Arsenic poisoning in humans: signs, consequences, first aid

Arsenic is one of the elements of the periodic table, which has the serial number 33 and in Latin denoted as As (arsenicum). The substance is an unstable semimetal and has a color reminiscent of steel with a greenish tinge. In nature, it can exist both in a free form and in a multitude of compounds, presenting a certain danger to living beings, since it is poisonous. Arsenic can be found in many minerals, in particular lead, copper, cobalt, zinc, silver and tin ores, where it easily passes into soil or water, so arsenic poisoning can be obtained even accidentally, for example, by drinking from a metal vessel containing particles poisonous substance. By the way, such cases were reflected in the annals of the Chinese people.

A bit of history

Arsenic is considered one of the poisons, the mention of which has the oldest roots. Who first identified this chemical element from natural compounds is for certain unknown. Some historians attribute the primacy to the German scientist and alchemist Albert the Great (XIII century), but there is no strong documentary evidence for this. But in the works of the Swiss physician and alchemist Paracelsus (XVI century), you can find a detailed description of obtaining free arsenic in reaction with the egg shell.

In fact, obtaining arsenic in its free form did not present any special difficulties. For example, arsenic sulfide, which is a part of mineral ores, is similar in appearance and mercury to minerals, A extraction of mercury from these materials was considered very easy. This was used not only by the European alchemists (the Renaissance in Italy, Spain, England, France was marked by a huge number of deaths due to deliberate poisoning with arsenic, the culprits of which became even the most highly placed persons of these fairly developed states), but also the Russian healers who in those times were in Russia was more than enough.

Arsenic poisoning in the Middle Ages in Russia was considered one of the most popular ways to solve political issues, crack down on unwanted and rivals. For example, the same Ivan the Terrible used the services of an astrologer and pseudo-healer from Westphalia Elisha Bomelia, as a result of which all the courtiers who somehow did not please the ruler and even the tsar himself were poisoned with mercury, arsenic, lead. These metals in small quantities do not act immediately, forcing the victim to suffer. This gave Ivan the Terrible considerable pleasure. However, later it turned out that the king himself was receiving "treatment" with the same drugs from a light hand Bomelia.

In the XVII-XVIII centuries, a wave of poisoning swept Italy. The culprit of most of them is Theophany di Adamo, who personally produced poisonous water, which had no taste differences from plain water and a certain smell. This water was so called "aqua Tofana", and it contained arsenic and belladonna extract. Poisonous water killed its victims slowly, causing symptoms similar to various serious illnesses (for example, with typhoid fever). It is clear that the medicine at that time was still at a low level, so it was virtually impossible to diagnose the poisoning or the disease, which allowed the criminal to act for a long time with impunity, bringing to the grave more than 600 people.

Arsenic poisoning in our days is not so frequent, people have become more civilized and the times when with the help of this chemical element the important state (and not only!) Questions have sunk into oblivion. The reasons causing such a serious poisoning, threatening a terrible death to a man, have also changed.

[1], [2]

Causes of the arsenic poisoning

As already mentioned, arsenic poisoning can be obtained without even knowing it, because arsenic can be found in different environments: in soil, water, air. In nature, it exists in two forms: in the form of inorganic compounds with oxygen (oxides), chlorine (chlorides) and sulfur (sulphides) or in the form of an organic compound with hydrogen or carbon. The most dangerous are inorganic forms of arsenic, although inhalation of its organic forms can also cause significant damage to the body.

The danger of this fragile semimetal is that people widely use it in various areas of their lives: in agronomy, in industry, in dentistry, in the pharmaceutical industry, in the control of rodents.

The very Russian name of a poisonous substance has simple ancient roots, because it has been used for more than one century for baiting mice, rats and other rodents that damage the economy. As we can see, in the Middle Ages, not only many people fell from arsenic, but also hordes of rodents who settled on granaries and storerooms. This use of arsenic is known in our time, which carries a certain risk for both animals and humans.

The mouse poison itself in appearance and because of the absence of a specific odor is indistinguishable from flour, so its storage and use should be very cautious.

In agronomy, arsenic is considered a fairly strong pesticide, which helps in the fight against plant pests. However, the plants themselves and their fruits can also absorb particles of this poison with water and nutrients from the soil, which then enter our body. Relations with this use of arsenic in agronomy in the cultivation of fruit plants and root crops had to be limited.

But in industry, arsenic is used quite widely and without special restrictions. Compounds As with silicon are used in the manufacture of semiconductor elements, actively used in electronics.

Metallurgy has found use of arsenic, adding it to various non-ferrous metals (most often copper and lead), which makes them more durable. By the way, the combination of arsenic-lead is found in the shot for hunting rifles, which is designed not only to injure, but also to kill. The fame of arsenic with metals is popular in the manufacture of bearings. Addition of arsenic makes such compounds more susceptible to high temperatures and corrosion, makes it more durable and durable.

The chemical combination of arsenic with oxygen (arsenic oxide) is used in the production of glass, for impregnating wood products, which makes them more resistant to the aggressive effects of various environmental factors (soaking and corrosion in liquid, damage to insects, etc.), as antiseptic solution when making animal skins.

But as we already know, arsenic compounds are considered quite unstable, which means that both during the manufacturing process and when using products containing particles of this poisonous substance, arsenic can penetrate into air and water, which subsequently reach a person who is in close contact with this product.

Previously, arsenic was actively added to some decorative building materials (wallpaper paints, plasters, etc.). With high humidity, arsenic formed organic volatile compounds, which in large quantities can also cause poisoning when inhaled with air.

Arsenic is also widely used in medicine. Despite the fact that this microelement is poisonous, in some cases it can not kill, but on the contrary save a person's life. So, it is known widespread use of arsenic in the composition of inorganic compounds in the treatment of leukemia, because this substance is able to suppress the pathological synthesis of leukocytes, and also to stimulate the production of red blood cells. Similar drugs are used in the treatment of anemia.

Inorganic preparations based on arsenic find their application in the treatment of chronic skin diseases (pink lichen, psoriasis, etc.). They are also used in exhaustion, neuroses, neurasthenia.

Organic compounds of arsenic are found in preparations that are used to treat pathologies caused by protozoan parasites ("Aminarson", "Novarsenol", etc.).

Despite the fact that arsenic in limited quantities is contained in the human body and performs many useful functions (stimulates metabolism and the production of red blood cells, promotes the absorption of nitrogen and phosphorus, inhibits oxidative processes, etc.), an increase in its content in blood and tissues can lead to the appearance of toxic phenomena. Therefore, the use of drugs containing arsenic compounds should be strictly controlled by the doctor, and dosages should be minimally effective.

It's no secret to anyone that arsenic is still used in dentistry. In this regard, many are concerned about the question, is it possible to poison arsenic in the treatment of teeth?

Yes, the drug called "Arsenic anhydride" was previously actively used as a temporary filling for necrosis of the dental nerve. However, now such treatment is less and less, despite the fact that the dose of arsenic in the seal is unlikely to cause poisoning, except that one after another several teeth. It turns out that theoretically this is quite possible, but in practice, if all the precautions and time limits are met, there were practically no such cases.

First, arsenic is placed in the tooth by the lower layer and covered with a seal that prevents its entry into the digestive tract. Secondly, the seal is placed for a limited time, during which no intoxication occurs. It's another matter if you do not come to the dentist on time to remove the "poisonous" seal. In this case, it is possible to observe local symptoms, such as inflammation of the gums near the tooth, destruction of the bone beneath it, which in the future can lead to the loss of one or more teeth. To slight intoxication will indicate metallic taste in the mouth.

In principle, if there are some concerns, you can require the doctor to use other materials to treat the tooth or just change the dental clinic, which adheres to conservative obsolete methods and means.

As we see, arsenic compounds are quite actively exploited by mankind. It turns out that arsenic, despite its toxic properties, people use to harm themselves? This is not quite true. In fact, arsenic poisoning in most cases occurs either through carelessness or due to non-compliance with safety standards. We should not exclude episodes when a person voluntarily harms his health, wishing to end his life. True, arsenic poisoning is by no means the most attractive method of suicide.

So, you can poison yourself with arsenic, using water and food containing this chemical element (and no matter how it got there), inhaling the poisoned air in which arsenic particles are present, accidentally swallowing the mouse poison, taking it for flour, or when trying to commit suicide.

[3]

Risk factors

The risk factors for arsenic poisoning can be considered:

• living in a region where arsenic levels are high in soil, water or air,
• work in the mines, where as a part of the minerals discovered and As,
• participation in the processing of wood by arsenic compounds,
• work at the processing enterprises of non-ferrous metallurgy,
• work on the production of glass, where arsenic trioxide is used as a clarifier,
• the manufacture of semiconductor products in the electronics industry,
• The use of arsenic in the fight against rodents,
• work with pesticides containing arsenicum,
• dressing of skins using arsenic,
• severe depression, thoughts of suicide.

Let's say at once that in industries where arsenic is used, all measures must be taken to ensure the safety of workers. Another thing is if the safety requirements were ignored by the management of the enterprise or by the workers themselves.

[4], [5], [6], [7], [8], [9], [10]

Pathogenesis

In order for arsenic poisoning to occur, it is necessary that the poison enters the human body. There, it reacts with the so-called thiol groups in the molecules of enzyme cells, which are responsible for their functional properties. As a result of this reaction, cyclic compounds are formed, which have toxic properties and disable thiol enzymes. Deficiency of such enzymes in turn entails a violation of many vital functions.

The mechanism of action of most arsenic compounds is similar. A slightly different nature of the effect in arsenic hydrogen, which can be poisoned by inhaling it from the air in the production. This arsenic compound belongs to hemolytic poisons, since it participates in the destruction of erythrocytes, as a result of which oxygen starvation and disturbance of various oxidative processes occurring with the participation of oxygen develop in the body.

When poisoning with arsenic hydrogen, local damage to the mucous respiratory system does not occur, but the kidneys, whose tubules are blocked by the decomposition products of red blood cells, suffer very badly.

The danger of this compound is that it is a by-product of many industrial and domestic (for example, hydrogen filling of balloons and balloons) processes.

The remaining arsenic compounds provoke a violation of the patency of the vessels of various organs, causing their paresis or paralysis. This leads to a sharp drop in blood pressure (collapse), which predetermines the further symptoms of poisoning.

Most often, arsenic poisoning occurs when particles of matter enter the esophagus or respiratory organs, less often penetration of the poison into the body is noted through the skin. According to statistics, the specific gravity of arsenic poisoning is relatively small, especially if we compare the number of deaths from this poison to the present day and in the Middle Ages. Among the victims are mostly employees of companies that use arsenic, and suicides who have decided on this unsightly way to part with life. Rarely arsenic poisoning occurs as a result of accidents. However, among other poisons arsenic is distinguished by a high rate of deaths (about 30%).

[11], [12], [13]

Symptoms of the arsenic poisoning

In principle, the clinical picture of arsenic poisoning in many ways depends on how the poison has got into the body. The peroral path implies, first of all, damage to the stomach and intestinal mucosa, since arsenic has an irritating and cauterizing effect on delicate tissues. When inhaled particles of arsenic (with the exception of arsenic hydrogen), the first signs of poisoning indicate damage to the mucosa of the respiratory tract and eyes: tears flow, sneezing, coughing with mucus separation, and tenderness in the chest.

It is  possible to wait for the first signs of  acute arsenic poisoning within half an hour after the poison has entered the body (depending on the form of arsenic, the initial symptoms may appear a little later, in 2-6 hours). However, if you consume a dose of a poisonous substance on an empty stomach, the symptoms will occur much earlier and with a high probability will lead to a fatal outcome. A similar situation is observed if a person inhales arsenic pairs with a large concentration of poisonous substance.

Using arsenic along with food, a person does not prevent poisoning of the body, but only delays the appearance of symptoms of intoxication.

What kind of symptoms are we talking about? We list all possible manifestations of toxic effects on the body of arsenic and its compounds:

• the sudden appearance in the mouth of a metallic taste and the smell of garlic,
• The sensation, as if the throat is scratched with something sharp,
• attacks of nausea and often recurring exhausting vomiting (especially with oral administration) that lead to severe thirst, hoarseness of voice and a decrease in skin turgor due to dehydration of the body,
• a strong diarrhea resembling cholera, while the stool begins to resemble rice flakes (a symptom appears several hours later), painful false urges for defecation due to disruption of the digestive system,
• strong compressive pain in the stomach in the form of regular spasms,
• a burning sensation in the esophagus, gastric bleeding due to a burn of the gastrointestinal mucosa,
• headaches and dizziness,
• there is an incomprehensible rhinitis, in case of contact with arsenic, conjunctivitis may develop in the eyes,
• deterioration of the general condition, incomprehensible weakness, lack of exercise, a sense of fear, deafness,
• there is a drop in blood pressure, increased heartbeat, worsening of the nervous conduction of the myocardium, a weakening of the pulse, associated with cardiovascular disorders.
• obscuration of consciousness, hallucinations, delirium, psychomotor agitation due to damage to the nervous system (arises from the ingestion of large doses of arsenic)
• difficulty breathing due to spasm of the larynx, pulmonary edema, development of respiratory failure (disruption of the respiratory system),
• changes in blood composition, a decrease in the number of red blood cells, anemia,
• the development of acute renal failure due to renal tubules, a decrease in the amount of urine and its retention in the body, uric acid poisoning, the appearance of blood particles in the urine,
• increases in size and the liver begins to ache, jaundice develops,
• there is a convulsive syndrome, pain and twitching of the calf muscles,
• loss of consciousness, coma.

When poisoning with organic forms of arsenic, which are used in medications, other symptoms can be added:

• allergic and anaphylactic reactions accompanied by hyperemia of the facial skin, dyspnea, swelling of the larynx and tongue, coughing, frequent but weak pulse, collapse,
• a few hours after stabilization, the symptoms resume and are supplemented by chills, fever, skin rashes, vomiting, seizures, similar to epileptic, loss of consciousness.

The rate of development of acute symptoms depends on the dose of arsenic that has got into the patient's body. The higher the dose, the more severe the disease and less likely to save a person's life. High doses of arsenic cause an almost instantaneous death, small ones cause torment 1-2 days, after which again a possible death is likely.

If a person works in industry and is in constant contact with the poison, he may well develop chronic intoxication. Chronic arsenic poisoning  does not appear immediately. The first symptoms can be expected after 2 weeks of regular contact with the poison, and after 2 months.

The thing is that the dose of arsenic entering the body in this case is very small, besides, it is excreted within the day with urine and feces, without having had time to disrupt the work of organs and systems. But since chronic poisoning arsenic must enter the body regularly, then gradually more and more new violations of the physiological functions of various structures are emerging.

So, the first signs of chronic intoxication are:

• increased fatigue and general weakness of the body, loss of strength,
• intensification of skin pigmentation, skin hyperemia in the eyelids, underarms, temples, neck, testes in men, mammary glands,
• thickening and hardening of the skin (hyperkeratosis),
• the appearance of scaling on the body, the development of dermatitis,
• edematous syndrome, especially the eyelids swell, eyes and eyelids acquire a reddish, inflamed shade,
• redness and dryness of the mucous membranes of the nose and mouth,
• the appearance of small growths (corn, wart) on the palms of the hands and feet,
• formation of white transverse lines on the nail plate,
• alopecia,
• reduction of red blood cells, pallor of the skin, anemia,
• muscle weakness,
• inflammation and bleeding gums,
• deterioration of the teeth, progressive caries.

At the next stage of intoxication (subacute arsenic poisoning), diagnostic studies can show:

• damage to the cerebral cortex (encephalopathy),
• disrupting the work of the nervous system responsible for the lower part of the body (neuropathy of the lower extremities, which manifest themselves in the form of pain and weakness of the legs, paresthesias);
• inflammatory processes in the heart and pericardial bag (myocarditis, pericarditis),
• inflammatory processes in the broncho-pulmonary system (laryngitis, tracheitis, bronchitis).
• an increase in the lumen of small capillaries,
• hearing impairment (neurosensory bilateral deafness),
• development of skin cancer and other oncological pathologies.

The clinical picture of intoxication can vary depending on the dose and type of toxic compound, the time of exposure, the measures taken to remove the poison from the body. However, in any case, even mild poisoning with arsenic is fraught with serious, sometimes irreversible, health problems.

[14], [15], [16], [17],

Complications and consequences

As you can see, the picture is not pleasant. But people with suicidal tendencies have something to think about. With arsenic poisoning, death does not always come instantaneously, a person can be saved by applying effective treatment in time, the emotional state can also be restored, but it's not possible to regain health in all cases.

Whatever the cause of arsenic poisoning, its consequences are failures in the work of many organs and systems. With oral administration, the organs of the digestive tract suffer greatly, with inhalation of arsenic into the body serious pathologies of the respiratory system are observed. But then the arsenic molecules still fall into the blood and are carried throughout the body, causing more and more complications.

Changes in the composition of the blood indicate anemia, which means that the organs and body systems lack oxygen and nutrients. As a result of hypoxia, the heart, the brain, the nervous system primarily suffer, the restoration of which is problematic.

As a result of any intoxication, the liver and kidneys hit hard, and if you consider that arsenic is also excreted by the kidneys, it is not always possible to avoid the development of kidney failure.

Even if, as a result of treatment, the arsenic molecule can be completely deactivated and removed from the body, it will be necessary to treat the consequences of the poison stay in the body for a long time in the future.

But the most dangerous consequence of arsenic poisoning is still the death of the patient, which is considered far from a rare occurrence. Sometimes a person dies, although it could have been saved. The reason for this phenomenon is the untimely rendering of first aid, ignoring the emerging symptoms, and later resorting to a medical institution.

[18], [19], [20],

Diagnostics of the arsenic poisoning

When arsenic poisoning is indicative, it is not so much the external symptoms that the doctor learns from the patient himself or his loved ones, but rather the results of laboratory tests. After all, as we already know, the presence of arsenic in the body can not but affect the composition of blood and urine. It is the tests that make it possible to determine the presence of arsenic compounds in physiological fluids, and also to calculate its concentration. And this moment makes it possible to make certain predictions for the life of the patient and to develop the most effective scheme of his treatment.

The main materials for laboratory studies are blood and urine. Studies of blood and urine with acute arsenic poisoning will show an increased concentration of a poisonous substance, according to which one can judge the severity of the condition of the victim. However, it must be understood that the results of the analyzes may not be exactly accurate if the poison was ingested with food or stored in it because of the already existing chronic kidney failure (in the latter case, organic arsenic compounds).

In critical states, the content of As in a single portion of urine is indicative. High concentrations clearly indicate acute arsenic poisoning, however, low ones do not refute the diagnosis. Arsenic in non-toxic concentrations (less than 20 mg) is present in the body of each person, but its presence in daily urine in a concentration exceeding 50 μg / l, indicates the intoxication of the body with this poison. This is not about a single portion of urine, but about the daily amount of urine, because the rate of excretion of As with urine is not a constant value.

If there is a slight increase in the concentration of arsenic in urine, clarification of the clinical picture of poisoning should be made. The fact is that normal seafood can raise the level of arsenic in the body. Sometimes this figure can be quite large - about 1.7 mg / l. In this case, clarify the nature of the arsenic compound found in urine, or re-assay a few days (usually about a week) after eating sea food.

So far we have spoken about acute arsenic poisoning. And what about the subacute and chronic form? Will blood and urine tests that do not provide reliable information about how much arsenic was originally in the body be relevant?

In fact, an expanded blood test, liver enzyme activity and kidney performance indicators, a general urine analysis and the actual concentration of arsenic in the urine collected during the day are still as relevant as in acute conditions. After all, they allow us to detect not only the presence of poison in the body, but also the pathological processes provoked by it. In blood, a low number of platelets, a change in the structure and activity of red blood cells, a decrease in hemoglobin concentration, etc. Can be detected. In the urine may appear protein, blood, the level of leukocytes will be increased because of purulent-inflammatory processes in the kidneys.

In addition to laboratory information, the doctor can also be provided with instrumental diagnostics. Arsenic as a chemical element belongs to the group of semimetals, and therefore, for X-rays it remains impenetrable. After oral administration of arsenic, its accumulations are clearly visible on the chest radiograph with contrast materials. Alas, this method of investigation is not always indicative, because there are other ways of getting poison into the body, and scattered particles on the x-ray are practically invisible.

By the way, the presence of arsenic in the composition of nails and hair can be detected on the roentgenogram even several months after the poisoning episode.

Diagnosis of arsenic poisoning includes not only measures to detect poison in the body and measure its concentration, but also procedures that allow recording various disturbances in the work of human organs and systems caused by toxic arsenic compounds. Disorders of the heart due to the negative effects of arsenic are clearly visible on the electrocardiogram. Some information can also provide measurements of heart rate and blood pressure. Failures in the work of the nervous system are examined with the help of electroneurography. In case of serious damage to the gastrointestinal mucosa, gastrointestinal and colonoscopy may be necessary. With lesions of the liver and kidneys, in addition to laboratory tests, an ultrasound procedure can be prescribed.

[21], [22], [23], [24], [25]

Differential diagnosis

Since the symptoms of arsenic poisoning are mostly not specific and a similar clinical picture can be observed with other pathologies of health, a major role is assigned to differential diagnosis. If laboratory tests show a high level of arsenic in physiological fluids, a preliminary diagnosis does not require revision. But in the case of low levels of venom against the backdrop of a clear clinical picture, doubts may arise, which only differential diagnostics can dispel, for which repeated analyzes and additional studies may be required.

Treatment of the arsenic poisoning

Treatment measures for arsenic poisoning always begin with gastric lavage (with oral administration of poisonous compounds) and administration of an antidote, a drug that is capable of binding the poison to non-toxic compounds and removing it from the body. 

The benefit of a specific antidote for poisoning exists and is called Unithol.

"Unitol" can be used both for purifying the stomach from poisons (rinsing is done with warm water, into which the antidote is added), and for disinfection of the whole organism. The drug is administered intramuscularly up to 4 times a day in a daily dose of not more than 150 ml, on the second day the frequency of administration does not exceed 3 times a day, then within a week no more than 1-2 times.

The drug should not be taken with severe liver damage and hypertension. The drug is well tolerated by most patients. Only in rare cases can there be an increase in heart rate, nausea, pale skin, dizziness, not requiring withdrawal of the drug.

In hypertension, instead of Unitol, you can enter "tetacin calcium". It is entered in the form of a dropper. Take 20 mg of a 10 percent solution and mix with a solution of NaCl or glucose. Multiplicity of administration - 1 or 2 times a day. The course of treatment is 1 month. Scheme introduction: 3 or 4 days in a row, then break also 3-4 days.

"Thetacin calcium" is not used for kidney diseases and liver disorders. Side effects of the antidote include: disorders of the digestive tract and kidneys, a decrease in the level of hemoglobin.

When poisoning with arsenic as an effective antidote, you can enter an antidote, used for poisoning with salts of heavy metals. First, give the patient a glass of water, after half a glass (100 ml) of antidote. After half an hour you need to rinse your stomach.

Acute arsenic poisoning can be treated with another specific antidote, prepared from 50 ml of ferrous sulfate solution and 150 ml of pure boiled water. The antidote should be given throughout the day many times (6 times per hour), until the vomiting due to intoxication stops.

"2,3-dimercaptopropanol-1" is an antidote for lewisite, a substance used in combat operations and containing arsenic.

In homeopathy, when poisoning with arsenic, antidotes from metals are used under the names Antidotum metallorum. It can be taken as undiluted ¼ - ½ cup in 200 ml (drink the medicine as soon as possible) or mix a glass of antidote and 1.5 cups of water and use a mixture to wash the stomach.

As poisoning with arsenic is accompanied by vomiting and diarrhea, due to which the precious liquid leaves the body, the victim is recommended to drink plenty of water and perform dehydration therapy. In the treatment of dehydration, subcutaneous injection of sodium chloride and glucose, intravenous infusions of sodium chloride and calcium chloride. The oral reception of "Regidron", "Hydrovit", "Trigidron" is indicated when vomiting subsides.

In parallel, symptomatic treatment for pain along the GIT (morphine, promedol, novocaine blockade) is performed.

On the first day of arsenic intoxication, peritonial and hemodialysis procedures are performed that will prevent the development of renal failure or help improve the patient's condition with the presence of acute renal dysfunction.

If the liver is affected, the following will be relevant:

• intravenous glucose injections with insulin,
• Oral administration of tablets "Methionine" (2 tablets 3 times a day, not prescribed for severe liver diseases with impaired functionality),
• internal reception of a solution of "Choline Chloride" 5 ml 3 to 5 times a day for 14-21 days (can cause digestive disorders).

With such symptoms as a violation of blood circulation and respiratory function, conduct blood transfusion procedures, introduce funds for vasoconstriction, resort to artificial respiration. When allergic manifestations show the use of antihistamines.

After cessation of vomiting begin to actively give vitamins orally, before that you can enter them paternally in the form of solutions.

As a physiotherapeutic treatment for the removal of unpleasant symptoms use warm baths, apply warmers, give to drink an oxygen cocktail. Other methods of physiotherapy can be prescribed in connection with metabolic disorders and the functions of different organs (electrotherapy, ultrasound, magnetotherapy, medical baths, etc.) after stabilization of the patient's condition after acute poisoning.

In severe cases, in the absence of breathing and palpitation, active resuscitation measures are carried out.

Alternative treatment

Arsenic poisoning poses a great danger to human life. Without effective medical assistance, the victims in most cases are threatened with rapid or slow death. Alternative treatment can somewhat reduce the toxic effect of poisons on the body, but it can not completely deactivate them. Recipes of alternative medicine can be used as an addition to the main treatment, but not in its place. Therefore, we provide this information purely for informational purposes.

The following recipes and methods are more or less effective in light poisoning, and also as maintenance therapy during the recovery period.

• Sea salt. Washing the stomach with an aqueous solution of sea salt will help not only to effectively purify it of poison particles, but also saturate the body with important trace elements that go away during diarrhea and vomiting (1 tsp to 200 ml of warm water). The same solution can be used to make enemas, clearing the intestines.
• Milk and egg white. A good remedy for poisoning with metal poisons, which can be used to maintain vomiting, even if the poison is not accurately known. To prepare a "medicine" milk is mixed with a whipped egg whites.
• Potato juice. Potato juice is indicated for the weakening of oxidative reactions (acidosis) stimulated by arsenic, and the healing of burns on the gastrointestinal mucosa caused by poison.
• Dill and honey. One of the most ancient means used for various poisonings. Honey is stirred in a glass of water and 1 tablespoon is added. Dry fennel powder or ½ tsp. Crushed seeds of known spices (you can use fresh raw materials in the same amount).

A few words about the treatment of poisoning with herbs. Useful composition, which is used for various intoxications: the extract of the golden root on alcohol (5-10 drops) is added to water. Take the composition 2 to 3 times a day, sweetening with honey.

Of the herbs useful for poisoning, it is possible to isolate licorice root, field horsetail, green fruits and walnut leaves, grass, root and dandelion flowers, elecampane root (especially useful in liver damage). Herbs are used as infusions and decoctions.

[26], [27], [28], [29], [30], [31], [32],

First aid for arsenic poisoning

Regardless of the dose of arsenic compounds found in the body, first aid to the victim in the course of the poisoning is provided according to the standard scheme. And the earlier measures are taken to remove the poison from the body, the better the prognosis for life.

In domestic conditions, arsenic poisoning occurs mainly by the oral route. Do not wait for the appearance of the first symptoms and calculate the dose, if it suddenly became known that a person swallowed arsenic. To determine by eye, this poisoning is easy or heavy, it is impossible for an ignorant person, therefore in any case it is necessary to urgently seek help from specialists. Ideally, you need to call an "ambulance" or quickly deliver the victim to the hospital in another way.

While the "ambulance" is traveling, all measures should be taken to remove the poison from the body. Such measures include:

• stimulation of vomiting by irritation of the root of the tongue (performed in the absence of the urge to vomit), cleansing of the mouth of vomit masses containing particles of arsenic compounds, clean water,
• gastric lavage (use a lot of warm water, in which you can add a little salt),
• for effective gastric lavage and inactivation of arsenic molecules in water it is recommended to add one of the components:
• Unithol solution (20-30 ml of 5% solution per 2 liters of warm water),
• a suspension of magnesium oxide used to reduce the acidity of the gastric juice (40 g per 2 liters of slightly warmed water).
• abundant drink (the procedure helps not only to remove the poison quickly along with the urine, but also struggles with the dehydration of the body caused by vomiting and diarrhea); in no case can not fight with vomiting and diarrhea, it is necessary to promote the natural cleansing of the body by using warm milk,
• reception adsorbents (is not very effective procedure, but for lack of other funds helps to reduce the dose of poison in the body somewhat); you can use the usual "Activated Carbon", the reserves of which are in almost every home medicine cabinet,
• help to accelerate the removal of arsenic from the body and reduce its toxicity, vinegar and citric acid; on a glass of warm water take a spoonful of vinegar or 3 g of citric acid,
• It is possible to take a salt laxative, but many sources recommend not doing so,
• siphon enemas,
• when you get arsenic on your skin, just rinse your body with warm water and soap, without letting the poison soak into the blood.

All the above measures a person can take and himself, if he knows that the poison has got into the body, and there is no one to help. If the victim is at home himself and his condition deteriorates rapidly, calling an "ambulance" should leave the door to the apartment open, so that the medical staff can easily and quickly provide the necessary assistance even if the patient is unconscious.

The main thing is not to panic and not to be limited to only the first aid, which does not guarantee 100% removal of poison from the body. In addition, even for a short period of action, arsenic can cause serious disruption of the body, which can only be remedied with the assistance of professional doctors.

The emergence of critical symptoms requires those who provide first aid, concentration and tranquility. This is not the time for panic. Act quickly and confidently.

• If the victim is unconscious, before the arrival of an ambulance, he must be laid on a flat surface on his side so that asphyxiation does not occur as a result of tongue sagging and mucosal discharge into the bronchi. Before arrival of an ambulance, if possible, intramuscularly administer a 5% solution of unitol (the dose is calculated from the ratio of 1 ml of the drug for every 10 kg of the patient's body weight). Be sure to constantly monitor the pulse, breathing, blood pressure, so that if necessary, go to affordable resuscitation.
• If there are no signs of breathing and heartbeats are not heard, urgent resuscitative measures are needed, including indirect cardiac massage and parallel artificial respiration.

[33], [34], [35], [36], [37],

Prevention

For the prevention of poisoning with arsenic and its compounds, an important role is played by the observance of personal hygiene. Sometimes poison enters the body by carelessness, if the arsenic particles after work and insecticides, mouse poison, arsenic-treated materials have got on the skin of the hands. Unwashed hands in this case become the main source of infection.

After working with such materials, you need to thoroughly wash the open parts of the body with water and soap. Moreover, one should not eat food during the spraying of plants with pesticides and work with arsenic compounds.

In production, in order to prevent chronic arsenic poisoning of the company's employees, quality ventilation and protection of the skin and respiratory tract from contact with arsenic should be ensured.

If a person lives in an area where the level of arsenic in the soil and water is increased, you should try to less contact with the land, do not swim in contaminated water bodies and use only imported purified water.

When working with mouse poison, special care must be taken when disposing of the poison in places that are inaccessible to children. In no case can you store the remains of poison in the kitchen or in the pantry next to food. The poison must be stored in a tightly closed container in a secret place, which only a limited circle of people knows about. Use flour, which is doubtful during cooking, is not recommended until you are sure of its safety.

When treating teeth in dentistry, insist on the use of safer materials than arsenic anhydride. Fortunately in our time there is no shortage of such materials.

[38], [39], [40], [41], [42], [43],

Forecast

The prognosis for arsenic poisoning depends entirely on the dose taken and the timeliness of the measures for neutralizing and removing poison from the body. The most favorable prognosis for chronic poisoning, since a single dose in this case is small. The main thing is, as early as possible to pay attention to unusual symptoms. In acute poisoning with large doses of arsenic compounds, the likelihood of a lethal outcome is high. However, effective and quick assistance to the victim in many cases allowed to save a person's life even in critical conditions.

[44], [45]