Phosphorus poisoning
Introduction
Introduction to phosphorus poisoning Poisoning caused by exposure to phosphorus. There are acute and chronic points. Phosphorus has four allotropes of yellow phosphorus, red phosphorus, purple phosphorus and black phosphorus. Yellow phosphorus, also known as white phosphorus, is the most toxic. A human absorption of 1 mg/kg can kill. Occupational acute poisoning is more common in production accidents. The skin is burned by molten phosphorus and absorbed into the body to cause poisoning. In daily life, poisoning may occur due to misuse of yellow phosphorus. basic knowledge The proportion of illness: 0.002%-0.005% (in patients with organic phosphorus pesticides, the incidence rate is 100%) Susceptible people: no specific population Mode of infection: non-infectious Complications: peripheral neuritis pulmonary edema
Cause
Cause of phosphorus poisoning
The toxicity of yellow phosphorus is very high. The minimum lethal dose for adults is about 60-100 mg, and the lethal dose of zinc phosphide is about 40 mg/kg. When yellow phosphorus enters the human body, its toxicological effect is to destroy the function of the enzyme in the cell, mainly causing damage to the liver, heart, kidney and other parenchymal organs, causing steatosis such as the above organs and striated muscles, peripheral circulatory failure, bone decalcification and Bleeding, etc. In addition, yellow phosphorus can cause strong burns and corrosion on the skin and mucous membranes, and can absorb poisoning through the wound surface. Phosphate enters the body and reacts with gastric acid to produce phosphine and zinc chloride, which have stimulating and corrosive effects on the gastrointestinal mucosa, causing inflammation, congestion, ulceration and hemorrhage, etc., and the phosphine produced by it In the cellular enzymes, affecting cell metabolism, causing internal suffocation, so that the central nervous system, respiratory, cardiovascular system and liver and kidney function are affected, and the central nervous system is the earliest and most severely affected.
Prevention
Phosphorus poisoning prevention
The key to prevent poisoning is to use yellow phosphorus as raw material instead of red phosphorus or other chemical substances; pay attention to safe production, strengthen the maintenance of protective equipment and drug storage; do personal protection; pay attention to personal hygiene, the best after exposure to phosphorus Rinse with 5% sodium bicarbonate solution; smoke and eat without contaminated hands; personnel engaged in phosphorus production should have regular physical examination, including liver function and X-ray examination of the jaw. Those who suffer from serious oral diseases, liver and kidney diseases, blood diseases and endocrine diseases should not engage in phosphorus operations.
Complication
Phosphotoxicosis complications Complications peripheral neuritis pulmonary edema
The sequelae cause peripheral neuritis. If a large amount of yellow phosphorus fumes or phosphine is inhaled, the patient may have difficulty breathing within ten minutes, and subsequent symptoms such as pulmonary edema may die in a short period of time.
Symptom
Symptoms of phosphorus poisoning Common symptoms Distinct coma, dyspnea, dizziness, dizziness, gastrointestinal symptoms, nausea, central nervous system inhibitors... diarrhea blood pressure drop
Within half an hour to several hours after eating a match with yellow phosphorus or other phosphorus-containing preparations, there is burning pain in the mouth, esophagus and stomach of the patient, and nausea, vomiting, abdominal pain, diarrhea, vomit and feces are smelly of garlic. Flavor, fluorescent in the dark, mild recovery can be gradually recovered within 1 week, vomit and fecal blood in severe patients, even a large amount of hematemesis, can occur in 1 to 2 days of coma, shock, leading to death, if the amount of misuse When it is very large, it can cause rapid shock without obvious vomiting, abdominal pain and diarrhea. Some patients may have symptoms of absorption poisoning after the symptoms of 1-3 days have improved, and then vomiting, diarrhea, abdominal pain, vomiting, and diarrhea may be bloody. Liver enlargement, jaundice, epistaxis and subcutaneous hemorrhage, severe breathing difficulties, paralysis, liver, kidney failure, paralysis, blood pressure drop, coma, etc., can die within 1 to 3 weeks, a few patients with esophagus or gastrointestinal Perforation due to corrosion.
Ingestion of phosphide (such as zinc phosphide), in addition to gastrointestinal symptoms, pulmonary edema, jaundice, etc., and neurological symptoms such as dizziness, numbness, convulsions, confusion, coma and circulation Systemic symptoms such as palpitations, decreased blood pressure, slow heart rhythm and myocardial damage.
If a large amount of yellow phosphorus fumes or phosphine is inhaled, the patient may have difficulty breathing within ten minutes, and subsequent symptoms such as pulmonary edema may die in a short period of time.
Examine
Phosphorus poisoning check
Phosphorus can be detected in vomit and feces, and phosphorescence can be detected at night or in the dark. Blood tests can have white blood cells and thrombocytopenia, blood sugar lowers, cholesterol, bilirubin, phosphorus, calcium, etc., prothrombin is reduced, and Prolonged clotting time, less urine, protein, red blood cells and casts.
Diagnosis
Diagnosis and identification of phosphorus poisoning
Identification with acute organophosphate poisoning
Acute organophosphorus poisoning mainly inhibits the activity of cholinesterase and causes the accumulation of acetylcholine to cause accumulation of cholinergic nerves, followed by inhibition and failure. If the rescue is not timely, respiratory failure may occur in a short time. death.
(A) mild: dizziness, headache, nausea and vomiting, excessive sweating, blurred vision, dilated pupils, whole blood cholinesterase activity is generally 70-50%.
(B) Moderate: In addition to the above symptoms, there are fasciculation, runny, sweating, mild dyspnea, abdominal pain, diarrhea, confusion or confusion, and the whole blood cholinesterase activity is generally 50-30%.
(C) Severe: In addition to the above symptoms, the pupil is small as a needle tip, difficulty breathing, cyanosis, pulmonary edema, convulsions, incontinence, coma and respiratory paralysis, and the whole blood cholinesterase activity is generally below 30%.
