood pressure, heart rhythm disturbances, cardiac arrest.
• Respiratory system damage- burning in the upper respiratory tract ( by inhalation of sprayed pesticides), shortness of breath ( feeling short of breath), chest pains, and so on.

Poisoning with organophosphorus compounds ( FOS) - sarin, dichlorvos

FOS poisoning can manifest itself:

• headaches;
• dizziness;
• increased sweating;
• increased secretion of saliva;
• convulsions;
• significant increase in blood pressure ( against the backdrop of convulsions);
• labored breathing ( due to contraction of airway muscles);
• abdominal pain ( due to contraction of the muscles of the gastrointestinal tract);
• paralysis of the limbs;
• psychomotor agitation ( at the initial stage of poisoning);
• mental disorders ( late stages of poisoning).

Antifreeze poisoning ( ethylene glycol)

Ethylene glycol poisoning can manifest itself:

• Damage to the gastrointestinal tract. It is characterized by nausea, vomiting, diarrhea, abdominal pain.
• Kidney damage. The main harm of ethylene glycol in the body is due precisely to the defeat renal tissue. The by-products of this alcohol metabolism cause necrosis ( death) of renal structures, resulting in renal failure.
• CNS). At the level of the central nervous system, ethylene glycol provokes the development of cerebral edema, which is the direct cause of headaches, impaired consciousness, seizures, or even coma.

acid poisoning ( acetic, hydrocyanic, boric, sulfuric, hydrochloric, lemon)

Poisoning can develop when using:

• Acetic acid. It is a component of vinegar essence ( 70% acetic acid solution) and vinegar ( 5 - 15% acetic acid solution), which are used in cooking for cooking. When ingested into the gastrointestinal tract pure form vinegar and vinegar essence cause pronounced chemical burns mucous membranes, which is accompanied by their edema. As complications, gastrointestinal bleeding, respiratory disorders ( due to swelling of the mucous membrane of the pharynx and larynx). Absorbed into the systemic circulation, the acid disrupts metabolic processes in the body, destroys blood cells and affects blood vessels, resulting in a marked drop in blood pressure. The acid also damages the kidneys ( causing the death of their tissues and disruption of the process of urine formation) and the liver.
• hydrocyanic acid. This acid is a component of cyanides. The mechanism of its poisoning action is similar to that of potassium cyanide poisoning ( as a result of metabolic disorders at the cellular level, cells are destroyed and the functions of vital organs are disrupted, which leads to death of a person).
• Boric acid. In medical practice alcohol solution used as an antiseptic disinfectant) means for external use ( with infections of the eyes, skin, etc.). When applying boric acid to large areas of the body, systemic absorption of a large amount of the drug is possible, as a result of which signs of poisoning may appear ( nausea and vomiting, diarrhea, headaches and dizziness, general weakness, impaired consciousness and convulsions). The same symptoms will be noted when boric acid is taken orally, but in this case they may be more pronounced ( due to accelerated absorption of acid through the mucous membrane of the gastrointestinal tract).
• Sulfuric acid. This is an extremely strong acid, which has a pronounced irritant effect. If its vapors are inhaled, burns of the mucous membrane of the respiratory tract are possible, while when ingested, burns of the mucous membrane of the oral cavity, esophagus and stomach are possible. The patient may die from pain shock (pronounced drop in blood pressure and CNS damage), as well as from suffocation ( against the background of edema of the respiratory tract mucosa).
• Of hydrochloric acid. Hydrochloric acid is a natural component of gastric juice. At the same time, applying too concentrated solutions of this acid to the skin or mucous membranes can provoke burns of varying severity. With the use of concentrated acid inside, there may be damage to the gastric mucosa and its inflammation ( gastritis), accompanied by severe paroxysmal pain in the abdomen, nausea, vomiting, loss of appetite, and so on.
• Citric acid. Citric acid is found in many fruits and berries, and is also used in powder form as a dietary supplement. Citric acid poisoning can develop with a single consumption of a large amount of it ( e.g. 1-2 teaspoons). In this case, irritation of the mucous membrane of the oral cavity and pharynx, as well as damage to the gastric mucosa ( with the development of symptoms of gastritis). In severe cases, gastrointestinal bleeding may occur ( due to damage to the blood vessels of the mucosa). Inhalation of the powder citric acid irritation of the respiratory mucosa may be noted, which will be manifested by cough, shortness of breath, hemoptysis ( secretion of blood with sputum).

Alkali poisoning

When swallowing an alkali solution, a deep lesion of the mucous membranes of the gastrointestinal tract is noted, accompanied by severe pain in the abdomen ( up to the development of pain shock), gastrointestinal bleeding ( vomiting and diarrhea with blood), general intoxication of the body. Also, there may be swelling of the mucous membrane of the pharynx and larynx, which can cause the death of the patient ( from airway obstruction and suffocation). At further development poisoning, there may be a pronounced drop in blood pressure, loss of consciousness and coma.

If alkalis or their vapors get on the mucous membrane of the eyes, a deep lesion is noted, which without emergency assistance can lead to complete blindness.

Poisoning from household chemicals disinfectants, detergents, technical liquids)

Household chemicals include:

• Disinfectants. Disinfectants may have different chemical composition ( based on chlorine, fluorine, sulfates, acids, etc.), but all of them have a pronounced antimicrobial effect. At the same time, it is worth noting that the ingress of such substances into the human body can cause damage to various organs and systems. So, for example, if a person drinks a chlorine-containing or fluorine-containing liquid, this can lead to a burn of the mucous membrane of the oral cavity, esophagus and stomach. The severity of the symptoms that develop in this case ( pain in the abdomen, nausea and vomiting, intoxication of the body and damage to the central nervous system) will depend on taken dose, as well as timeliness medical measures. In severe cases, loss of consciousness, respiratory failure and death can occur.
• Detergents. This group includes washing powders, soaps, gels and other personal care products. For the most part, they are weak alkalis, and therefore, when they get on the mucous membranes ( eyes, mouth, genitals) can cause chemical burns ( accompanied by redness and ulceration of tissues). When such substances are taken orally, there are signs of acute gastrointestinal poisoning - nausea, vomiting with blood, bloody diarrhea, severe abdominal pain. In severe cases, systemic intoxication of the body may develop, which can lead to damage to the central nervous system, loss of consciousness, convulsions and death of the patient.
• Technical liquids. This term is used to denote fluids used to service vehicles ( brake fluid, lubricants, coolants and flushing fluids, antifreeze and so on). None of the listed substances is intended for ingestion, and if it enters the gastrointestinal tract, it can cause clinical manifestations of poisoning ( nausea, vomiting, diarrhea, abdominal pain and headaches). In addition, depending on the chemicals that make up the liquid, the patient may experience damage to certain body systems ( predominantly CNS, hematopoietic systems, kidneys), which can be fatal.

Arsenic poisoning

freon poisoning

If the patient survives, he may develop various complications ( mental disorders, incomplete restoration of vision, damage to the liver, kidneys and other organs).

Paint fumes poisoning

sulfur poisoning

Sulfur compounds have a pronounced irritant effect, and therefore can affect the skin, as well as the mucous membranes of the respiratory tract ( by inhalation of vapors) or mucous membranes of the gastrointestinal tract ( ingestion of a toxic substance). Patients at the same time may complain of perspiration and sore throat, agonizing cough, respiratory failure ( due to mucosal edema). It may also appear strong pain in the abdomen, nausea and vomiting.

When toxins enter the body, they affect the central nervous system, which is manifested by the development of a state of moderate intoxication ( the person is lethargic, drowsy, inactive, may complain of headaches and dizziness). With severe intoxication, cerebral edema may occur, accompanied by the development of seizures, loss of consciousness, damage to the respiratory center and death of the patient.

Gasoline poisoning

Gasoline poisoning can be observed:

• By inhaling gasoline vapours. At the initial stage of poisoning, moderate stimulation of the central nervous system is noted ( CNS). The person is agitated and euphoric feeling of pleasure, happiness), but may complain of headaches and dizziness, nausea, palpitations. At high concentrations of gasoline vapors in the inhaled air, CNS depression may be noted, accompanied by hallucinations ( the patient sees things that do not exist), drowsiness, loss of consciousness coma.
• When gasoline enters the lungs. In this case, toxic inflammation of the lung tissue may develop, which can cause respiratory failure and general intoxication of the body. The disease is manifested by fever, chest pain and cough, during which yellowish sputum may be released.
• When using gasoline inside. In this case, there are signs of damage to the gastrointestinal tract ( abdominal pain, nausea, repeated vomiting and diarrhea). In severe cases, liver damage may be noted, accompanied by its enlargement, pain in the right hypochondrium, digestive disorders, and so on.

Acute and chronic mercury vapor poisoning

Mercury poisoning can be:

• acute- when a person inhales a large amount of mercury vapor in a short period of time.
• Chronic- when a person inhales a small amount of mercury vapor for a long time ( months or even years), as a result of which the toxic compound accumulates in tissues and organs, disrupting their functions.

Acute poisoning with mercury vapor can manifest itself:

• general weakness;
• increased fatigue;
• headaches;
• shortness of breath ( feeling short of breath due to pneumonia);
• dry cough;
• pain in the chest;
• nausea and vomiting;
• diarrhea ( diarrhea);
• the appearance of a taste of metal in the mouth;
• increased secretion of saliva;
• bleeding gums;
• an increase in body temperature to 39 - 40 degrees.

Chronic poisoning with mercury vapor can manifest itself:

• Damage to the central nervous system. Patients are constantly tired, drowsy, indifferent to the outside world. They may have noted frequent change moodiness, tearfulness, or irritability. Sometimes they may complain of severe headaches. Over time, there is a deterioration in memory, a decrease in the ability to concentrate, and so on. Also characteristic manifestation intoxication is the trembling of the tips of the fingers and toes, lips and other parts of the body.
• Damage to the sense organs. Patients may experience decreased sense of smell ( ability to smell) and taste, as well as impaired sensation in the hands and feet.
• Against the background of a progressive decrease in blood pressure, cardiac arrhythmias may be noted.
• Defeat digestive system and liver. Characterized by decreased appetite, frequent nausea, discomfort or pain in the abdomen and right hypochondrium ( in the area of ​​the liver).
• b> Damage to the kidneys. An irreversible violation of the urinary function of the kidneys is noted only with prolonged and severe intoxication of the body with mercury compounds.

oxygen poisoning

An increase in the concentration of oxygen in the inhaled air leads to an increase in its concentration in the blood. This disrupts the transport function of the blood ( which normally transports oxygen to tissues and removes carbon dioxide from tissues). At the same time, red blood cells cannot remove carbon dioxide at a normal rate, as a result of which it accumulates in the body, causing the development of toxic effects. In addition, a high concentration of oxygen can adversely affect the lung tissue, as well as the central nervous system, leading to the development of dangerous complications.

Oxygen poisoning can manifest itself:

• damage to the central nervous system ( CNS). The toxic effect is due to an increase in the concentration of oxygen at the level of the central nervous system, as well as the accumulation of excess carbon dioxide in the brain tissues. Clinically, this is manifested by numbness of the fingers and toes, darkening of the eyes, noise or ringing in the ears, dizziness. Almost always, oxygen poisoning is accompanied by convulsions, during which the patient can die from respiratory arrest.
• Damage to the lungs. In this case, there is dryness and inflammation of the mucous membranes of the respiratory tract, dry cough and burning pain in the chest. With further breathing with a mixture with an increased concentration of oxygen, damage to the lung tissue can be noted, as a result of which the process of transporting oxygen into the blood will be disrupted.
• Damage to the cardiovascular system. An excess of oxygen and carbon dioxide in the tissues can provoke a sharp expansion of blood vessels. As a result, there will be a pronounced drop in blood pressure, which can cause a violation cerebral circulation and loss of consciousness, abnormal heart rhythms, or even cardiac arrest.

Drug poisoning ( isoniazid, barbiturates, paracetamol, atropine, phenazepam, cardiac glycosides, corvalol, hydrogen peroxide, clonidine, aspirin)

Symptoms and signs of drug poisoning

Occupational poisoning

Occupational poisoning can be:

• Sharp. They occur relatively rarely, usually due to violations of safety regulations or an emergency situation, when a large amount of a poisonous substance enters the environment and the human body once. Acute poisoning is accompanied by a rapid and severe dysfunction of vital organs, which can lead to death. At the same time, qualified assistance provided in a timely manner can lead to a complete cure, preventing the development of complications in the future.
• Poisoning. Diagnosis, first aid and treatment of poisoning. Complications and consequences after poisoning. Prevention of poisoning

Poisoning- a set of adverse effects caused by the ingress of a toxic substance into the gastrointestinal tract and respiratory tract or its contact with the skin, eyes or mucous membranes (polystyrene, vagina, etc.).

What causes chemical poisoning:

Poisons include certain drugs, household chemicals, solvents, pesticides, and other chemicals.

Symptoms of chemical poisoning:

Symptoms of poisoning depend on the type and amount of poison ingested, and individual characteristics the victim. Some poisons with low toxicity cause certain disorders only when long-term exposure or re-ingestion in large quantities. Other substances are so poisonous that even a single drop of such a poison on the skin can lead to dire consequences. The toxicity of a substance in each case also depends on the genetic characteristics of a person. Some normally non-toxic substances are toxic to people with a certain genotype (set of genes).

The dose of a substance that causes symptoms of poisoning is also very dependent on age. For example, in a small child, the ingestion of more paracetamol is more likely to cause symptoms of poisoning than the same dose in an adult. For an elderly person sedative from the group of benzodiazepines (seduxen, relanium, phenazepam) can be toxic in doses that do not cause any disturbance in a middle-aged person.

Symptoms of poisoning may be mild but unpleasant, such as itching, dry mouth, blurred vision, pain, or may be life-threatening, such as disorientation, coma, irregular heartbeat, difficulty breathing, and marked agitation. Some poisons begin to act after a few seconds, while others take several hours or even days after they enter the body.

There are poisons that do not cause obvious symptoms until there is irreversible damage to the function of vital organs, in particular the liver or kidneys. Thus the symptoms of poisoning are as innumerable as the number of poisons.

Diagnosis of chemical poisoning:

Optimal management of patients with poisoning requires a correct diagnosis. Although the toxic effects of some chemicals are very characteristic, most of the syndromes seen in poisoning may be due to other diseases.

Poisoning is commonly included in the differential diagnosis of coma, seizures, acute psychosis, acute liver or kidney failure, and depression. bone marrow. Although this should be done, the possibility of poisoning can be disregarded when the patient's main manifestations are mild mental or neurological impairment, abdominal pain, bleeding, fever, hypotension, pulmonary congestion, or skin rash. In addition, the patient may not be aware of the effect of the poison on him, as is the case with chronic, latent poisoning, or after an attempted suicide or abortion, the patient will also not be inclined to agree with such a diagnosis. Physicians should always be aware of the various manifestations of poisoning and maintain a high degree of alertness to them.

In all cases of poisoning, an attempt should be made to identify the toxic agent. It is obvious that without such identification it is impossible to carry out specific therapy with antidotes. In cases of murder, suicide, or criminal abortion, the identification of poison can have legal implications. Where poisoning is the result of industrial exposure or therapeutic error, precise knowledge of the active agents is necessary to prevent similar occurrences in the future.

For acute accidental poisoning active substance may be known to the patient. In many other cases, information can be obtained from relatives or acquaintances, by examining containers located at the site of poisoning, or by interviewing the patient's doctor or pharmacist. Often similar actions allow you to install only tradename product, which does not allow you to know its chemical composition. The bibliography at the end of this chapter lists a number of books that list the active constituents of substances used in the household, agriculture, patent medicines, and poisonous plants. A small reference book of this type should be carried by every doctor in his portfolio. The latest information of this kind can also be obtained from the Centers for the Treatment of Poisoning and from representatives of the manufacturers of these substances. In chronic poisoning, it is often impossible to quickly determine the toxic agent from the anamnesis. The lesser urgency of therapeutic measures in these cases usually allows for the necessary thorough study of the patient's habits and the state of the environment.

Some poisons may cause the development of characteristic clinical signs sufficient to strongly suggest an accurate diagnosis. With a thorough examination of the patient, a characteristic smell of cyanide can be detected; cherry staining of the skin and mucous membranes, revealing the presence of carboxyhemoglobin; pupillary constriction, drooling and hyperactivity of the gastrointestinal tract caused by insecticides containing cholinesterase inhibitors; lead border and paralysis of the extensor muscles, characteristic of chronic lead poisoning. Unfortunately, these typical signs are not always present, and in case of chemical poisoning, their presence is rather an exception.

Chemical analysis of body fluids provides the most correct definition substance that caused poisoning. Some common poisons such as acetylsalicylic acid(aspirin) and barbiturates can be detected and even quantified with relatively simple laboratory tests. Other poisons require more complex toxicological studies, such as high-performance gas or liquid chromatography, which are only performed in specialized laboratories. In addition, the results of toxicological studies are rarely available in a timely manner to decide on initial treatment in acute poisoning. However, samples of vomit, aspirated stomach contents, blood, urine, and feces should be retained for toxicology testing if diagnostic or legal issues arise. Chemical analysis of body fluids or tissues is especially important in diagnosing and assessing the severity of chronic poisoning. Ultimately, the results of such an analysis are useful for evaluating the long-term results of some types of therapy.

Treatment for chemical poisoning:

For proper treatment A patient with poisoning needs to know both the basic principles of managing such patients and the details of therapy for specific poisonings. The treatment process includes:

• prevention of further absorption of the poison;
• removal of the absorbed poison from the body;
• symptomatic supportive therapy or symptomatic treatment for circulatory, respiratory disorders, neurological disorders and impaired renal function;
• introduction of systemic antidotes.

The first three steps apply to most types of poisoning. The fourth step is most often used only when the toxic agent is known and a specific antidote is available. Sometimes, however, when a patient is highly suspected of having an opiate overdose, they are given naloxone. It should be recognized that there are no specific antidotes for most poisons, and it is not necessary to know which toxic agent caused the poisoning in order to provide the necessary maintenance therapy. Thus, although the physician should always attempt to establish the active poison, these attempts should not delay the administration of vital therapeutic measures. .

Prevention of absorption of ingested poisons. If an appreciable amount of poison has been swallowed, attempts should be made to minimize its absorption from the gastrointestinal tract. The success of such attempts depends on the time elapsed since the poison was ingested and on the site and rate of absorption.

• Evacuation of stomach contents

Always, if there are no specific contraindications, you should try to empty the stomach. These attempts can be very successful if made soon after the poison has been ingested. Significant amounts of poison can still be expelled from the stomach several hours after ingestion, as gastric emptying may be delayed as a result of gastric atony or pylorospasm. This occurs with poisoning with phenothiazines, antihistamines, and tricyclic antidepressants.

After swallowing many poisons, vomiting occurs spontaneously. In a smaller number of cases, it can be induced at home by mechanical stimulation of the back of the throat. Vomiting effect of ipecac syrup (the concentration should not exceed more than 14 times the concentration liquid extract), given in a dose of 15 - 30 ml, is more effective and safe even at home. Its action begins an average of 20 minutes after ingestion and depends in part on absorption in the gastrointestinal tract, so simultaneous administration should be avoided. activated carbon, which is an adsorbent. A second dose of ipecac syrup should be given to the patient if he does not vomit 20 minutes after taking the first dose (after taking two doses, vomiting will develop in 90-95% of patients). If there is no scrap of ipecac syrup, every effort should be made to find it, even if this requires taking the patient to the hospital. Apomorphine administered intramuscularly at a dose of 0.06 mg/kg acts within 5 minutes, but may cause prolonged vomiting. When administered intravenously at a dose of 0.01 mg/kg, apomorphine induces vomiting almost immediately, with no subsequent effect on the central nervous system. Sometimes it is not possible to induce vomiting and valuable time should not be wasted waiting. An attempt to induce vomiting should not be made in victims who are in a convulsive state, in patients with severe central nervous system depression, or (due to the risk of perforation of the stomach or esophagus or due to aspiration of vomit into the trachea) in persons who have swallowed a potent caustic chemical or small quantities(less than 100 ml) liquid hydrocarbons that are strong lung irritants (eg kerosene, polish).

Compared to vomiting, gastric lavage is more preferable and acts immediately, but usually it does not contribute more effective removal poison from the stomach than vomiting. It can be performed in patients who are unconscious, the evacuation of the contents of the stomach reduces the risk of aspiration of vomit. Its performance, however, is contraindicated after ingestion of strong corrosive substances, because of the danger of perforation of damaged tissues. At correct execution gastric lavage carries a small risk of aspiration of stomach contents into the lungs. The patient should lie on his stomach with his head and shoulders down. Using a mouth expander, a gastric tube is introduced into the stomach, the diameter of which is sufficient to pass solid particles (30 gauge). If the functions of the central nervous system are depressed, if the insertion of the probe causes vomiting, or if a substance that is an irritant to the lungs has been swallowed, it is reasonable to introduce a cuffed endotracheal tube into the trachea before performing gastric lavage. The contents of the stomach are aspirated with a large syringe, and removed from the body along with it. most poison. After that, 200 ml (in children less) of warm water or liquid solution is injected into the stomach and aspirated until the aspirated liquid becomes clear.

Interference with absorption in the gastrointestinal tract.

Since neither vomiting nor gastric lavage completely empties the stomach, attempts should be made to reduce absorption by administering substances that bind poisons that have entered the body. Many poisons are adsorbed by powdered activated carbon. High quality activated carbon can adsorb 50% by weight of many common poisons. Liquid activated charcoal (20-50 g in 100 * 200 ml) should be administered after gastric emptying.

Adsorption by activated carbon is a reversible process and the efficiency of adsorption of many poisons varies depending on the pH value. Acidic substances are adsorbed better by acid solutions and therefore can be released into small intestine. It is desirable that activated charcoal with adsorbed poison pass through the intestines as quickly as possible. This will also reduce intestinal absorption of any unadsorbed poison that has passed through the pylorus. In patients with good renal and cardiac function, this is best achieved by oral or intramuscular administration of osmotic laxatives. agents such as magnesia or sodium sulfate (10 - 30 g in a solution with a concentration of 10% or less).

Prevention of absorption of poison from other organs and systems. Most locally applied poisons can be removed from the body by copious washings with water. In certain cases, weak acids or alkalis, or alcohol in combination with soap, are more effective, but rapid and abundant washing with water must be carried out until these solutions are available to doctors. Chemical antidotes dangerous, because the effect of heat generated during chemical reaction may cause tissue damage.

The systemic distribution of injected poisons can be slowed by applying a cold compress or ice to the injection site, or by applying a tourniquet proximal to the injection site.

After inhalation of toxic gases, vapors or dusts, remove the victim to clean air and maintain adequate ventilation. The patient cannot move, he should wear a protective mask.

Excretion of absorbed poison from the body. In contrast to preventing or slowing down absorption, measures that speed up the excretion of a toxic agent and the body rarely have a large effect on the peak concentration of the poison in the body. However, they can significantly reduce the time during which the concentration of many poisons remains above a certain level, and thereby reduce the risk of complications and tackle the life of the patient. When assessing the need to perform such measures, it is necessary to take into account the clinical condition of the patient, the properties and pathways of the metabolism of the poison and the amount of absorbed poison according to the anamnesis data and the results of determining its concentration in the blood. The introduction of some poisons can be accelerated by various methods; the choice of method depends on the condition of the patient, the amount of poison in the body and the availability of experienced personnel and equipment.

• Bile excretion

Certain organic acids and active drugs are secreted into the bile in the opposite direction of the large concentration gradient. This process takes time and cannot be accelerated. However, intestinal absorption of substances already secreted into bile, such as glutethimide, can be reduced by the administration of activated charcoal every 6 hours. Cholestyramine (16 g per day) significantly accelerates its excretion (half-life from the blood is 80 days).

• Urinary excretion

The acceleration of renal excretion is justified in cases of poisoning much a large number poisons. renal excretion toxic substances depends on glomerular filtration, active tubular secretion and passive tubular resorption. The first two of these processes can be protected by maintaining adequate circulation and kidney function, but in practical terms, they cannot be accelerated. On the other hand, passive tubular resorption of many poisons plays an important role in increasing their duration of action and can often be reduced by readily available methods. In poisoning with drugs such as salicylic acid preparations and long-acting barbiturates, the effectiveness of increased diuresis induced by the administration of large volumes of electrolyte solutions in combination with intravenous furosemide has been demonstrated in increasing renal excretion.

Changing the pH of urine can also inhibit the passive reversible diffusion of some poisons and increase their renal clearance. The epithelium of the renal tubules is more permeable to uncharged particles than to ionized solutions. Weak organic acids and bases readily diffuse out of the tubular fluid in their non-ionized form, but are retained in the tubules if they are ionized. Acidic poisons are ionized only at a pH exceeding their pK. Alkalinization of urine sharply increases the ionization in the tubular fluid of such organic acids as phenobarbital and salicylate. In contrast, the pKa of pentobarbital (8.1) and secobarbital (8.0) are so high that renal clearance does not increase appreciably with increasing urinary pH at physiological alkaline limits. Alkalinization of urine is achieved by infusion of sodium bicarbonate at a rate determined by the pH value of urine and blood. Severe systemic alkalosis or electrolyte disturbances should be avoided. The combination of induced diuresis with alkalinization of the urine can increase the renal clearance of some acidic poisons by a factor of 10 or more, and these measures have been found to be very effective in salicylates, phenobarbital, and 2,4-dichlorophenoxyacetic acid poisoning. Conversely, lowering the pH below its normal values ​​has been shown to increase the clearance of amphetamines, phencyclidines, fenfluramine, and quinine.

In conclusion, it should be noted that the renal excretion of certain poisons can be increased by highly specific methods. An example of this is the elimination of bromide from the body by the administration of chloride and chloruretics. These methods are discussed under the consideration of individual poisons.

• Dialysis and hemosorption

Dialysis has been found to be effective in removing many substances from the body, including barbiturates, borate, chlorate, ethanol, glycols, methanol, salicylates, sulfonamides, theophylline, and thiocyanate. Theoretically, it should accelerate the elimination from the body of any dialyzable toxin that is not irreversibly bound to the tissues. Its effectiveness does not extend to large molecules, non-dialysable poisons, and is reduced to a large extent by the binding of the toxic substance to proteins or its solubility in fats.

Peritoneal dialysis can be easily performed in any hospital and can be done for a long time. However, its implementation in order to remove poisons from the body is justified only if the patient has impaired renal function, it is impossible to carry out hemodialysis or hemosorption, or forced diuresis cannot be applied.

Hemodialysis is undeniably more effective in terms of excretion from the body large quantities dialysable poisons. For barbiturates, dialysis rates of 50–100 ml/min have been achieved, while the rate of excretion from the body is 2–10 times higher than with peritoneal dialysis or forced diuresis. With blood perfusion through activated charcoal or ion-exchange resin, even greater clearance rates of most poisons are achieved than with hemodialysis. Clearly, extracorporeal dialysis and hemosorption may be considered the procedures of choice for the rapid elimination of poisons from the body of patients who have absorbed such amounts of poison as to make their survival unlikely even with the best supportive care. Since not every hospital has the necessary equipment and experienced staff for hemodialysis and hemosorption, consideration should be given to transferring such patients to a facility with such facilities.

Complex formation and chemical bonding. The excretion of certain poisons from the body is accelerated by chemical interaction. actions with other substances with subsequent excretion through the kidneys. These substances are considered systemic antidotes and are discussed under individual poisons.

supportive therapy. Most chemical poisonings are reversible, self-limiting painful conditions. Skillful supportive care can save the lives of many severely poisoned patients and keep their detoxifying and excretory mechanisms functioning until the poison concentration is reduced to safe levels. Symptomatic measures are especially important when the active poison belongs to the category of substances for which a specific antidote is unknown. Even when an antidote is available, vital signs should be prevented or controlled with appropriate supportive care.

A patient with poisoning may suffer from various physiological disorders. Most of these are not specific to chemical poisonings and the management of such patients is discussed elsewhere. This section briefly discusses only those aspects of maintenance therapy that are specifically relevant to the treatment of poisoning.

Depression of the central nervous system. Specific Therapy, aimed at combating the inhibitory effect of poisons on the central nervous system, is usually not necessary and difficult. Most patients with poisoning come out of a coma, as from a long anesthesia. Careful care is needed during the unconscious period nurse and careful monitoring of the patient. If the depression of the centers located in the medulla oblongata occurs as a result of circulatory or respiratory disorders, then it is necessary to immediately and vigorously begin measures to maintain these vital functions using chemical means and mechanical procedures. The use of analeptics in the treatment of patients with poison-induced central nervous system depression has been largely abandoned. It is certain that these substances should never be used to awaken consciousness, and it is doubtful that their use to hasten the recovery of spontaneous breathing and active reflexes has ever been justified. In contrast, the drug antagonist naloxone, administered intravenously in adequate doses, usually reverses the central nervous system depression associated with drug overdose.

Seizures. Many poisons (eg, chlorinated hydrocarbons, insecticides, strychnine) cause seizures due to their specific stimulating effect. In patients with poisoning, convulsions may also occur due to hypoxia, hypoglycemia, cerebral edema, or metabolic disorders. In such cases, these violations should be corrected as far as possible. Regardless of the cause, seizures are often necessary application anticonvulsants. Intravenous diazepam, phenobarbital, or phenytoin are usually effective.

Cerebral edema. Raise intracranial pressure, caused by cerebral edema, is also a characteristic sign of the action of some poisons and a non-specific consequence of other chemical poisonings. For example, cerebral edema is observed in case of poisoning with lead, carbon monoxide and methanol. Symptomatic treatment consists of the use of adrenocorticosteroids and, when necessary, intravenous administration. hypertonic solutions mannitol or urea.

Hypotension. The causes of hypotension and shock in the poisoned patient are numerous and often there are several causes at the same time. Poisons can cause inhibition of vasomotor centers in the medulla, block autonomic ganglia or adrenergic receptors, directly inhibit the tone of smooth muscles of arteries or veins, reduce myocardial contractility or induce the appearance of cardiac arrhythmias. Less specific is when the poisoned patient is in shock due to tissue hypoxia, extensive tissue destruction by corrosives, loss of blood and fluid, or metabolic disorders. If possible, these violations should be corrected. If the central venous pressure is low, then the first therapeutic action should be to replenish the volume of fluid in the body. Vasoactive drugs are often useful and sometimes necessary in the treatment of a poisoned patient who develops hypotension, especially in shock due to central nervous system depression. As with shock from other causes, choosing the most appropriate medicinal product requires analysis of hemodynamic disturbances, which is carried out after measuring the value of blood pressure.

cardiac arrhythmias. Violations of the generation of an excitation wave or cardiac conduction in patients with poisoning occur as a result of the action of certain poisons on the electrical properties of the heart fibers or as a result of myocardial hypoxia or metabolic disorders in the myocardium. The latter need to be adjusted, and antiarrhythmic drugs are used according to indications, based on the nature of this arrhythmia.

Pulmonary edema. A patient with poisoning may develop pulmonary edema due to inhibition of myocardial contractility or damage to the alveoli by irritating gases or asphyxiated fluids. last view edema is less treatable and may be accompanied by laryngeal edema. Therapeutic measures include aspiration of exudate, giving high concentrations of oxygen under positive pressure, the introduction of aerosols of surfactants, bronchodilators and adrenocorticosteroids.

Hypoxia. Poisoning can cause the development of tissue hypoxia through various mechanisms, and in one patient several of these mechanisms may operate simultaneously. Inadequate ventilation may result from central respiratory depression, muscle paralysis or airway obstruction with accumulated secretions, laryngeal edema, or bronchospasm. Alveolar-capillary diffusion may be impaired in pulmonary edema. Anemia, methemoglobinemia, carboxyhemoglobinemia, or shock can impair oxygen transport. Inhibition of cellular oxidation may occur (eg, cyanides, fluoroacetate). For treatment, it is necessary to maintain adequate airway patency. The clinical situation and site of the obstruction may indicate frequent suctioning, insertion of an oropharyngeal airway or endotracheal tube, or tracheotomy. If, despite a normal airway, ventilation remains inadequate, as evidenced by clinical condition or measurement of minute volume or blood gases, it is imperative to perform mechanical ventilation using appropriate mechanical means. In tissue hypoxia, the introduction of high concentrations of oxygen is always indicated. In cases where there is severe depression of the central nervous system, the introduction of oxygen often leads to respiratory arrest and must be accompanied by artificial ventilation.

Acute renal failure. Renal failure with oliguria or anuria may develop in a patient with poisoning due to shock, dehydration, or electrolyte imbalance. In more specific cases, it may be due to the nephrotoxic effects of certain poisons (eg, mercury, phosphorus, carbon tetrachloride, bromate), many of which are concentrated and excreted by the kidneys. Kidney damage caused by poisons is usually reversible.

Electrolyte and water imbalances. Electrolyte and water imbalances are common signs of chemical poisoning. They may be due to vomiting, diarrhea, renal failure, or therapeutic measures such as bowel cleansing with laxatives, forced diuresis, or dialysis. These disorders can be corrected or prevented by appropriate therapy. Certain poisons are more specific, causing metabolic acidosis (eg, methanol, phenol, salicylate) or hypocalcemia (eg, fluoride compound, oxalate). These disorders and all types of specific treatment are described in the sections on individual poisons.

Acute liver failure. The primary manifestation of some poisonings (eg, chlorinated hydrocarbons, phosphorus, hipofen, certain fungi) is acute liver failure.

Administration of systemic antidotes. Specific antidote therapy is possible only in case of poisoning with a small number of poisons. Some systemic antidotes are chemicals that exert their therapeutic effect by lowering the concentration of a toxic substance. This is achieved by combining an antidote with a specific poison (eg, ethylenediaminetetraacetate with lead, dimercaprol with mercury, reagents having sulfhydryl groups with a toxic metabolite of acetaminophen) or by increasing the excretion of poisons (eg, choride or mercury diuretics for bromide poisoning). Other systemic antidotes compete with the venom for receptors at their site of action (eg, atropine with muscarine, naloxone with morphine, physostigmine reverses some of the anticholinergic effects of tricyclic antidepressants as well as antihistamines, belladonna, and other atropine-like substances). Specific antidotes are discussed in the sections on individual poisons.

Chemical poisoning is the oppression of body systems resulting from exposure to toxins. Perhaps a sharp manifestation of intoxication. However, there is the possibility of a sluggish course of poisoning, lasting for years. The course of the process is affected by the type of poison, how and in what volume it entered the body.

Chemicals poison a person with toxins. There are two types of intoxication: acute poisoning and chronic.

Poisons are often presented:

• Solvents;
• pesticides;
• Reagents from laboratories;
• Household and automotive chemicals;
• Elements used for industrial purposes;
• Medicines.

Chemical elements enter the body orally, through breathing, being absorbed through the skin or mucous membranes, while forming burns. Often poisoning is provoked by the anthropogenic factor.

In adults, intoxication occurs due to a violation of safety regulations or in emergency situations at industrial facilities. Children often suffer because of the negligent attitude of adults.

Involuntary intoxication with pesticides - ICD-10 code - X40-X49.

Intoxication with drugs and substances of biological origin - ICD-10 code - T36-T50.

Poisoning at work

It occurs in people whose activities involve actions with chemicals or biochemical reactions. Unless an industrial accident is expected, poisoning causes accumulation of poisons when the concentration reaches a critical level.

Pesticides can adversely affect people whose profession involves close contact with harmful substances oriented to combat pests or weeds. Most often, packers, transporters, loaders suffer. Persons engaged in agricultural activities are exposed to intoxication with pesticides.

Working at such an enterprise is dangerous because toxins can concentrate in the human body. long time. In this case, the symptoms are so weak that a person does not perceive it as a disease. Poisoning is detected in the last stage, when it is difficult to cure the ailment.

Single substances affect the totality of life systems. Allocate:

• Neurotropes affecting the CNS. Representatives: manganese and carbon disulfide compounds, mercury, arsenic, lead elements, etc.
• Nephrotoxic species affecting the urinary system.
• Hepatotropic species affecting the liver.
• Hepatotoxic species affecting the circulatory system. Poisoning occurs with benzene vapor. They can provoke thrombosis, lymphocytosis, etc.
• Years of work with chemistry characterize irreversible consequences, as the level of chemical trace elements becomes critical.

Poisoning at home

The chemistry used in everyday life leads to frequent intoxication. Often poisoning takes sharp shape, actively expressed by a certain symptomatology. By quickly recognizing the symptoms, you can save the life of the victim.

Poisoning can occur with the most mundane actions. For example, cleaning clothes or metal products with chemicals, using detergents to disinfect the house, etc.

Consider the popular substances often used in everyday life.

Surfactants - surfactants

Representatives: soap, dishwashing detergents, shampoos, washing powders, etc. Once inside, most often orally, they manifest:

• foam in the mouth;
• Pathologies of the gastrointestinal tract;

• The manifestation of gag reflexes;
• colic;
• Redness of the epidermis.

Substances can accumulate in muscle tissue, in the brain, in the liver.

Oxidizers

Prolonged contact with oxidizing agents causes poisoning by their vapors. In this case, the respiratory system suffers. The oral cavity swells, there is suffocation, lacrimation, itching of the mucous membrane of the eyes. Products containing chlorine are hazardous due to their fumes.

Structures based on alkali

Representatives: means for removing blockages in pipes, detergents for dishes. Contents: sodium silicate - a dangerous ingredient, ammonia, lime, soda.

Concentrated compounds, getting on the skin, appear:

• Thirst;
• Diarrhea, vomiting, damage to the digestive tract;
• The formation of cerebral edema, pain in the head;
• Burns of the mucous membranes of the mouth, nose, eyes;
• The formation of ulcers on the digestive tract;
• We'll suffocate.

Intoxication in large doses leads to death. Poisoning causes shock syndrome, hemorrhage and pulmonary edema. The level of concentration affects the degree of poisoning.

Acetic acids and alcohols

Cause fatal burns to organs if swallowed. Practice shows injury to the stomach. Any use of products containing acetic acid or alcohols must be carried out in accordance with the instructions for use.

Organophosphate compounds

• Lachrymation, salivation;
• Excessive excitement;
• Nausea, outpouring of vomit;
• Trembling of the limbs, subsequently - convulsions;
• Paralysis of the respiratory system.

Pathologies develop due to the amount of less than 5 ml entering the body. The result can be dysfunction of the respiratory system, visual disturbances. As soon as the first symptoms are detected, a visit to the doctor is mandatory!

Danger of cosmetics

Cosmetics can contain a number of toxic substances that adversely affect the body. For example, shower gels and shampoos may contain surfactants designed to create lather. Prolonged exposure to substances on the skin causes dryness, destruction hair follicles resulting in hair loss.

Cosmetics may contain refined oil, which provides moisture to the skin, as well as an impenetrable film that clogs pores. This leads to breakouts, acne formation, etc.

A common variant of intoxication is hair dye. This type of poisoning requires the intervention of a toxicologist. Symptoms - burning and pain, may occur immediately or after some time. Poisoning with hair dye often causes fainting.

Signs and symptoms of chemical poisoning

Signs of chemical poisoning are determined by the typology, the duration of exposure to the drug. The amount of venom ingested matters. Symptoms of chemical poisoning are distinguished by the complexity of the forms of intoxication.

mild intoxication

Manifested by standard signs of poisoning:

• dizziness;
• apathetic state;
• chills;
• Paleness of the skin;
• Pain in the stomach area;
• Upset stomach;
• General weakness;
• dizziness;
• vomit;
• Annoying cough (in case of poisoning with toxic fumes).

Severe intoxication

A severe form of poisoning manifests itself through:

1. Changes in the color of the skin, for example, cyanosis or the acquisition of a red tint.
2. Outpouring of vomit.
3. Salivation.
4. Fainting states.
5. Numbness of limbs.
6. Convulsive manifestations.
7. Heart rhythm disturbances.
8. Difficulty in the respiratory process.
9. Changing the colors of the skin and mucous membranes.
10. Body ache.
11. Pain syndromes of the head.
12. Temperature rise.
13. Coma state.

Reagent contact with skin

Chemical elements have both internal negative impact, as well as external. Skin burn requires attentive attitude, the poison can be absorbed through open wounds and cause the same harm as oral penetration and vapor intoxication.

Interactions with the epidermis can manifest themselves through:

• Redness of the skin in the affected area;
• Rash;
• Blisters of burn etiology;

• Pain and burning sensation in the contact area.

First aid rules

Exposure to toxic substances brings a number of fatal pathologies. First aid should be provided as soon as possible.

Actions to provide first aid consist of the following activities:

• The entry of poison through the esophagus into the stomach requires immediate lavage. To do this, the victim drinks a lot of warm water, then vomiting is caused. To be done multiple times. In case of chemical poisoning with acid or alkaline compounds, it is not necessary to clean the stomach. Otherwise, the repeated passage of the poison can cause perforation of the esophagus and increase its effect. The victim must accept vegetable fat such as sunflower oil.
• Intoxication with vapors of chemicals or gases is accompanied by the provision of fresh air to the victim. It should be taken out into the street or seated in a draft, then allowed to drink water. The person needs to be laid on his back, legs raised above the level of the head, head turned to the side so that there is no possibility of choking on vomit.
• If the chemical is swallowed, a bowel cleansing procedure is applied with an enema to prevent absorption of the substance into the intestinal wall.
• The victim is given sorbents. It should be borne in mind that the drug for the absorption of toxins is not an antidote. Sorbents are designed to eliminate toxins that are not absorbed into the blood.
• In case of a negative effect on the skin, the burn should be washed with running water.
• The defeat of the respiratory tract by pesticides is neutralized by belladonna tablets or atropine drops.
• Respiratory arrest must be restored with artificial respiration.
• Before taking all the necessary measures for first aid, it is required to call doctors so that medical assistance is provided.

Treatment

Chemical poisoning should be treated in a hospital. Therapy is prescribed after assessing the condition. The chemical agent is neutralized by the antidote. However, not every poison is equipped with an antidote, then the treatment is directed to:

1. Taking measures to stop the absorption of a substance into the blood and organs.
2. Removal of a sorbent preparation that has captured toxins.
3. Restoration of the functioning of life.

Prevention measures

The storage, use and transport of chemicals must be carried out in accordance with safety precautions.

Keep children away from medicines, home cleaning products, vinegar, gasoline, etc. Conduct explanatory conversations in advance. Store substances only in their original packaging in specially designated places. Read instructions before use. Do not neglect the recommendations.

Chemical poisoning is a complex of negative manifestations caused by the penetration of toxic substances into the human body. Intoxication can manifest itself abruptly and be accompanied by a rapid deterioration in well-being or proceed sluggishly and not let you know for years. The process depends on the type, amount of poison and the way it enters the body.

Distinguish between acute and chronic chemical poisoning. Poison can be:

1. Medications.
2. Pesticides.
3. Household and auto chemical goods.
4. Solvents.
5. Reagents used in laboratories.
6. Chemical elements used in production.

Toxins can enter the body through the respiratory tract or the digestive tract. Cases of penetration of poisons through the skin or mucous membranes are observed. Poisoning can be caused by an anthropogenic factor.

Adults are poisoned due to non-compliance with safety rules or in case of accidents at work. Children become victims of exposure to chemicals due to the negligence of adults.

ICD 10 code - X40-X49 (accidental poisoning with toxic substances), T36-T50 (poisoning with drugs and biological substances).

Features of intoxication at home and at work

Exposure of the body to toxic chemicals can occur in the workplace and at home.

Occupational intoxication is observed in workers of manufacturing enterprises whose activities are associated with chemical compounds, decay products during biochemical reactions. If we are not talking about an accident at work, poisoning is chronic and manifests itself in a characteristic clinical picture with the accumulation and reaching the critical concentration of the toxin in the body.

Pesticide poisoning occurs in people whose profession is associated with the production, packaging, transportation of substances used to control pests and weeds. Pesticide intoxication is a common occurrence among agricultural workers.

At industrial enterprises, toxins can accumulate in the blood and tissues of a person for decades and manifest themselves mild symptoms. Chronic poisoning can be fully communicated in the last stages of the disease.

The peculiarity of some toxic substances is the negative impact on several body systems. Among the toxic substances are distinguished:

• neurotropic chemical elements and their compounds (affect the nervous system: compounds of manganese and carbon disulfide, carbon monoxide, mercury, phosphate, lead, benzene, arsenic);
• hepatotropes (cause a negative effect on the liver);
• nephrotoxins (affect the function excretory system and cause kidney disease Bladder and urinary system)
• hematotoxins (become the cause of serious blood diseases. Benzene vapor is a great danger. In chronic poisoning, leukopenia, lymphocytosis, and thrombocytopenia develop).

Occupational intoxication, characterized by the accumulation of poisons, is dangerous due to gradual damage to organs and systems, depression of the central nervous system. Often, people who have been working with chemicals for years have irreversible negative processes in the body at the time of a critical level of toxin content.

You can get poisoned at home by taking medicines uncontrollably, ineptly using a gas stove. In case of a chimney or hood malfunction, spraying plants with pesticides, ingestion of cosmetics or household chemicals. Vapors of solvents, paints and varnishes, mercury can cause symptoms of intoxication if the medical thermometer is damaged.

In most cases, poisoning at home is acute and manifests itself as obvious characteristic features. At timely handling to specialists, it is possible to avoid damage to organs, restore their function, eliminate the negative consequences of the poison on the body.

Signs and symptoms of pesticide poisoning

Manifestations of intoxication with chemicals depend on the type of poison, the amount and duration of entry into the body.

Main features mild intoxication are:

• weakness, apathy;
• skin blanching;
• stomach ache;
• nausea;
• vomit;
• diarrhea;
• chills;
• dizziness;
• cough (when chemicals enter through the respiratory tract).

With severe intoxication, note:

1. Redness, blueness of the skin.
2. Vomit.
3. Increased salivation.
4. Fainting.
5. Problems with consciousness.
6. Anemia.
7. Seizures.
8. Heartbeat disorders.
9. Difficulty breathing.
10. Mucosal discoloration.
11. Headache.
12. Aches in the joints.
13. Oliguria.
14. Hyperthermic syndrome (an increase in temperature is observed with toxic damage to the brain).
15. Coma.

Upon contact of the reagent with the skin, the following may be observed:

• focal redness of the skin;
• rashes;
• the appearance of burn blisters;
• pain and burning at the point of contact;
• tachycardia;
• dyspnea.

Signs of chemical poisoning are a reason to immediately seek qualified medical help. Loss of time is fraught with the development of complications, irreversible pathological processes. With severe intoxication and the absence of therapeutic measures, the victim may die.

The leading cause of death is carbon monoxide poisoning. The peculiarity of the substance is the absence of odor and color, a quick effect on humans.

First aid rules

Competent provision of emergency first aid is an important stage in saving the victim from the influence of chemicals, fumes of toxic substances, gas.

1. If poison enters the digestive tract, the stomach should be immediately washed out, giving the victim plenty of warm water to drink and inducing vomiting. The procedure is recommended to be carried out repeatedly. If intoxication is caused by ingestion of alkali or acid, gastric lavage should not be done, in order to avoid an increase in the reaction. Give to drink lime water, milk, sunflower oil, egg whites.
2. In case of poisoning by inhalation of vapors or gas, it is necessary to remove or take the person to fresh air. In order not to poison yourself, you need to cover your nose and mouth with clothes. The victim needs to unbutton the collar, release the neck from the tie, scarf, scarf and give water to drink. An unconscious person should be laid down and their head turned to the side in case of vomiting.
3. In case of food poisoning or ingestion of poison, cleansing enemas are given. They use boiled warm water, temperature not higher than 37 C. These actions reduce the absorption of toxins in the intestinal walls.
4. The intake of sorbents is necessary for the absorption of toxic substances. But sorbents are not antidotes - they eliminate those toxins that have not had time to be absorbed into the blood. They should be taken immediately after the first symptoms appear and cause " ambulance". It is important to observe the dosage: 1 tablet of activated carbon is designed for 10 kg of human weight. Cleanse the body with a smaller dose will not work.
5. In case of contact of the reagent with the skin, the damaged area must be thoroughly rinsed with water.

Intoxication with pesticides occurs due to violation of the instructions for the use and storage of chemicals. First aid for exposure to organophosphorus compounds:

• when the poison enters the respiratory tract, the patient should be given 2 tablets of belladonna (Belladonna herb extract) or 8 drops of atropine 0.1%;
• if poison enters the gastrointestinal tract, the victim needs to drink 1 liter of water with 7-10 tablets of activated charcoal dissolved in it and provoke vomiting;
• when breathing stops, perform artificial respiration;
• give a laxative (a solution of magnesium sulfate or Karlovy Vary salt);
• deliver the poisoned person to the hospital.

What drugs to take for chemical poisoning

After first aid, chemical poisoning is treated in a hospital. For therapeutic measures, the patient's condition is assessed. If the chemical agent is known, the doctor may prescribe an antidote. In case of an overdose of narcotic opium alkaloids, Naloxone is prescribed. But not all poisons have antidotes, therapy is aimed at:

1. Stopping the absorption of toxins into the body.
2. Removal of the toxic substance absorbed by sorbents from the body.
3. Elimination of symptoms of poisoning (restoration of the function of the affected systems or organs).

In the absence of vomiting, which allows emptying the stomach, the patient is given syrup of Ipecac. The medicine can be given to drink to a child and an adult (15-30 ml), but simultaneous administration with sorbents should be excluded. In the absence of vomiting after 20-30 minutes, a second dose of the drug should be taken.

In a hospital setting, it may be prescribed intramuscular injection Apomorphine, which causes vomiting within 5 minutes.

For the adsorption of poisons are prescribed: Activated carbon: black and white, Carbolong, Smecta, Enterosgel, Polysorb MP, Polyphepan, Filtrum-STI. To remove adsorbed toxins from the body, laxatives are used: Magnesia, Sodium sulfate. In the presence of convulsions, the patient is administered intravenously Phenytoin, Diazepam, Phenobarbital.

In case of intoxication after chemotherapy, which is accompanied by vomiting, drugs are used that stop unpleasant urges. The above sorbents are used.

Possible Complications

The consequences of exposure to toxins can be complications:

1. Edema of the lungs, brain, larynx.
2. Decreased functions of the central nervous system.
3. Hypotension (severe decrease in blood pressure).
4. Cardiac arrhythmia.
5. tissue hypoxia.
6. Acute form of renal or hepatic insufficiency.
7. Violation of the water and electrolyte balance of the blood.

Chemical poisoning is characterized as a dangerous condition of the victim and ignored symptoms can lead to disability of a person. It is necessary to provide first aid in time, call a doctor and begin to treat intoxication.

Due to the prevalence of household and interior care products, cosmetics, detergents and repellents, poisoning is possible household chemicals symptoms of which require first aid.

How does household chemical poisoning occur?

To keep neat appearance, cleanliness and disinfection of objects and premises, elimination of harmful insects use products of the chemical industry, which have a domestic purpose. However, during operation, household chemicals can be harmful to health. You can poison them in the following way:

• If the product gets inside due to violation of storage rules.
• With frequent use of an abundant amount of the drug, it can accumulate inside the body and cause allergies.
• During the inhalation of vapors of chemicals in the absence of ventilation, irritation of the mucous membrane of the mouth and nose, the formation of ulcers may occur.
• During contact with unprotected skin.

Depending on the composition and scope, household chemicals are classified as follows:

1. Detergents for the body, hair, dishes, characterized by intense foaming.
2. Products containing turpentine or acetone as solvents.
3. Liquids used to eliminate greasy contaminants containing chlorinated hydrocarbons.
4. Repellents, insecticides containing organophosphorus compounds.
5. Detergents containing alkalis: ammonia, caustic soda.
6. Aggressive cleaners for removing heavy soiling, rust and clogging of sinks, bathtubs, toilet bowls. Usually they contain hydrochloric, acetic, oxalic, carbolic acids.
7. Cosmetics containing alcohol.

The use of these products for other than intended purposes can cause irreparable harm to human health. You can prevent a dangerous condition by knowing the symptoms of poisoning.

Symptoms and consequences

The impact on the body of various household chemicals is not the same. Depending on the composition, they can be divided into five groups.

Surfactants

Almost all detergents designed to eliminate grease stains contain surface-active substances (surfactants). They effectively remove dirt that is difficult to wash off with water. Such substances combine with fat molecules and water and "detach" the dirt from the contaminated surface. Thanks to these additives, powder and soap remove stains and grease.

These compounds are detrimental to skin covering by removing its protective lipid layer. They are able to accumulate in the internal organs: the brain, heart muscle and liver.

The main symptoms of surfactant poisoning:

• foamy discharge from mouth;
• pain in the stomach, intestines;
• vomit;
• difficulty breathing;
• disruption of the liver.

Chlorine and oxygen oxidizers

Such compounds provide surface disinfection, destroy organic compounds. They are part of the means for disinfection and elimination of pollution of sanitary ware, bleaches, stain removers.

As a result of regular exposure to oxidizing vapors, the following occurs:

1. Edema of the oral mucosa, respiratory organs.
2. Irritation of the upper respiratory tract, suffocation.
3. Itching in the eye area, tearing.
4. Cough, respiratory failure.

With constant continuous exposure, there are:

• vascular atherosclerosis;
• anemia;
• deterioration of the hair condition: brittleness, dullness, loss;
• high blood pressure.

Once inside, oxidizing agents cause:

1. Destruction of red blood cells (hemolysis).
2. Liver damage.
3. Erosion of the mucous membranes in the mouth, trachea.
4. Burns of the stomach, intestines.

alkalis

Alkali may contain means for cleaning blockages of sewer pipes, detergents for dishes and other kitchen utensils. The most common types of alkali are sodium silicate, lime, soda, ammonia (ammonium chloride). Upon contact with substances high concentration alkalis on the surface of the skin or inside the body, symptoms occur:

• Strong thirst.
• Diarrhea or vomiting (may have blood impurities if the alkali has damaged the walls of the stomach and intestines).
• Edema and severe pain due to burns of the mucous membrane of the eyes, nasopharynx.
• Painful ulcers in the gastrointestinal tract.
• Suffocation attacks.

Poisoning with concentrated alkali can cause death as a result of pain shock, internal bleeding, and pulmonary edema.

acids

When falling into the body, products containing acid burn the internal organs, and can burn the stomach.

Symptoms of poisoning with acidic detergents are similar to those of alkali poisoning.

Organophosphorus compounds

Poisoning with agents containing such compounds is accompanied by:

1. nervous excitement.
2. Lachrymation.
3. Profuse salivation, nausea, vomiting.

With prolonged exposure to funds with FOS, the development of tremor and paralysis, convulsions, respiratory failure is possible.

If the substance is ingested (more than 50 ml), respiratory function disorders are observed, damage optic nerve.

If poisoning with household chemicals occurs, it is necessary to call a doctor and take measures to provide first aid to the victim.

First aid

Before starting first aid measures for poisoning with household chemicals, it is necessary to find out the alleged cause of the poisoning. When contacting the hospital, notify the dispatcher about the impact of the poisonous substance and ask for advice from the doctor on duty over the phone.

While waiting for qualified assistance, it is necessary to eliminate the impact chemical agent, provide the patient with access to a stream of fresh air.

Depending on the cause of poisoning, take the following measures:

• If the toxic substance has entered the oral cavity, rinse it with water.
• Place the patient in such a way that in case of vomiting he does not choke on vomit. If a person is unconscious, open his mouth slightly, make sure that the tongue does not fall. In the presence of dentures, braces - remove them from the oral cavity.
• If a product containing caustic substances gets into the eyes, rinse them with plenty of water. Chlorine-containing products are recommended to be washed out with a 2% solution. baking soda.
• In case of poisoning with cosmetics - drink a large amount of liquid, induce vomiting.
• A burn caused by contact with lime must not be wetted. It is necessary to remove the remnants of the substance with a napkin, and grease the burn site with glycerin.
• If a chemical with a high concentration of acid, alkali, chlorine gets on the surface of the skin, it is necessary to keep the affected area under a stream cold water at least 20 min. If the cause of irritation is hydrofluoric acid, pre-moisten the area of ​​​​contact with the substance with a napkin.
• For internal alkali poisoning: prepare a weak acetic solution by adding 4 tbsp. l. vinegar 3% concentration. The patient needs to take the solution at intervals of 15 minutes. 1 st. l. Also, taking 1 tbsp will help alleviate the condition of the victim. l. vegetable oil every 30 minutes.
• In case of internal poisoning with acid-containing substances, it is necessary to prepare a soda solution by adding 5 tbsp. l. soda in 1 liter. water. Give the victim 3 tbsp. l. solution at intervals of 10 minutes. It is recommended to give the patient milk - 1 sip every 10-15 minutes. good remedy to prevent the absorption of a substance into the blood is the use of raw egg white.

What can not be done in case of accidental internal use?

A number of actions that help eliminate the symptoms of standard food poisoning can be harmful when poisoning with household chemicals. In such cases, it is not recommended:

1. Give the victim activated charcoal.
2. Drink a solution of potassium permanganate, a large volume of liquid.
3. Apply an enema wash.

To weaken the effect of a poisonous substance, it is recommended to take several tablets of activated charcoal, however, in a victim with damage to the oral cavity and larynx, this will cause severe pain.

Taking a solution of potassium permanganate or drinking plenty of water (more than 400 ml) will cause vomiting. Then the masses of toxic substances will go back through the esophagus. Means containing acid, alkali, chlorine will cause a second burn of the esophagus and respiratory organs, and foaming substances can block the flow of air into the lungs.

To wash the stomach, doctors use a special probe that excludes damage to the small intestine. Therefore, washing at home is undesirable.

The patient receives further assistance to eliminate the consequences of poisoning in a medical facility.

Video: how not to get poisoned by household chemicals?

Ways to prevent poisoning

To avoid poisoning with household chemicals, it is necessary to limit its use as much as possible. If it becomes necessary to clean sewer pipes, clean the surface of plumbing fixtures with concentrated cleaning agents, work only with gloves, do not inhale the vapors of the detergent or use a protective mask when working with it.

You should follow the basic rules for the use of household chemicals:

• Read the instructions carefully before use possible reactions when exposed to a substance.
• Keep detergents and cosmetics out of the reach of children. Close the container carefully after use. It is better to use products that have child protection on the lid.
• Do not pour household chemicals into containers from food products, drinks, even if a warning label is left on it. An adult may not notice it, and a child will not be able to read it.
• Do not leave products that can cause harm to health near food.

In case of poisoning with household chemicals, you cannot self-medicate, otherwise you can cause irreparable harm to the body. A careful and careful attitude to the use of the achievements of the chemical industry, designed to make living conditions more comfortable and homework easier, will help to avoid the occurrence of dangerous conditions.