Bromine poisoning
Introduction
Introduction to bromine poisoning Bromide such as sodium bromide, potassium bromide, ammonium bromide, tribromide or tribromide tablets and bromocaffeine mixture are commonly used drugs for medical treatment, and bromidepoiso-ning is caused by overdose. Due to its slow excretion, accumulation of poisoning may occur in long-term application in the treatment of diseases, and bromide is easy to pass through the placenta. If a large amount of pregnant women take it, it may cause fetal or neonatal poisoning. Sodium bromide, potassium bromide and ammonium bromide are all white crystalline powders. They are salty and have been reported as a cause of multi-person poisoning caused by salt cooking. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious complication:
Cause
Cause of bromine poisoning
Cause
Poisoning is caused by misuse and ingestion.
Pathophysiology
Bromine is a substance that is highly irritating and corrosive to mucous membranes. The degree of tissue damage is generally greater than that of chlorine. Inhalation of low concentrations of bromine can cause cough, chest tightness, increased mucosal secretions, headache, dizziness, general malaise, etc. Some people can cause gastrointestinal symptoms; after inhalation, the nasopharynx and oral mucosa can be stained There is a special smell in the mouth, there are tears, fear of light, cough, hoarseness, glottic edema and even suffocation; some patients may develop allergic dermatitis, exposure to high concentrations of bromine can cause severe skin burns. Long-term inhalation of bromine may have accumulation, in addition to the symptoms of mucous membrane irritation, accompanied by neurasthenia syndrome.
Prevention
Bromine poisoning prevention
Strengthen management, do a good job in health education, and strictly prohibit eating and mistaking.
Complication
Complications of bromine poisoning Complication
It also has toxic effects on the central nervous system and can also cause kidney and liver damage.
Symptom
Symptoms of bromine poisoning Common symptoms Abdominal pain, bromine and salty diarrhea, fatigue, stun, vertigo, joint pain, nausea, constipation
Mainly the symptoms of central nervous system depression, but can occur after the inhibition of excitement, oral administration of large amounts of bromide caused by acute poisoning children with bromine and salty taste, nausea, vomiting, abdominal pain, constipation or diarrhea, bloody restlessness, fatigue Insomnia or lethargy, headache, dizziness, disturbance of consciousness, loss of orientation, etc., followed by emotional abnormalities, agitation, severe mania, delirium, hallucinations, coma, or toxic psychosis; Joint pain, tremor, ataxia, speech vagueness, visual disturbance, drooping eyelids, nystagmus, dilated pupils, enlarged or unequal, slow light reflex, decreased body temperature and blood pressure, superficial breathing, arrhythmia, stupor, etc. Accumulated chronic poisoning In addition to gastrointestinal symptoms and depression, hallucinations, memory loss, feeling slow, finger tremors, gait sputum, etc., acne-like rash can still occur, mothers take bromine before delivery, their newborn There may be bronchial rash.
Examine
Bromine poisoning check
1. The history of toxic exposure is poisonous to life. If you suspect the possibility of taking poison, you should understand the patient's living conditions, mental state, the type of drugs you take regularly, whether there are medicine bottles, medicine bags, and whether there are any shortage of drugs in your home. Estimate the time and dose of medication. For carbon monoxide poisoning, you should know about the indoor fire, the chimney, and other people at the time. Sometimes it is necessary to get to know the patient's colleagues, family members, relatives or witnesses on the spot. If food poisoning is suspected, the same symptoms should be investigated in the same meal. Water pollution and pollution of things can cause regional epidemics. Conduct an epidemiological investigation if necessary. For occupational poisoning, the occupational history should be asked, including the type of work, the length of service, the type and time of exposure to poison, environmental conditions, protective measures, and whether there have been accidents at work. In short, for any poisoning, you should know the scene of the disease and find evidence of exposure to the poison.
2, clinical manifestations for patients with sudden appearance of purpura, vomiting, coma, convulsions, difficulty breathing, shock and unknown reasons, should consider the possibility of acute poisoning. Patients with unexplained anemia, leukopenia, thrombocytopenia, peripheral neuropathy, and liver disease should also consider the possibility of poisoning.
If patients with acute poisoning have a positive history of toxic exposure, they should analyze the characteristics of the symptoms, and whether the time and sequence of occurrence are consistent with the regularity of the performance of a certain poisonous bed. To further further the key and necessary physical examination according to the main symptoms, pay attention to the level of consciousness, breathing, pulse, blood pressure, and give emergency treatment. In the case of the condition, a systematic and detailed supplementary examination will be carried out. For example, when considering organophosphorus pesticide poisoning, pay attention to whether there is garlic smell, whether there is dilated pupil, muscle fibrillation, increased bronchial secretion and pulmonary edema. After a differential diagnosis of the possibility of expelling other diseases, a diagnosis of acute poisoning is obtained.
3. When laboratory tests for acute poisoning, routinely remove the remaining poisons or specimens that may be toxic, such as vomit, stomach contents, urine, feces, blood specimens, etc. Perform toxicological analysis or bacterial culture if necessary. Although the toxicant analysis is important, it cannot wait until the test results are reported before starting treatment. For chronic poisoning, checking for the presence of poisons in the environment and in the human body can help to determine the diagnosis.
Diagnosis
Diagnosis and identification of bromine poisoning
It can be diagnosed based on medical history, clinical symptoms and laboratory tests.
It should be differentiated from other acute poisoning caused by irritating and neurotoxic gases, such as acute carbon monoxide poisoning, acute hydrogen sulfide poisoning, acute phosphine poisoning, acute methyl chloride poisoning, acute methyl iodide poisoning.
Bromide poisoning is mainly manifested in mental disorders, and about two-thirds of cases are paralyzed. Therefore, it is necessary to distinguish the state of paralysis caused by various reasons, according to whether the patient has taken a large dose of bromide, and Acute urgency, serum bromine content is generally above 150mg%, cerebrospinal fluid content is above 75-250mg%, urine bromine test positive and so on can be identified.
