Bismuth poisoning
Introduction
Introduction to cockroach poisoning Bismuthpoisoning is mostly caused by the application of large amounts of bismuth nitrate in the treatment of diarrhea. The sick child may have nausea, vomiting, salivation, pain in the tongue and throat, abdominal pain, diarrhea, black stool, blood, skin, mucous membrane bleeding, headache, convulsions, etc. Sputum poisoning is often caused by excessive use of bismuth nitrite in the treatment of diarrhea, and is more common in children. After poisoning, it should induce vomiting, gastric lavage, catharsis with salt laxatives, oral administration of milk or egg white, and treatment with sodium dimercaptopropane sulfonate. basic knowledge The proportion of illness: 0.001% - 0.003% Susceptible people: no specific people Mode of infection: non-infectious Complications: constipation, diarrhea
Cause
Cause of poisoning
The lethal dose of oral bismuth subnitrate in children is about 3 to 5 g. Excessive intravenous or intramuscular soluble strontium salts can cause acute poisoning. Insoluble strontium salts (such as barium hypocarbonate) are often used as internal or external preparations for the treatment of gastrointestinal diseases. Although they are rarely absorbed, they can cause sputum poisoning if used in large quantities or in long-term applications. Lactating women repeatedly apply cod liver oil sputum due to rupture of the nipple, and infants may cause poisoning due to intrusion.
Prevention
poisoning prevention
Strictly observe the use method and dosage of tinctures. When the above performance occurs, the drug should be stopped immediately. Oral overdose should be gastric lavage as soon as possible, and metal antidote such as dimercaptopropanol or dimercaptosulfonate should be applied and symptomatic treatment should be given.
Complication
Sputum poisoning complications Complications constipation diarrhea
When oral sputum preparations are used to treat gastrointestinal diseases, constipation can be caused and feces can be gray or black. Intramuscular injection of sputum can cause acute poisoning or renal failure, and it is often reversible. Chronic poisoning can cause stomatitis, and the gums have blue lines. Rash, fear of eating, weight loss, diarrhea and jaundice, topical sputum can cause skin ulcers in children, while perivascular poisoning can be seen on the bones, in children can interfere with membranous cartilage ossification, while in adults Accompanied by unilateral or bilateral sacral skull arthropathy.
Symptom
Symptoms of poisoning of cockroaches Common symptoms Polyneuritis is allergic to sputum salt. There are blue lines, black stools, abdominal pain, dyspnea, diarrhea, nausea, gingival swelling.
Acute poisoning is mainly due to oral entry. The sick child may have nausea, vomiting, salivation, tongue and throat pain, abdominal pain, diarrhea, black stool, blood, skin, mucous membrane bleeding, headache, sputum, etc. Kidney damage can cause liver enlargement, jaundice, protein and cast in urine, and even acute liver and kidney failure. Applying a large amount of bismuth nitrite, symptoms of nitrite poisoning, such as dizziness and redness. , pulse rate, chest pressure, dyspnea, and purpura caused by methemoglobinemia; severe disease due to heart, vasospasm, blood pressure can be reduced, shock and so on.
Examine
poisoning check
1. Blood measurement: Simple measurement method can be used, such as (1) addition and subtraction method: take 1-2 drops of blood of the patient, dilute with 3-4 ml of distilled water, add 1-2 drops of 10% sodium hydroxide solution, mix, When the amount of COH in the blood increases, the blood remains reddish after the addition of alkali, and the normal blood is green. This test is positive at a concentration of up to 50%. (2) Spectroscopic examination: a few drops of blood were taken, 10 ml of distilled water was added, and a special absorption band was observed by a spectroscope.
2, EEG examination: visible diffuse low amplitude slow wave, parallel with the progression of hypoxic encephalopathy.
3, head CT examination: poisoning can be seen in the brain has a pathological density reduction area.
Diagnosis
Diagnosis and identification of sputum poisoning
According to the history of exposure to higher inhalation, the symptoms and signs of acute central nervous system damage, combined with the results of timely measurement of blood COH, according to the Chinese diagnostic criteria (GB8781-88), can be diagnosed as sputum poisoning, occupational sputum poisoning is mostly Accidents, contact history is relatively clear, suspected of living poisoning, should ask about the environmental conditions at the time of the disease, such as the fire chimney with or without ventilation or leakage and other people in the same room have the same symptoms.
