Poisonings — the diseases developing owing to exogenous impact on a body of human or an animal of chemical compounds in the quantities causing disturbances of physiological functions and creating danger to life.
In the Wednesday surrounding the person there are chemicals having toxic properties, poisonous plants and poisonous animals. Owing to production of a huge number of the chemical compounds which are widely applied to agricultural, production, household, medical and other purposes there was a so-called toxic situation. Several thousands are annually synthesized and several hundreds of new chemical means are entered into practice. Many of them as a result of disturbance of conditions of safety measures by production, use and storage can become the cause of acute and chronic poisonings.
Classification, symptoms and first aid in poisoning
There is no uniform classification of poisonings in connection with their etiological variety, a large number of toxic agents, a variety of ways of their receipt to an organism, conditions and ways of interaction of poisons with an organism.
Classification of poisonings by the name of the substance which caused them (poisoning chlorofosy, arsenic, a dichloroethane and so forth), is most widespread on the name of group which the toxic agent, (poisonings with barbiturates, acids, alkalis and so forth), by the name of the whole class combining various chemicals on community of their use (poisoning with toxic chemicals, drugs) or origin (poisonings with vegetable, animal, synthetic poisons) treats.
Depending on a way of intake of poisons to an organism distinguish:
- inhalation (through airways),
- peroral (through a mouth),
- percutaneous (through skin),
- injection (at parenteral administration) poisonings and so forth.
At characteristic of poisonings widely use also the existing classifications of poisons by the principle of their action (irritating cauterizing, hemolytic and so forth) and "selective toxicity" (nephrotoxic, hepatotoxic, cardiotoxic, etc.).
Clinical classification provides discharge of acute and chronic poisonings and also concerns assessment of weight of a condition of the patient (easy, moderately severe, heavy and extremely heavy) that taking into account conditions of developing of poisoning (household, production, medical) and its reasons is of great importance in the medicolegal relations.
1. Poisoning with carbon and illuminating monoxide
Poisoning with carbon monoxide (SO carbon monoxide) perhaps on productions where carbon monoxide is used for synthesis of a number of organic substances, in garages at bad ventilation, in not aired again painted rooms and also in house conditions – at leak of illuminating gas and at out of time closed oven gates in rooms with oven heating.
Early symptoms of poisoning are the headache, weight in the head, nausea, dizziness, sonitus, heartbeat. A little later there are muscle weakness, vomiting. At further stay in the poisoned atmosphere the weakness increases, there is a drowsiness, a black-out, an asthma. At victims during this period the pallor of integuments, sometimes existence red a spot on a body is noted. At further inhalation of carbon monoxide the breathing becomes shallow, there are spasms there comes death from paralysis of the center of breath.
"First aid consists, first of all, in immediate removal poisoned from this room. At weak shallow breathing or its stop it is necessary to begin immediately artificial respiration which should be carried out before emergence of independent adequate breath or before emergence of strong indications of biological death. Patients with a serious poisoning are subject to hospitalization as development of heavy complications from lungs is possible and nervous system in later period".
2. Food poisonings
"At intake of the substandard (infected) animal products (meat, fish, sausages, canned and fish meat, milk and products from it, etc.) there is food poisoning – food toxicoinfection. The disease is caused by the microbes and products of their activity which are in this product – toxins". Meat, fish can be infected during lifetime of animals, but most often it occurs in the course of cooking and the wrong storage of foodstuff. The first symptoms of a disease are shown in 2-4 hours after reception of the infected product in certain cases a disease can be shown through a bigger period of 20-26 hours.
The disease usually begins suddenly: sharply there are a general malaise, nausea, often repeated vomiting, colicy pains in a stomach, a frequent loose stool, sometimes with impurity of slime and streaks of blood. Very quickly intoxication showing a lowering of arterial pressure, increase and weakening of pulse, pallor, thirst, high speed accrues; Tura (38 — 40 °C). If to leave the patient without the aid of the phenomenon of intoxication accrue catastrophically quickly, cardiovascular insufficiency increases there are convulsive reductions of muscles, there occurs collapse and death.
First aid consists in immediate gastric lavage by water by means of gastric the probe or by calling of artificial vomiting — plentiful drink of warm water (1.5 — 2 l) with the subsequent irritation of a root of language. It is necessary to wash out to "clear water". It is necessary to give plentiful drink and in independent vomiting. For the fastest removal from intestines of the infected products the patient needs to give Carbolenum (gastric coal) and laxative. Intake of any food is forbidden (during 1 — 2 days), but plentiful drink is appointed. To the victim it is necessary to cause emergency medical service or will bring him to medical institution.
Poisoning with mushrooms can occur at reception of poisonous mushrooms and also edible mushrooms if they are spoiled. In poisoning with mushrooms it is necessary to begin immediately gastric lavage with water, potassium permanganate solution by means of the probe or method of artificial vomiting. Then give laxative, cleansing several times give enemas.
Botulism – an acute infectious disease in which there is a damage of the central nervous system the toxins emitted by an anaerobic sporiferous bacillus belongs to food poisonings.
The disease begins with a headache, a general malaise, dizziness. The chair is absent, the stomach is blown up. Body temperature remains normal. The state progressively worsens, in a day from the beginning of a disease signs of severe damage of a brain appear: there is a doubling in eyes, squint, a blepharoptosis, paralysis of a soft palate, a voice becomes muffled, the act of swallowing is violated. The abdominal distension increases, the ischuria is observed. The disease quickly progresses, and the patient a course of the first 5 days dies of paralysis of a respiratory center and warm weakness. First aid is similar to the help in other food poisonings. It is necessary to know that the main method of treatment is the fastest introduction to the patient of specific anti-botulinic serum. Therefore the patient with botulism should be taken to hospital immediately.
3. Poisoning with toxic chemicals
In agriculture now chemical drugs — toxic chemicals for fight against weeds, diseases and wreckers of cultivated plants widely use. At strict implementation of the instruction for use and to storage of toxic chemicals the possibility of poisoning of the population is completely excluded. The poisonings with toxic chemicals taking place are result of gross violations of these instructions. Most often there are poisonings with organophosphorous connections (a thiophos, chlorofos) which can get to an organism in the inhalation way together with the inhaled air and is enteral — together with foodstuff. At hit on mucous membranes their burns are possible.
The eclipse period of a disease proceeds 15 — 60 min. Then there are symptoms of damage of nervous system, the increased salivation, department of a phlegm, perspiration. Breath becomes more frequent, becomes noisy with the rattles heard at distance. The patient becomes uneasy, excited, spasms of the lower extremities and a hyperperistalsis soon join. A little later there come muscles paralyzes including respiratory. The apnoea leads to asphyxia and death.
"In the poisonings which arose owing to inhalation of toxic chemicals, the main objective of first aid is immediate transportation of the victim in a hospital. At an opportunity the patient needs to give 6 — 8 drops of 0.1% of solution of atropine or 1 — 2 tablet of a belladonna. In case of an apnoea it is necessary to carry out continuous artificial respiration. In poisonings owing to hit of poisons in digestive tract the gastric lavage by water with a suspension of activated carbon is necessary; give salt laxatives. Toxic chemicals from skin and mucous membranes should be removed with a water jet".
4. Poisoning with acids and alkalis
In poisoning (intake) of a koncentrirovannyyoma with acids and caustic alkalis the serious condition which is explained first of all by the arisen extensive burns of an oral cavity, drinks, a gullet, a stomach razvivayotsya very quickly, and it is frequent also throats, is later impact of the soaked-up substances on vitals (liver, kidneys, lungs, heart). KontsentrirovanYonyy acids and alkalis have pronounced properties to destroy fabrics. Mucous membranes — znayochitelno less strong fabrics, than skin therefore they collapse and nekrotieirutsya quicker and more deeply.
On a mucous membrane of a mouth, lips there are burns and crusts. In burns sulphuric acid crusts of black color, in burns of nitric — gray-yellow color, in burns salt — yellowish-green color, in burns acetic — gray-white color.
Alkalis get through fabrics easier and therefore it strike fabrics deeply. A burn surface very friable, breaking up, whitish color. Immediately after intake of acid or alkali the patients have severe pains in a mouth, behind a breast. Patients rush about from pains. Painful vomiting is almost always observed, it is frequent with blood impurity. Quickly there is painful shock. The laryngeal edema with the investigating additionally development of asphyxia is possible. At reception of large amounts of acid or alkali the warm weakness, collapse very quickly develops. Hard defeats by liquid ammonia proceed. The pain syndrome at this defeat is followed by suffocation as also airways suffer.
Giving first aid dolyozhen at once to find out what substance there was poisoning as ways of assistance depend on it.
"In poisoning concentrated by acids if there are no symptoms of a perforation of a gullet and stomach, it is necessary to wash out first of all a stomach via thick probe 6 — 10 l of warm water with addition of burned magnesia (20 g on 1 l of liquid). If it is impossible to carry out washing via the probe, then such patients can allow to drink milk, vegetable or animal oil, egg whites and other enveloping means.
In poisoning with carbolic acid and its derivatives milk, oil, fats are contraindicated. In this case it is better to allow to drink burned magnesia with water lime water. These substances are shown also in poisonings with all other acids.
In poisoning with the concentrated alkalis it is also necessary to wash out immediately a stomach of 6 — 10 l of warm water or solution of citric or acetic acid. Washing is shown in the first 4 h after poisoning. In case of lack of the probe and impossibility of washing (serious condition, a laryngeal edema, etc.) the enveloping means, 2 — 3% allow to drink solution of citric or acetic acid (on 1 tablespoon each 5 min.). The main objective of first aid is nemedlenyony delivery of the victim to medical institution where emergency medical assistance will be rendered to it. It is necessary to remember that at suspicion on perforation of a gullet or stomach (a sharp abdominal pain, nevynosiyomy pains behind a breast) to give to drink to the victim and the more so it is not necessary to wash out a stomach".
5. Poisonings with medicines and alcohol
Poisoning with medicamentous means is more often vseyogo is observed at children, in families where incorrectly hrayonit drugs — in the places available to children. OtravleYoniya of adults occur at accidental overdose, suicide attempts and at the persons suffering from a narkomayoniya. Manifestation of poisonings is extremely various and depends on a type of medicinal substance.
At a feather to a dosage soothing and febrifuges there is a disturbance of proyotsess of braking and excitement in the central nervyony system, paresis of capillaries and the strengthened return by heat body. It is followed by the strengthened sweating, development of weakness, drowsiness which can pass into a deep sleep and even into unconsciousness, an inogyod with breath disturbance.
The victim has to be brought to medical institution nemedyolenno. At disturbance of breath and warm activity it is necessary to hold resuscitation events.
Quite often poisonings develop at a pereyodozirovka of sleeping medicines (barbamyl, Noxyronum, nembutal, etc.). In poisoning the deep braking of the central nervous system is observed, the dream turns into unconsciousness with the subsequent paralysis of a respiratory center. Pale patients, breath superficial and rare, spasmodic, often rattling, bubbling.
At the kept consciousness it is necessary to wash out a stomach, to cause active vomiting. In case of disturbance of breath the artificial respiration is shown.
In poisonings with drugs there are dizzinesses, nausea vomiting, weakness, drowsiness. At considerable overdoses the deep sleep, its unconscious standing which comes to an end with paralysis of a respiratory center and the center of blood circulation develop. The patient is pale, cyanosis of lips, breath wrong is observed, pupils are sharply narrowed.
First aid consists in the fastest delivery of the victim to medical institution. At a stop of breath and blood circulation hold resuscitation events.
At reception of significant (toxic) amounts of alcohol perhaps even fatal poisoning. Alcohol makes impact on heart, vessels, digestive tract, a liver, kidneys. It has the main impact on a brain. At heavy degree of intoxication of people fills up, then turn a dream into unconsciousness. Vomiting, an involuntary mocheotdeleniye are often observed. The respiratory center is sharply oppressed that is shown by rare spasmodic breath. In paralysis of the center of breath there comes death.
First of all it is necessary having provided (to open inflow of fresh air a window, to take out poisons lenny on the street, to cause vomiting by "small washings", at the kept consciousness it is necessary to allow to drink hot strong coffee). In an apnoea it is necessary to hold artificial respiration and other resuscitation events.
Poisonings at children
Parents very often face such problem as children's poisoning. Many dealt with safe food poisonings. Process can be limited to steam in the days near a bathtub. Medical practice of treatment of poisonings is very diverse, and parents have to know, than it is possible to get poisoned how to protect the child and what help to render it. Below we will consider what needs to be made before arrival of ambulance. And what first aid to give children in poisoning. What to do and how to treat food poisoning at the child?
Types of poisonings. Toxic gets into a human body through a digestive tract, integuments, upper airways. Toxic agents are subdivided into three groups.
- The first group represents the most dangerous connections: poisons of animal origin, toxic poisons, drugs of household chemicals, poisonous mushrooms, poisonous plants, poisons of industrial production.
- The second group also dangerous connections, is conditionally poisonous plants, conditionally edible mushrooms, drugs, alcohol.
- The third group is conditionally dangerous connections: edible mushrooms, plants. Not many parents know how to treat food poisoning at the child. At violation of the rules of storage, preparation, at incorrect processing by pesticides, ordinary connections gain toxicity. Mushrooms which accumulate in themselves all toxics, especially are especially dangerous if they grow on the soil polluted by waste.
Where and how children can get poisonings?
Through a digestive tract if they used:
- poisonous berries and mushrooms,
- the vegetables processed by insecticides, fruit, berries,
- stale products and water because staphylococcus in the spoiled food and water does not perish at heat treatment,
- medicines which are in free access
- drugs and alcohol
- drugs of household chemicals
- vinegar, gasoline
- the medicine received through mother's milk
- in couples of poisonous plants,
- vapors of paint, varnishes, acetone, kerosene, gasoline, and other substances
- vapors of carbon monoxide.
By means of skin, after engagement with:
- ointment, at excessive use,
- dangerous dyes,
- the poisons, fertilizers which are used in the industry, agriculture.
Paramount symptoms of poisoning. Diarrhea, an abdominal pain, vomiting are not the main symptoms of poisonings. To learn the reason of feeling sick of the child without special knowledge quite difficult. Knowledge of all symptoms in poisoning is necessary in due time to make out poisoning and at once to help the child. If the child got poisoned with low-quality water, expired foodstuff, then there is vomiting, nausea, diarrhea, an abdominal pain, apathy. The child refuses food, so it is necessary to treat immediately food poisoning at the child.
Heavier symptoms, speak about probable poisoning:
- the breath which was speeded more up also breath holding is probable,
- differences arterial pressure (increase, then lowering)
- arrhythmia, weakening of pulse,
- superexcitation, or on the contrary, block,
- cyanosis and pallor of integuments,
- faints, spasms, loss of consciousness,
- lack of coordination of movements
- hallucinations, drowsiness.
If there is a suspicion of poisoning, it is necessary:
- it is urgent to cause emergency medical service while the ambulance goes to you, consult by phone with the doctor on duty,
- to put the child in a comfortable position and not to leave unguarded,
- in vomiting, the child should be seated to himself on knees the head down, and for definition of toxin put a basin.
- in a loss of consciousness of the child it is necessary to lay sideways. Having wrapped a finger a handkerchief, to sanify a mouth from emetic masses. Also it is necessary to watch that nausea did not prevent to breathe.
- Whenever possible ask the child about the cause of poisoning, attentively examine the child, check clothes, check whether there are no burns of skin, various reddenings, spots, foreign smells.
Check your house, in particular places where household chemicals, a first-aid kit, cosmetics are stored. It is possible to try to establish the cause of poisoning, watching changes which happen to the child. Various means cause different symptoms therefore vomitings can not be. Do not self-medicate at all. Wait for arrival of the doctor. If "Ambulance" is late, get advice by phone at the toxicologist and the pediatrician, and strictly implement their recommendations.
If poisoning happened because of food. In this case it is necessary to wash out a stomach and further plentifully to drink water. Washing is done by from two to five times. But it provided that the child in consciousness. If food poisoning passes with diarrhea, vomiting, it is necessary to allow the child to drink Regidron, children's glyukozo-saline solution. Duration, frequency and a dosage will be told by the doctor. During this period the food has to be frequent, but in the small portions. It is possible to give mashed potatoes on water, viscous porridges on water, vegetables on couple, vegetables decoctions, then boiled fish and low-fat meat. Only the doctor can establish the correct diagnosis. If at the child besides diarrhea, vomiting, an abdominal pain, the increased temperature, it is necessary to call urgently the doctor to exclude appendicitis and other serious illness.
Poisoning with chemicals. If the child got poisoned through a gullet with chemicals, it is impossible to provoke vomiting, at repeated pass of liquid at all, there can be a difficulty of breath and cause a burn of fabrics. It is necessary to call urgently "Ambulance" and to treat poisoning at the child. If poisoning was alkalis or acids, the child should allow to drink vegetable oil: up to 3 years – one teaspoon, up to 7 years – one dessert, 7 years – one tablespoon are more senior. In poisoning through integuments, it is necessary to take off clothes and to wash up a body warm water with soap.