Poisonings with organic solvents
Acetone. It is applied as solvent in effecting of the various varnishes, artificial silk, films and so forth the Weak narcotic poison,amazing all departments of the central excitatory system. Inpours into an organism through a respiratory organs, a digestive organs (at intake).
Symptoms: the clinical pattern is similar to an alcoholic intoxication. However the coma does not reach the big depth. The mucosa of an oral cavity and a pharynx is inflamed. From a mouth – an acetone odour. At acetone poisoning in pairs there are symptoms of irritation of the slimy coating of eyes, respiratory pathes, headaches, unconscious are possible states. The augmentation and morbidity of a liver, yellowness of scleras are sometimes observed. Appearance of signs of sharp renal insufficiency (diuresis decrease, appearance of protein and erythrocytes in urine) is possible. Often educe bronchitis and a pneumonia.
First aid. To deduce the victim on fresh air. At a faint to yield to inhale liquid ammonia. Rest. Hot tea, coffee. Urgent the help and treatment at a grave condition – see Alcohol (poisonings Alcohol and its substitutes). Besides, preventive maintenance of sharp renal insufficiency, therapy by oxygen, antibiotics, including inhalation by them. Ethylene dichloride, perchloromethane, trichloroethylene fall into to bunch of the chlorinated hydrocarbons widely applied as solvents in many branches of effecting, in a life for agglutination of plastic products, clothes cleanings and so forth Toxic action of these materials is bound to narcotic influence on the excitatory system, sharp dystrophic changes of a liver and nephroses. Ethylene dichloride is most toxic. Lethal dose at its reception in 20 ml. poisonings are possible at poison receipt inside, through respiratory pathes, cutaneous coverings.
Excrete four leading clinical syndromes: The toxic lesion of the central excitatory system shows in early terms after a poisoning in the form of dizziness, instability of the gait, the expressed psychomotor excitation. In heavy cases the coma which frequent complication is infringement of breath as a mechanical asphyxia (abundant allocation of a saliva) educes. Syndrome of a sharp gastritis at which it is marked repeated vomiting with a significant admixing of gall, in heavy cases the frequent liquid chair, flocculative with a specific odour. The syndrome of sharp cardiovascular insufficiency shows nonperishable falling of arterial pressure with absence of sphygmus on peripheric arteries and is observed routinely against psychomotor excitation or a coma. In some cases falling of arterial pressure is preceded by its short-term increase and a sharp tachycardia. Development of cardiovascular insufficiency is characteristic for poisonings with ethylene dichloride and is the bad factor as routinely concludes a lethal outcome within the first 3 days. Syndrome of a sharp toxic hepatitis with the phenomena pechenochno-renal failures. The toxic hepatitis educes at the majority of patients for 2-3 days after a poisoning. The basic clinical exhibitings – liver augmentation, spastic pains in the field of a liver, yellowness of scleras and cutaneous coverings. Infringement of function of nephroses shows development of dysfunction of various degree. Some patients within the first week after a poisoning have a sharp renal insufficiency (uraemia) that is more typical for poisonings with Carboneum. Inhalation poisonings with ethylene dichloride and perchloromethane can yield a heavy clinical pattern, at action of steams of perchloromethane pechenochno-renal insufficiency often educes. Causes of death: early – cardiovascular insufficiency (1-3 days) and serotinal a coma, an uraemia.
First aid and treatment in a coma precisely same, as at an alcoholic poisoning as and in that and other case the penetrating narcosis with infringement of breath, a circulation and an acidosis takes place. A lesion of nephroses the same as similar infringements at a poisoning with antifreeze (Alcoholic poisonings and its substitutes see). For restoration of function of a liver appoint bunch vitamins In, With, glucocorticoids, an insulin with glucose, treatment is made in a hospital to the serotinal terms after a poisoning.
Turpentine. Solvent of varnishes, paints, raw materials for reception of camphor, etc. Toxic properties are bound to narcotic action on the central excitatory system and aboriginal cauterising action. A lethal dose – 100 ml.
Symptoms: sharp pains on a course of an esophagus and in a gaste, vomiting with an admixing blood, a liquid chair, frequent desires on a defecation, strong delicacy, dizziness. At heavy poisonings – psychomotor excitation, delirium, disorientation, spasms, consciousness loss. In a penetrating coma are possible infringements of breath as a mechanical asphyxia. Complications: a pneumonia, a sharp nephrite. Development of sharp renal insufficiency is possible.
First aid: a stomach lavage, salt purging (not a castor oil). Abundant drink, slimy decoctions. Inside absorbent coal, ice scraps.
Treatment. A stomach lavage through a sonde and other actions (Acids see).