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Crisis Groups For Disaster Management
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ANTIDOTES
Sr.No.
Chemical
Antidotes
1 Acid & Sulphur oxides
If eyes are affected wash with water, sodium carbonate (4% solution). Do not give chemical antidotes if possible as the process creates heat and injury.Use milk, lemon water or milk of magnesia.
2 Acitonitrile
Acrylonitrile
Lactonitrile
Cyanogens
Chloride or Bromide
Treatment of cobalt E.S.T.A very carefully if it doesn’t work, give nitrite/ thio sulphate treatment.
3 Alkalis
Phosphates
And Ammonia
Give milk or water and make him to vomit. For hypocalcaemia effect of phosphate, Give 5 ml of gloucanate 10% solution through vein. Predrisolone can be given orally or through vein. If eyes or skin is affected, wash with water for 15 minutes.
4 Ammonia
If contacted with skin, wash with water and then wash with soft lactic acid and soframycin ointment. If it has entered in to eyes, wash them with water for 15 minutes in shower and then apply benoxinate (Novasine) 0.4% solution. Boric Acid or lactic acid drops also can be applied. If it has entered into throat, smel cotton dipped in ethanol or ether. Gire oxygen if there is any trouble in breathing.
5 Aniline Toluidine nitrobenzene
Methylene blue (1 % solution) Ascorabic acid (5%). Take oxygen if breathing trouble.
6 Anticoagulants (heparin) etc
Protomin sulphate (1 % solution), vitamin-K (1 % solution)
7 Antimony and stibyn
Dimercaprol (Bal)
8 Arsine (hydrogen arsenide)
Meracaptive (40%), Dimercaptol, penicillaminex
9 Atrophine Pillocarpine (1% solution)
proserine (0.05% solution)
10 Barium & its salt
Magnesium sulphate (30 gm in 250 ml/water), Morphine (5 to 10 mg)
11 Barbiturates
Bemegride (0.5 % solution)
12 Benzene, Xylene, Toluene
Wash with plenty of water if skin is affected. Fresh air or oxygen, diazepam (0.1 % m.g/k.g.), slowly through vein,bed rest. Do not give epinephrine, ephedrine, alcohol,oil, milk.
13 Beryllium
Calcium edentate
14 Bleaching solution
Milk, melted ice cream, egg, milk of magnesia, aluminium hydroxide gel. Do not give acid anti-dotes.
15 Bromides
Wash with water if skin is affected. Give salt 1 gm in water orally every hour. If not possible, give saline through vein. Give milk or water freely.
16 Boric acid, Boron derivatives
Epicac solution and activated charcoal, if vomiting, 5% dextrose through vein
17 Cadmium
Calcium disodium edtate i.m (through muscle) or i.v. (through vein)
18 Carbon monoxide
Give 100 % oxygen through mask. 20% manitol i.v.,prednisolol (1 m.g./k.g.i.v.)
     
Courtesy By: Dr.K. U. Mistry & Dr. A. K. Patel
 
POISONING, FIRST AID AND ANTIDOTES

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.

Poisoning by Swallowing:

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).

 
Poisoning by Gases:

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.

Poisoning by Injection:

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.

FURTHER INFORMATION ON POISONING AND SPILLAGE CONTROL
General First Aid in Poisoning:
Carbon Monoxide Poisoning:
Poisoning with Toxic Chemicals:
Poisoning with Acids and Alkalis:
Alcohol Poisoning:
Common Poisons and Their First Aid
Specific (Antidote) Treatment of Acute Poisoning
Antidots and emergency Treatment-Table
 



General First Aid in Poisoning:
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.
Preserve packets or bottles which you suspect contained the position and also any vomits, sputum etc., for the doctor to deal with.
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.
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.

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.
Soothing drinks should be given. Milk, egg beaten and mixed with water or sojee congee are good for the purpose.

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Carbon Monoxide Poisoning

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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Poisoning with Toxic Chemicals

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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Poisoning with Acids and Alkalis

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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Alcohol Poisoning:

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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