Poisoning by vapors of acetic, hydrocyanic, boric acids: treatment, gastric lavage

Acids have become quite widespread in everyday life. Today, acids are encountered in everyday life, in agriculture, in production, in research institutes and in practical laboratories. Sometimes even cooking and ordinary home preservation cannot do without the use of acids. Hence the significant increase in trauma patients who are hospitalized with a diagnosis of acid poisoning. The most dangerous is the penetration of acids into the body. However, external damage to tissues and mucous membranes by acids is no less dangerous for the health and life of the patient.

Causes acid vapor poisoning

There are three main causes: poisoning at work, careless handling and use for the purpose of committing suicide. At work, it is necessary to comply with a number of requirements, there must be serviceable equipment, equipped hoods, properly selected dishes and protective devices. It is necessary to wear protective gloves, masks, glasses, and sometimes even special protective suits. Neglect of the rules for the use of acids and protective equipment, irregular and careless checks and instructions lead to accidents, which can lead not only to poisoning of an employee, but also to mass poisoning.

In everyday life, poisoning most often occurs due to carelessness, for example, when spraying plants, treating the garden from pests, working with varnishes and paints, in construction. Many people neglect basic means of protection, exceed recommended dosages, leave acid cans open, combine them with other acids or water, leave them in the sun or near a radiator. Quite often, acids are stored carelessly, and they spread or release toxic fumes. Or acids are simply splashed or spilled. When using acids in the food industry and cooking, the main causes of accidents are overdosing, when an excessive amount of acid is added to a product or preserves. Also, food acids are often confused with non-food acids, adding them to food products. Men are most often poisoned by carelessness, since they tend to be dismissive of instructions and safety precautions.

Women are most often poisoned intentionally, with the purpose of suicide. Today, there is also a tendency for teenagers to commit intentional poisoning.

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Symptoms acid vapor poisoning

Poisoning can manifest itself in different ways depending on the acid that has had an effect and in what quantity. A common feature of all acid poisoning is a pronounced local reaction, which manifests itself in the form of a burn and tissue necrosis. When ingested, a burn occurs. When ingested externally, damage to the skin of varying area and depth occurs. All this is accompanied by a burning sensation, deterioration in health, a sharp headache, pressure and pain in the chest and heart. The complexion changes sharply, the mucous membrane becomes overdried, acquires a bluish tint. Severe painful vomiting develops, often with blood impurities, bleeding may begin.

Pain or toxic shock develops quite quickly, the person loses consciousness, the pupils stop reacting to light, and necrosis of the affected areas occurs. Cardiac and respiratory function is impaired, a nervous or convulsive seizure, tremor, or paralysis of smooth muscles may develop.

Severe poisoning, which occurs several days after contact with acids or during prolonged work with them, is indicated by an increase in temperature, dry mouth, weakness, sometimes delirium and hallucinations, migraines. There is a tremor in the body, panic, the pupils become dilated. The main reflexes - swallowing and even breathing - may be impaired. Blood pressure drops sharply, tachycardia occurs. Free hemoglobin appears in the blood due to the destruction of red blood cells, which leads to the appearance of a blue tint of the mucous membranes, lips, skin. The entire metabolism is disrupted, severe intoxication occurs, diuresis decreases. Edema, pulmonary emphysema, the development of cardiac and respiratory failure, disruption of cardiac activity, the opening of external and internal bleeding are possible.

In the early stages of acid poisoning, there may be impaired perception, distorted smells, and taste sensations. Headache, light dizziness, nausea, pain in the temples and behind the breastbone, and increased heart rate also develop. Breathing becomes frequent, and there is a feeling of shortness of breath. There may be a feeling of heat, or, conversely, cold, trembling, and light tremor. Burns are accompanied by a burning sensation, pain, and light redness.

Stages

Depending on the severity, three stages are observed. At the mild stage, there is initial intoxication of the body or local impact of the acid on the affected organs and tissues. Minor burns are observed at the points of contact of the acid with the body. There are no changes in the main vital parameters: the blood does not thicken, damage to internal organs is practically not observed.

With moderate intoxication, the organ that was exposed suffers greatly. With food poisoning, the esophagus and stomach suffer first, with external poisoning, damage occurs to the main areas of the skin and mucous membrane that were in contact with the acid. Moderate intoxication develops, as a result of which the blood thickens, vital signs are disrupted. It ends in shock, convulsions or paralysis.

In the severe stage, not only the organs and tissues that came into contact suffer, but also the surrounding tissues. All the walls of the esophagus are affected, erosions and ulcers appear, bleeding may occur. The result is damage to the entire digestive tract, as well as the respiratory tract. A person may begin to choke. Pain or toxic shock, damage to the nervous system, tremor, and smooth muscle failure also develop. Everything ends in acute renal or hepatic failure, heart paralysis.

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Acetic acid poisoning

A common type of poisoning observed in everyday life. Acetic acid has found wide application in the preparation of various dishes, marinades, sauces, and also in food preservation. It is used for cleaning, washing, removing scale, unpleasant odor.

When poisoning occurs, two effects appear at once - local and resorptive. The essence of local damage is that the tissues that were directly exposed to the poison are damaged. Vomiting often occurs, in which bloody impurities appear. The substance is gradually absorbed, a resorptive effect is observed. Intensive hemolysis of erythrocytes occurs, a large amount of free hemoglobin is released. Accordingly, anemia develops, the body loses oxygen, carbon dioxide and metabolic products cease to be excreted. The skin and mucous membranes turn blue. Cyanosis develops, which contributes to the disruption of metabolic processes in the body, disruption of the heart, kidneys and liver.

Numerous complications may develop, leading to suffocation and respiratory failure. Bleeding is dangerous and is usually quite difficult to stop. Complications develop either immediately after the toxic substance enters the blood, or a week or even a month after poisoning. The most dangerous complications are those affecting the kidneys, in which kidney cells are damaged and gradually die.

The help consists of washing the stomach, which is washed until the water is clear. The stomach is washed even if there is severe vomiting and blood impurities, since the main task is to remove acid from the stomach, prevent its further absorption into the blood, and eliminate the damaging effect. Washing should be done within 6 hours after the substance has been ingested, otherwise it will be ineffective due to the fact that the acid is no longer absorbed.

Laxatives should not be used. If swelling of the larynx and blockage of the airways, suffocation occurs, a tracheotomy should be performed immediately, during which a special tube is inserted into the larynx through which breathing occurs.

Later, after the threat to life has passed, symptomatic and supportive therapy is started. The pain that accompanies the lesions is relieved. For this, painkillers are used, including narcotics.

In case of hypovolemia, as well as to remove toxic hemolysis products from the blood and the body as a whole, infusion therapy is performed, up to 5-10 liters of solutions are infused per day, which reduces the load on the heart muscle, eliminates the consequences of blood thickening. Drugs are administered to increase hemolysis, treat burns, prevent the development of infectious and inflammatory processes, and relieve edema. Laser irradiation of the esophagus walls is often used, hormonal drugs are administered to prevent stenosis and bleeding.

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Hydrocyanic acid poisoning

Hydrocyanic acid is a poison that has long been used for mass murder, suicide, and deliberate poisoning. The lethal concentration of this substance is only 1 mg/kg of body weight. It acts very quickly. In pharmaceutical reference books and literature it is presented as hydrocyanic acid, and in common parlance it is often called potassium cyanide.

The mechanism of action consists of penetrating into the blood and blocking enzymes, which leads to hypoxia. Cardiac activity is very quickly suppressed, changes in biochemistry are irreversible.

It can be found in light industry, used to make glass, silver products, and make zinc alloys. It can be found, for example, in insecticides, herbicides, and during deratization. In everyday life, it can even be found in fruit seeds.

It enters mainly through the respiratory and digestive organs. In some cases, it can even pass through the skin barrier and seep through the skin tissue. The first reaction that occurs is a violation of intracellular pressure, the blood loses trace elements. Numerous disorders develop, the victim suffocates. Then severe convulsions with vomiting occur. The danger of this condition is the entry of vomit into the respiratory tract, which becomes blocked and suffocates. If first aid is not provided, the person will die immediately. At low concentrations, death occurs within a few minutes, and at high concentrations, a person dies in a few seconds.

Therefore, it is necessary to provide assistance within a few minutes - administer an antidote and remove the poison from the body. At the same time, one must not forget the need to monitor the person's vital signs. Then the patient is necessarily hospitalized and given further treatment.

Boric acid poisoning

Often seen in newborns. Occurs when a nursing mother treats her nipples with boric acid.

The acid is capable of localization in various parts of the body. Usually the substance is in the tissues for three days, after which it is excreted from the body. This has a toxic effect on all organs that participate in its neutralization. First of all, the liver, spleen, and kidneys suffer. This leads to the development of necrosis, in which the main tissue dies and is replaced by connective tissue.

Treatment includes replacement blood transfusion, gastric lavage. Along with this, a laxative is prescribed, peritoneal dialysis is performed, and diuresis is maintained or forced. In particularly severe cases, extracorporeal transfusion is used.

When performing such manipulations, it is necessary to carefully monitor the level of arterial pressure. To do this, support the kidneys, infuse fluids, administer adrenaline and noradrenaline, which stimulate the hormonal system. They resort to the use of glucocorticoids, which prevent the development of irreversible processes in the body. Blood plasma indicators and other vital indicators are monitored by infusion of supporting and stimulating solutions.

Read about other forms of acid poisoning here.

Complications and consequences

The consequences of intoxication may vary. It depends on what acid the person was poisoned with and on the concentration of the substance that entered the blood. The first serious consequence that occurs when in contact with acid is the development of burn disease. When liquid enters the body through the respiratory tract, a burn of the nasal passages, nasopharynx, pharynx, trachea, larynx and lungs occurs. When acid enters through the gastrointestinal tract, the esophagus and stomach are affected. If there was superficial contact, the mucous membranes and skin surface are affected.

Usually poisoning is accompanied by intoxication, which leads to the development of dyspeptic syndrome. The most severe complication is damage to the nervous system and respiratory center, which leads to respiratory depression, paralysis, and suffocation. The most dangerous type of complications is the development of cardiac and respiratory failure, irreversible damage to the kidneys and liver.

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Diagnostics acid vapor poisoning

To make a correct diagnosis, the doctor first carefully studies the patient's medical history and illness. After that, based on the clinical picture and medical history, a preliminary diagnosis is made. Laboratory and instrumental studies are conducted to clarify the diagnosis.

Gastric lavage and vomit are taken for examination. Biological and toxicological analysis is performed. Blood analysis is used to detect the level of free hemoglobin in the blood, to determine the activity of the main enzymes.

If necessary, instrumental examinations are prescribed: gastroscopy, rectoscopy, X-ray examination, ultrasound and others. They make it possible to determine and visualize the sites of damage, the degree and stage of the burn and inflammatory process, and determine the necessary treatment.

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Differential diagnosis

The basis of differential diagnostics is the determination of the acid that caused the poisoning. For this purpose, biochemical and toxicological analyses are carried out. The clinical picture can tell a lot.

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Treatment acid vapor poisoning

First, it is necessary to neutralize the effect of the poison and prevent its further absorption. After this, the patient is provided with access to fresh air. It is necessary to induce vomiting. In a hospital setting, the stomach is washed as quickly as possible. An antidote is administered immediately. Each type of acid has its own antidote.

Only after the threat to life has passed and vital signs have stabilized, do they begin treating the consequences. They fight pain shock. For this, they administer strong painkillers. Infusion therapy is immediately carried out, which makes it possible to replenish the fluid and ion deficit that occurred as a result of the action of acids. For this, a large number of supporting substances are infused. In addition, they ensure the thinning of the blood, which thickens during poisoning. Neutralizing therapy and hemodialysis are carried out in parallel. These procedures are aimed at removing toxic substances and decay products from the blood that formed during the period of inflammation.

If other symptoms occur, treatment is carried out to eliminate them. Then fasting is indicated for several days. You can only drink water in large quantities. After this time, diet No. 1a is prescribed, which should be followed for 2-3 months.

What to do in case of acid poisoning?

In case of acid poisoning, it is necessary to stop the acid from acting on the body as quickly as possible. If the acid has been ingested, vomiting should be induced. Then an ambulance should be called as quickly as possible, informing the operator that the patient has severe poisoning. If it is possible to administer an antidote, it should be administered as quickly as possible, without waiting for the doctor to arrive.

First aid for acid poisoning

Rinsing is performed immediately. If there is blood in the vomit, rinsing is still performed. Before rinsing, premedication is performed: various painkillers and antispasmodics are administered. This prevents further absorption of acid into the blood.

To ensure forced diuresis and alkalization of the blood, ice cubes and various medications are used. This makes it possible to neutralize the action of acids that have already penetrated the blood. For pain relief, painkillers and narcotics are used; in case of bleeding, cold is applied to the stomach area. If necessary, a blood transfusion is performed. After the condition has stabilized, further treatment is started as indicated.

First aid for acid poisoning

The essence of first aid is to remove the substance that has entered the body and prevent its further absorption. The easiest way to do this is to induce a gag reflex. In order to neutralize the effect of the acid that has already managed to penetrate the blood, it is necessary to use an antidote. Each acid has its own. It is necessary to begin acting as quickly as possible, since poisoning with some acids leads to death in 1-2 minutes. At the same time, it is necessary to remember the need to monitor the patient's vital signs.

However, when poisoning with strong acids, the opinions of experts differ. Today, many doctors claim that it is better not to induce vomiting, since the reverse flow of acid together with gastric juice causes a severe burn of the esophagus. In addition, the risk of rupture of the stomach and large blood vessels increases sharply. A person can even get a heart attack or stroke as a complication. It is also not worth introducing alkalis, which provide neutralization of acid, since the reaction occurring in the body can provoke numerous complications, including bleeding, burns and ruptures of membranes. Liquids, especially water, should also not be given, since when combined with water, a violent reaction occurs with the release of gas, which corrodes the walls of internal organs and blood vessels. In addition, the reaction occurs with the release of heat, which intensifies the chemical burn. Laxatives should also not be taken, since this will only contribute to a deeper movement of acid through the digestive tract and cause a burn of the entire intestine.

If bleeding occurs, if possible. It is recommended to inject a hemostatic agent. If not, a heating pad with water or ordinary cold is applied to the stomach. Pain-relieving measures are also carried out. Everything must be done in the form of injections. If a spasm of the larynx occurs and it is difficult to breathe, it is necessary to provide access to air and let the person sniff menthol vapors. In case of loss of consciousness, let the person sniff ammonia.

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Gastric lavage for acid poisoning

The lavage is carried out using a probe, which is lubricated at the end with vaseline or oil. Cold water is used for lavage. It is carried out until clean water appears. Premedication is carried out before lavage. Lavage prevents further absorption of poison into the blood and removes acids from the stomach.

Medicines

Medicines should be taken with caution. It is better for the medicine to be prescribed by a doctor. Because any remedy in combination with acid behaves differently. A chemical reaction is possible between them, the consequences of which will negatively affect the state of health.

To remove acid residues from the stomach, you can use activated carbon, which cleanses not only the stomach but also the blood. Take 5-6 tablets at a time. After that, you can take it again after 5-6 hours.

To relieve pain, relieve spasms and activate the adrenal system, a 1% solution of atropine is administered in an amount of 0.1-1%.

For pain relief, to calm and relieve nervous and muscular tension, a 2% solution of papaverine is administered intramuscularly at 0.2-1 ml.

A 1% solution of pantothenic acid, administered at 0.1-0.5 ml, has an analgesic effect.

Vitamins

Every organism needs adequate nutrition and the necessary amount of vitamins. After suffering poisoning, during the recovery period it is recommended to take vitamins in the following daily concentrations:

• Vitamin PP – 60 mg
• Vitamin H – 150 mcg
• Vitamin C – 1000 mg
• Vitamin E – 45 mg.

Physiotherapy treatment

In case of poisoning, physiotherapy procedures as such are not used. They are used mainly at the recovery stage, during symptomatic treatment. For example, a laser is used to heal chemical burns. Electrophoresis is used for deep penetration of drugs into tissues. Cold procedures are used to eliminate pain symptoms. Thermal procedures are used for recovery and rapid regeneration of various wounds. Various types of radiation affect the burn area to prevent inflammation and infection.

Folk remedies

Folk remedies are used to restore the body and overcome the effects of poisoning. They are most effective as part of complex therapy. You should first consult a doctor and only then use any medications. Various strengthening and restorative agents, sorbents, herbal infusions that help relieve inflammation are widely used.

• Restorative mixture

To prepare, take 200 grams of dried apricots, raisins, dried apples, and prunes. Grind it all through a meat grinder. Mix the resulting mixture with honey, add 2 tablespoons of ground ginger and the same amount of ground cinnamon. Sprinkle with sesame seeds on top. Let the remedy brew for 24 hours. Take 1 tablespoon per day, washing it down with the juice of half a lemon.

• Strengthening juice

To prepare the juice, take a glass of pomegranate juice, add 50 ml of rosehip syrup, 50 ml of hawthorn syrup. Mix everything, add honey to taste. Drink at once.

• Drink for burns

To prepare the drink, take about 20 grams of sea buckthorn berries, crush them until oil appears. Pour boiling water over them. Allow to cool to a warm state. Add 1 teaspoon of lemongrass infusion or the juice of half a lemon to the resulting tea. Drink at one time. You can drink up to three cups of this tea per day.

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Herbal treatment

Herbal treatment is used as part of complex therapy for recovery after poisoning.

Stevia has proven itself well. It promotes rapid tissue regeneration, stabilizes cells and prevents their death. It stimulates the immune system, thereby significantly reducing the risk of developing infectious and inflammatory processes, and also replenishes vitamin deficiency.

To prepare the decoction, take 1 tablespoon of the herb, pour a glass of boiling water over it. Allow it to brew, strain. Drink throughout the day. You can add honey to taste.

Blood thickening is often observed in cases of poisoning. It is recommended to take a nettle decoction to thin it. 3-4 nettle leaves together with the stem are poured with a glass of boiling water and allowed to brew. After the remedy has brewed, it is filtered and drunk. The entire glass must be drunk during the day.

You can relieve inflammation with a chamomile decoction. To prepare the decoction, take 1 tablespoon of flowers and pour 500 ml of boiling water over them. Allow to brew. Drink half a glass three times a day, always warm.

Homeopathy

Homeopathic remedies have a powerful restorative effect. They are used as part of complex therapy. Before you start taking medications, you should first consult with your doctor. Homeopathic remedies may not be compatible with each other or with medications. Many of them are contraindicated after exposure to acids. In order not to harm yourself, you need to take the main precaution - consult with your doctor first.

• Ointment after chemical burns

The ointment is based on badger or fish oil. Add 2-3 drops of vitamin E and mix thoroughly. The ointment can be used both for external use and for healing wounds inside the body. It is used for burns of the esophagus and stomach. For internal use, take 1 teaspoon of the product 1-2 times a day. For external use, spread the ointment on the affected area of the skin, rub in and allow it to be absorbed.

• Regenerating elixir

To prepare, take 1 tablespoon of stevia, add the same amount of nettle leaves, put 5-10 rose hips. Pour in vodka or alcohol. Allow to infuse. Usually the remedy is infused for 7 days. After that, you can drink 1 tablespoon three times a day.

• Decoction for burns of the esophagus

To prepare the decoction, take 5 grams of calamus root and pour boiling water over it. Let it brew for half an hour. Then drink 1 teaspoon three times a day.

• Infusion for burns of the esophagus

To recover from a chemical burn, take about 2 teaspoons of propolis, pour a glass of vodka or alcohol over it. Let it sit for 7 days. Drink 1 tablespoon three times a day.

Surgical treatment

After a chemical burn, it may be necessary to remove part of the stomach or esophagus. This is necessary if the damage is irreversible and necrosis develops. Complete death of the stomach or esophagus can be prevented by removing the affected area. This will make it possible to localize the process.

Prevention

Acid poisoning can be prevented if you work with them carefully and follow safety precautions. It is important to conduct briefings at the enterprise, train employees and require them to use protective equipment. When working with acids, the exhaust hood should be on. If there is none, you need to open a window and ventilate the room.

When treating vegetable gardens and premises from rodents and insects, it is necessary to use automated means. It is necessary to constantly monitor the level of toxic substances in the air, especially if the work is carried out with caustic and volatile substances. When preparing food and preserving, it is necessary to observe the dosage of acid. It is also important to keep food and non-food acids separately, so that there is no possibility of mixing them up.

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Forecast

If first aid is provided promptly, the prognosis may be favorable. If first aid is not provided immediately after the substance enters the body, acid poisoning may have fatal consequences.

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