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