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DISASTER
MANAGEMENT
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| INFORMATION
REGARDING ANTIDOTES AND SPILLAGE |
| POISONING, FIRST AID AND
ANTIDOTES |
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Some substances when
taken into the body in fairy large quantities can be dangerous
to health or can cause death. Such substances are poisons.
Poisons get into body by swallowing or by
breathing poisonous gases, or by injection.
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| Poisoning by Swallowing: |
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Sometimes acids,
alkalis, disinfectants etc., are swallowed by mistake. They
burn the lips, tongue, throat, and food passage and stomach
and cause great pain. Other swallowed poisons cause vomiting,
pain and letter on diarrhea. Poisonous fungi, berries, metallic
poisons and stale food belong to the latter group some swallowed
poisons affect the nervous system. To this group belong (a)
alcoholic (methylated spirit, wine, whisky etc.) when taken
in large quantities, and (b) tables for sleeping, tranquilizers,
and pain killing drugs (aspirin or largectil). All these victims
must be considered as seriously ill .The symptoms are either
delirium or fits or come (unconsciousness). Some poisons act
on nervous system-(belladonna, strychnine).
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| Poisoning by Gases: |
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Fumes or gases from
charcoal stoves, household gas, motor exhausts, some chemicals
and smoke explosions etc., cause choking (asphyxia) which
may result in unconsciousness in addition to difficult in
breathing.
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| Poisoning by Injection: |
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Poisoning get into
the body through injection bites of poisonous snakes and rabid
dogs, or stings by scorpions and insects. Danger to life is
again by choking and coma.
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| (1) General
First Aid in Poisoning: |
| (1) |
Poisoning is a serious
matter. Patient must be transfer to a hospital/or a doctor
be sent for, at once with a note of the findings and, if possible,
the name of the poison.
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| (2) |
Preserve packets
or bottles which you suspect contained the position and also
any vomits, sputum etc., for the doctor to deal with.
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| (3) |
If unconscious -
(a) do not induce vomiting (b) Make the casualty lie on his
back on a hard, flat bed without any pillow and turn the head
to one side. As there is no pressure on the stomach and the
gullet is horizontal, the vomited matter will not get into
the voice box and the tongue will not close the air passage.
This is also the best posture for giving artificial respiration,
if needed (c) Sometimes when there is excess of vomiting the
three-quarter-prone posture (i.e.. the casualty is made to
lie on his side with one leg stretched, the other bent at
knee and thigh) will make things easier for the casualty.
(d) If breathing is very slow or stopped, start artificial
respiration and keep it up till the doctor comes.
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| (4) |
If conscious- (a)
Aid vomiting by tickling the back of throat or make him dark
tepid water mixed with 2 tablespoons of common salt for a
tumbler of water. (b) Even if conscious, when the poison is
a corrosive do not induce vomiting. Signs of corrosive: Lips,
mouth and skin show gray white or yellow, patches that are
to be looked for: acids, alkalis etc., cause such burns.
First aid: Factories,
which use certain poisons, shall have the respective antidotes
ready and displayed in an easily available place. The personnel
should be taught about the use of antidotes- so that anyone
can render assistance in case of emergency.
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| (5) |
The poison must be
diluted by giving large quantities of cold water (chilled,
if possible). This will dilute the irritant and delay absorption
and will replace fluid lost by vomiting. Tender coconut water
will be even better as this will be a food and also a diuretic.
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| (6) |
Soothing drinks should
be given. Milk, egg beaten and mixed with water or sojee congee
are good for the purpose.
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(2) Carbon Monoxide Poisoning
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Carbon monoxide poisoning
may occur in the chemical industry where it is used for synthesizing
certain organic compounds (acetone, methyl alcohol, phenol
etc.) in poorly ventilated garages, or in stuffy, freshly
painted premises. It may are happen in households when the
stove shutters are closed too early in premises with stove
heating.
The early symptoms are headache,
heaviness in the head, nausea, and dizziness, noise in the
ears, and palpitation. Later muscular weakness and vomiting
occur. If the victim remains in the poisonous atmosphere,
the weakness intensifies, somnolence, clouding of consciousness,
and despond develop. The skin turns pale and sometimes bright
and red spots appear on the body. In further exposure to carbon
monoxide the patient's respiration becomes shallow, convulsions
develop, and paralysis of the respiratory center terminates
in death.
First aid: The victim must
be immediately removed from the poisonous surroundings, better
into the open air in warm weather. If his breathing is weak
and shallow or arrested, artificial respiration should be
continued until adequate natural breathing or the true signs
of biological death appear. Rubbing should be carried out
and hot-water bottles applied to the legs. A brief whiff of
ammonium hydroxide is beneficial. A patient with severe carbon
monoxide poisoning must be immediately hospitalized in order
to prevent possible grave complications in the lungs and nervous
system which may develop later.
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| (3)
Poisoning with Toxic Chemicals |
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The latent course
of the disease is 15-60 minutes, after which the symptoms
of the affection of the nervous appears (e.g., enhanced salvation,
discharge of sputum, and perspiration). Breathing accelerates
and becomes noisy, with rales beard at a distance. The patient
becomes restless and excited. Cramp appears in the legs and
the intestine undergoes increased peristalsis which is followed
by muscular paralysis and paralysis of the respiratory muscular.
The respiratory arrest that follows, causes asphyxia and death.
In accidents connected with
the inhalation of the toxic chemicals the victim must be immediately
hospitalized. If possible, he should be given 6-8 drops of
a 0.1 per cent atropine solution or 1-2 tables of belladonna.
When respiration is arrested, artificial respiration should
be carried out. When the poisoning is caused by toxins getting
into the gastro - intestinal tract, the stomach should be
washed with water mixed with suspension of activated carbon.
Saline purgatives should also be prescribed. The toxic substances
should be removed form the skin and mucous membranes with
running water.
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| (4)
Poisoning with Acids and Alkalis |
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In poisoning with
concentrated acids and alkalis, a grave condition rapidly
develops due, in the first place, to extensive burns in the
mouth, throat, oesophagus, stomach, and often the larynx.
Later, the absorbed toxins affect the vital oranges (e.g.
liver, kidneys, lungs, or heart). Concentrated acids and alkalis
are able to destroy tissues. The mucous membranes, being less
resistant than the skin, are destroyed and necrosis occurs
more rapidly involving deeper layers.
Burns and scabs from on the
mucous membrane of the mouth and lips. When a burn due to
sulfuric acid the scabs are black, in a burn due to nitric
acid they are grayish-white
Alkalis more easily penetrate the skin and affect deeper layers.
The burnt surface is loose, decomposed, and whitish in colour.
As soon as an acid or alkali
is swallowed the patient feels strong pain in the mouth, behind
the breastbone and in the epigastrium. When laid be tosses
in bed from unbearable pain. There is almost always tormenting
vomiting often with admixtures of blood. Pain shock rapidly
develops. The larynx may swell and asphyxia develops. When
an acid or alkali is taken in great amount cardiac weakness
and collapse rapidly develops. The larynx may swell and asphyxia
develops. When an acid or alkali is taken in great amount
cardiac weakness and collapse rapidly develop.
Poisoning with ammonium hydroxide
takes a grave course. The pain syndrome is attended is attended
by asphyxia because the airways are also affected.
The person who is rendering first aid must
fond lout at once which chemical caused the poisoning because
the treatment varies according to the type of poison.
If the poisoning was caused
by concentrated acids and the symptoms of esophageal or gastric
perforation are absent the stomach should be lavaged through
a thick stomach tube using for it 6-10 liters of warm water
mixed with magnesium oxide (20 g per lifter of liquid), or
lime water. Sodium carbonate is contraindicated for a gastric
lavage. "Minor lavage", i.e. drinking 4-5 glasses
of water and then inducing vomiting, will not alleviate the
patient's condition and sometimes may even promote absorption
of the poison.
If a stomach tube is unavailable,
the patient may be given milk. Oil, egg white, mucilaginous
decoctions, or soothing substances. In poisoning with carbolic
acid (phenol, Lysol) milk, oil or fat should not be taken.
Magnesium oxide mixed with water or limewater should be given
in this case, as in poisoning by all other acids. Cold compresses
or ice should be put on epigastric region to lessen pain.
When the poisoning is sue
to concentrated alkalis, the stomach should be immediately
lavaged with 6-10 lifters of tepid water or a 1 per cent citric
or acid solution within four hours of the poisoning. When
a stomach tube is enviable and the patient's grave conditions
(swelling of the larynx) prevent a stomach lavage, mucilaginous
solutions are given, 2-3 per cent citric or acetic acid solution
(1 tablespoonful every 5 minutes), or lemon juice. Rinsing
of the mouth or administration of sodium hydrochloride solution
is contraindicated.
The patient should be immediately
admitted to a medical institution where he will be given the
necessary urgent medical help.
It should be kept in mind
that when a perforation of the esophagus or stomach is suspected,
they being manifested by severe pin in the stomach and unbearable
pain behind the breast bone, drinking and moreover, lavage
of the stomach are not permitted.
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| (5)
Alcohol Poisoning: |
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Alcohol taken in
considerable (toxic) quantities may cause fatal poisoning.
A fatal dose of ethyl alcohol is 8 g per 1 kg body weight.
Alcohol affects the heart, blood vessels, gastro- intestinal
tract, liver, kidneys, and mainly the brain. In a case of
severe intoxication, sleep is followed by unconscious state.
Vomiting and involuntary urination are frequent symptoms.
The respiratory center is drastically inhibited, which is
manifested by irregular breathing. Death ensures when the
respiratory center becomes paralysed.
First aid. Fresh air should
be provided (a window open or the victim taken outside), vomiting
induced by "minor lavageas" If the patient is still
conscious, he should be given hot strong coffee. A respiratory
arrest is managed by artificial respiration
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