Poisoning with vapors, chlorine solution, in the pool: signs, what to do, how to treat

Chlorine is a poisonous gas with a sweetish metallic taste and a pungent odor. In nature, it is found only in the composition of minerals. In small amounts, it is contained in the intercellular fluid of man and animal, participating in the work of nerve cells and metabolic processes. Chlorine is widely used in the production of pesticides, fertilizers, solvents, medicines, detergents and disinfectants, plastics, polyvinyl chloride, synthetic rubber, warfare agent. In everyday life it is used for bleaching, cleaning bathtubs, washbasins and toilet bowls, it is disinfected with water in the pools and water in the houses. Under what circumstances can it pose a threat to human life?

[1], [2], [3], [4]

Epidemiology

Statistics show that in the world most technogenic accidents are associated with the release of ammonia and chlorine into the atmosphere. And if we take into account how much substance is used in agriculture, in water purification, in pharmaceuticals, then the negative scale of its influence on a person becomes clear. Among domestic poisonings, about half of all cases fall on poisoning with this substance.

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

Causes of the poisoning with chlorine

To ensure that chlorine is safe, there are maximum permissible concentrations. Thus, in the atmosphere, the average daily gas content should not be more than 0.03 mg / m ³, one-time - 0.1 mg / m ³, in industrial premises - 1 mg / m ³. The causes of chlorine poisoning can be:

• industrial accidents;
• large gas content in the pool and water supply;
• the use of chemical weapons of mass destruction;
• violation of the rules of use in everyday life (high concentrations, closed rooms).

[10]

Risk factors

The risk factors include alcoholism, substance abuse, drug addiction. The chronic, throat, lung, heart, renal and hepatic insufficiency is exacerbated by the susceptibility to chlorine.

[11], [12], [13],

Pathogenesis

The pathogenesis of chlorine poisoning is a chemical trauma that disrupts the vital functions of the body. As a result of the reaction of gas with the moisture of the mucous membrane, hydrochloric acid and active oxygen are formed, which also have a toxic effect. In the beginning, the epithelium of the mucous membrane of the upper respiratory tract suffers, then the epithelial lining of the alveoli. There is a swelling, degeneration, then necrosis. These processes lead to an increase in the permeability of the alveolar walls, impaired blood circulation, damage to the pulmonary capillaries.

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

Symptoms of the poisoning with chlorine

Symptoms of chlorine poisoning depend on the dose of the poison agent and the duration of its exposure. The first signs are expressed in:

• throat and coughing due to irritation of the mucosa of the respiratory tract;
• bitter taste in the mouth and increased saliva;
• rubbing in eyes and watery eyes;
• nausea;
• headache;
• possible cramps.

Poisoning with chlorine vapor can occur both in production using gas, in agriculture when spraying crops, and at home. The ingress of gas vapors through the upper respiratory tract is called inhalation poisoning. Such poisoning can be obtained from any toxic gas - chlorine, ammonia, etc.

Symptoms of poisoning with chlorine and ammonia are similar: perspiration in the throat, coughing, choking, headache, lacrimation, skin irritation, chest pain, stomach.

Ammonia is most often affected by production, cleaning of sewerage and cesspools.

Cases of chlorine poisoning are not uncommon in swimming pools. Owners of private pools, trying to avoid the spread of infections, sometimes overdo it with the content of chlorine in the water. There are no single reports in the mass media that the amateurs of swimming became massively ill during the voyage.

Poisoning with chlorine at home

Often, chlorine poisoning occurs at home when used in large volumes in unventilated areas of cleaning products, bleach with non-compliance with the guidance on the concentration of the substance. Chlorine - cheap, and therefore attractive for many housewives method to clean, disinfect the toilet, bathroom, whiten the laundry. Violation of the rules of using the tool can result in large losses for both health and purse.

Chlorine poisoning in children

Poisoning with chlorine in a child is very dangerous. The reason for this can be both a pool and unattended cleaners. Parents are best used to disinfect substances that do not contain chlorine, and when visiting the pool to ask what is disinfected water. When the first symptoms of poisoning are important fast response of adults - interruption of contact with the source of infection, airing the room, call an ambulance.

[17], [18], [19], [20],

Stages

Depending on the exposure time of the toxin, acute and chronic poisoning is distinguished. Acute chlorine poisoning has the following stages:

1. the first - lightning - occurs due to poisoning with a large concentration of gas. Accompanied by suffocation, convulsions, redness and blueness of the skin, ends with a fatal outcome;
2. the second - heavy - it is characterized by temporary suffocation, loss of consciousness, possibly the onset of death, if there was a burn of the lungs;
3. the third - the middle - entails a difficulty in breathing, burning and choking in the throat as a result of a burn of the laryngeal mucosa, lacrimation, pulmonary edema;
4. fourth - easy.

Light mild chlorine poisoning is associated with minor ailments, expressed in a burning sensation in the nose and throat, with a runny nose, coughing, eyes blushing and watering. A person feels a general weakness for several days. These symptoms disappear after a few days.

Chronic chlorine poisoning occurs as a result of prolonged exposure to a small concentration of gas in the body. This happens, as a rule, in people whose professional activity is related to the production using chlorine. The disease is expressed in a constant dry cough, general weakness, depressive state.

[21], [22], [23], [24], [25], [26]

Complications and consequences

Prolonged exposure to chlorine for chronic poisoning affects the skin condition - dermatitis, bleeding acne, purulent skin lesions. Consequences and complications of acute poisoning can be chronic laryngitis, pharyngitis, tracheobronchitis, emphysema of the lungs, pneumosclerosis, cardiac and pulmonary insufficiency.

[27],

Diagnostics of the poisoning with chlorine

When diagnosing chlorine poisoning, it is very important to know all the details of what happened: the circumstances of the infection, the time spent in the danger zone, the toxin dose. Even if a person feels satisfactory, he must be hospitalized at least for a day in order to conduct laboratory, instrumental and functional studies.

When poisoning with chlorine, the gas composition of the arterial blood is examined. The oxygen content in it decreases in the case of a strong lesion, organic acids increase. As the edema of the lungs increases, hemoglobin, leukocytes, accelerate the clotting time.

A very important method of instrumental diagnostics for chlorine poisoning is lung X-rays in dynamics. Identification of changes in the organ, characteristic for edema, will allow to take urgent measures to save the patient. At an early stage, the size of the roots of the lungs increases, their vascular pattern increases, the pulmonary fields become less transparent, dark spots appear. Timely treatment begun after 6-8 hours gives a reverse picture. If there is an edema of the lungs, focal shadows merge, the lymph vessels swell. In the process of recovery, the radiograph changes after 2-10 days. The development of gray hypoxia (stage of collapse) is expressed by large-scale darkening of the lungs.

To assess the condition of other organs, MRI, CT is used. An ECG of the heart is also performed.

[28], [29], [30]

Differential diagnosis

Differential diagnostics is carried out with poisoning by other toxic substances, for example, ammonia, mercury, carbon monoxide, metal oxides, etc.

[31], [32], [33], [34],

Treatment of the poisoning with chlorine

The treatment of the victims must begin with the provision of the first emergency aid, which primarily consists in removing the source of contamination or evacuating a person from the affected area and providing it with fresh air. Then you need to take off his clothes and wash with water those areas of skin with which chlorine was in contact. When oral poisoning is important, immediately wash the stomach. Throat, nose and mouth can be rinsed with a weak soda solution. Eyes are thoroughly washed with warm water. Showing inhalation with soda and aqueous solution. If necessary, airway patency is provided. The use of antidotes for poisoning allows you to counteract the damaging substance, eliminate disruption in the body, normalize the condition. Antidote for poisoning with chlorine can be a conventional oxygen pillow. In the case of edema of the lungs, hormone therapy is used, and for the prevention of infections, antibiotics.

Medications

When chlorine poisoning, inhalations of bronchodilators are carried out: salbutamol, atrovent, berodual, etc. It is possible to carry out the procedure with a 10% solution of menthol in chloroform.

Salbutamol - a powder and a solution for inhalation, has a bronchodilator effect. A single dose is 2.5 mg 3-4 times a day, if necessary, can be increased to 5 mg. Use with caution in diseases of the thyroid gland, tachycardia, pregnancy, high blood pressure. Of side effects, there is a tremor, a rapid heartbeat.

Anti-inflammatory drugs, for example, ibuprofen, are also used.

Ibuprofen - is available in tablets, syrups. It is recommended 400mg 2-3 times a day, the maximum dose is 2.4 g per day. May cause dizziness, nausea, insomnia, nervous agitation, allergies. Contraindicated in hematological problems, gastrointestinal ulcers in the acute stage, children less than 6 years old, liver and kidney failure.

In case of difficulty in breathing, they are prescribed theofedrine, theophylline, and euphyllin.

Teofedrine - tablets, taken in the morning or daytime on a tablet or a half times a day by adults and children after 12 years. For children younger enough for the fourth part of the pill. If necessary, the frequency of reception can be increased up to 3 times. It is not prescribed for glaucoma, coronary disorders. It can cause nausea, vomiting, sweating, and urinary retention.

To get rid of a cough and speed up the excretion of sputum from the bronchi will help bromhexine.

Bromhexine - tablets, syrup, reduces the viscosity of sputum and its secretion. Doses for different age categories of their own, taken 3 times a day:

• 2-6 years - 4 mg or half a tablet (half or full teaspoon of syrup);
• 6-10 years - three fourth or whole tablet (1-2 spoons);
• after 10 years - a tablet 4 times a day (2-3 spoons).

You can use the preparation for inhalations, diluting it with distilled water in a ratio of 1: 1. With prolonged use of bromhexine, side effects rarely occur in the form of digestive disorders, swelling. Contraindicated in the first trimester of pregnancy, with hypersensitivity to the components of the drug, ulcer digestive organs

Eyes are instilled with 0.5% solution of dicoline or novocaine (0.25%).

Dikoin - powder, have a strong anesthetic effect. It is enough 2-3 drops in each eye. The drug is toxic, so it does not apply to pregnant women and children under 10 years of age.

Toxic burns of the lungs are treated with prednisolone or hydrocortisone.

Vitamins

When chlorine is poisoned by the victim simultaneously with other therapeutic measures, large doses of ascorbic acid are administered. After carrying out the first urgent measures and eliminating the threat of life, it is necessary to support the body with vitamins and microelements. To this end, you can resort to vitamin complexes that have in their composition vitamins B, vitamin E. It is important to include in your diet more fresh fruits and vegetables.

Physiotherapeutic treatment

To widely used physiotherapeutic methods of treatment of chlorine poisoning is oxygen therapy, the use of which is very important in hypoxia, tk. Compensates the lack of oxygen in the tissues. Among the first-priority measures to eliminate the effects of poisoning are various inhalations (soda, medicamentous).

Alternative treatment

When poisoning with chlorine by ingesting it inside through the mouth, the stomach is washed with milk or by dissolving the protein of the raw egg in water. Alternative treatment offers various recipes for expectoration in the event of bronchial involvement. Effective for this purpose is honey mixed with onion juice: mix in equal parts these ingredients, drink a tablespoon after eating. The same recipe is used to make a mixture of honey and horseradish juice. You can drink warm milk, having previously squeezed into it a garlic clove a few cloves of garlic. With burns of the larynx they drink olive oil with egg whites. To eliminate inflammation of the eyes, fresh tea leaves are used, and they can also be washed with a weak solution of honey.

[35], [36], [37]

Herbal Treatment

To treat upper respiratory tract diseases with herbs, including lesions resulting from chlorine poisoning, there are effective medicinal charges. They necessarily include licorice, which also neutralizes poisons that have got into the body; mother-and-stepmother - expectorant, anti-inflammatory agent; elecampane is a good antiseptic; althaea - has an analgesic effect. When poisoning is effective decoction of dill seeds, infusion of dry cranberries and cowberries, radiola rose extract.

Homeopathy

Now in the sale there are many homeopathic remedies that can be used to treat the symptoms caused by chlorine poisoning. So, with lesions of the mucous throat, we apply angin-heel C.

Angin-heel S is a complex preparation of vegetable, animal and mineral origin. Has an antiseptic, disinfecting effect on the source of the disease of any etiology. Round tablets from white to yellow color, odorless. Dose for adults - 1 piece under the tongue. For children, the tablet is rubbed and dissolved in water at room temperature (one to 2 tablespoons of water). Depending on the age and body weight, 2 to 3 teaspoons are recommended per reception. Daily frequency - 3 times. Duration of treatment - up to 3 weeks. Has contraindications for children under 1 year. Mercury in the drug can cause increased salivation, and allergic rashes are possible. In this case, you need to stop receiving.

Another similar in action is anginal. There are several options in which different medicinal herbs are arranged. When poisoning is more suited angina with sage, licorice and eucalyptus oil.

Angina - tablets dissolve in the mouth until completely dissolved. Pregnant and children under 5 years are not recommended. Adults can take a pill every 2-3 hours, children from 10 years - half as often as 3-4, younger than this age - on a quarter. Are capable to cause allergic displays. Do not apply to patients with cirrhosis of the liver, hepatitis, arterial hypertension.

Cough (chronic bronchitis, laryngitis, tracheitis), caused by damage to the upper respiratory tract, can be treated with a homeopathic remedy broncho-gran.

Broncho-gran granules, the dose of an adult - 7 pieces under the tongue, the children are calculated, based on the age - a granule for a year of life. For small patients, it dissolves in water. Take the drug for a quarter of an hour before a meal or an hour after it, the frequency - 2-6 times a day. Up to a year is prescribed only on the advice of a doctor. There are no other caveats.

It restores the functions of the liver and biliary tract after the toxic effect of the heparar comp. Heel.

Gepar Comp. Heel is a clear, odorless liquid for subcutaneous, intramuscular, if necessary intravenous injections. Oral administration is possible (single dose is diluted in 5-10 ml of water). For adults, it is 1 ampoule (2.2 ml), for children varies from 0.4 ml for babies to 1 ml for 6 years. There are no contraindications, allergy to compound agents is possible from side effects.

Surgery

Surgical treatment may be needed in case of stenosis of the larynx. Surgery is urgent for restoring breathing, as well as restorative.

Prevention

Prophylaxis in "chlorine" production is the passing of medical examiners once a year, as well as providing the necessary measures to maintain the permissible concentration of chlorine in the room. This should contribute to the functioning of the ventilation system, adherence to the tightness of containers with gas.

In everyday life it is necessary to exercise caution when using chlorine-containing substances, to ventilate the premises, wash hands, and protect children from access.

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

Forecast

The forecast is ambiguous - from immediate death to slow recovery. Survivors in the first day after a strong poisoning with chlorine, as a rule, get out. Passes not one week with signs of a pneumonia, a bronchitis. Pulmonary emphysema and disorders in the work of the heart can accompany the victim to the end of his life

[44], [45], [46]