Toxicologist

The need for emergency care in cases of poisoning may arise in doctors of any specialty. In the modern world, we are surrounded by a mass of various toxic substances, which increases the risk of toxic effects on any organ or system in the body. Such situations are possible both at work and at home, in transport, on vacation. Specialized emergency care for acute poisoning is provided by a toxicologist - a specialist who deals with the elimination of the toxic effects of certain substances on the body.

Who is a toxicologist?

Every day and every hour we experience the effects of various chemical compounds and substances. These include household chemicals, cosmetics, polluted environment, etc., etc. Scientists have found that there are more than five million different chemical compounds in the environment. At least 60,000 of these compounds are used as food additives (more than 5,000 names), about 4,000 names are used as medicines, and more than 2,000 are used as pesticides. The number of chemicals used in industry, agriculture, medicine, or everyday life is constantly growing, which over time creates an ever greater danger to human health.

Acute poisoning is a common occurrence in medical practice, so medicine has singled out a special category of doctor who would deal exclusively with treatment, prevention and study of all kinds of poisoning. Such a doctor is a toxicologist.

The specialty of toxicologist appeared in medicine in the 19th century, and since then not only has it not been exhausted, but has also become more in demand.

When should you see a toxicologist?

You should contact a toxicologist at the first signs and symptoms of poisoning:

• industrial poisons that can be used in production (poisoning with dichloroethane, methane, propane, butane, dyes, freon, alcohols, plasticizers, etc.);
• pesticides that are used to destroy pests of agricultural crops (poisoning with pesticides, insecticides, mercury-containing substances, carbamic acid preparations);
• medicinal products (taking unknown drugs, overdose);
• household chemicals, hygiene and cosmetic products, home and clothing care products;
• biopoisons that are found in plants, mushrooms, and also transmitted by snake and insect bites;
• military chemical poisoning agents (toxic gases sarin, mustard gas, phosgene, etc.).

The reason for contacting a toxicologist may be alcohol or drug poisoning, as well as suicidal or criminal use of toxic substances.

What tests should be taken when visiting a toxicologist?

Among the main tests that a toxicologist may prescribe during the first appointment, the following can be highlighted:

• general blood and urine analysis;
• lymph analysis;
• cerebrospinal fluid analysis;
• diagnostics of the cardiovascular system (electrocardiography, rheography, etc.);
• diagnostics of the central nervous system (encephalography), etc.

Before making a diagnosis, data from the patient's survey, examination and study of the clinical signs of the disease are also taken into account.

What diagnostic methods does a toxicologist use?

A toxicologist can use instrumental (functional) and laboratory diagnostic methods.

• Encephalography – helps to determine the bioelectrical activity of the brain and its changes during intoxication with psychotropic and neurotropic substances.
• Electrocardiography – helps to assess the presence and extent of toxic damage to the heart, as well as to check the rhythm and quality of cardiac conduction.
• Oximetry and spirography are methods for diagnosing breathing disorders.
• Fiberoptic bronchoscopy and chest X-ray are used primarily for diagnostic determination of toxic pneumonia.
• Esophagogastroduodenoscopy – diagnosis of damage to the digestive system.
• Radionuclide methods are diagnostic methods for suspected toxic damage to the liver and kidneys.

Laboratory diagnostic methods may include the following tests and studies:

• detection of toxic agents in biological fluids of the body (in blood, urine, and cerebrospinal fluid);
• Gas-liquid chromatography, spectrophotometry – methods that can confirm the presence of a toxic substance in a biomaterial using chemical reactions or instrumental methods.

The final diagnosis of intoxication is established by a toxicologist based on the results of chemical-toxicological studies and information about the clinical examination of the patient, with mandatory consideration of specific and non-specific biochemical analyses.

What does a toxicologist do?

A toxicologist deals with acute and chronic poisoning and is able to solve a wide range of problems, including knowledge of chemistry, biochemistry, physiology, immunology, genetics, etc. The task of a toxicologist is clinical and laboratory diagnostics of poisoning, clinical interpretation of the obtained laboratory data, development of effective and qualified treatment of poisoning, study of the epidemiology of poisoning, its causes and measures for prevention.

The specifics of the work of a toxicologist is to quickly and efficiently make the right decisions and build the right treatment tactics for acute poisoning. A toxicologist must be collected in any situation in order to competently provide the necessary assistance and alleviate the patient's condition.

A toxicologist must be aware of the effects of medicinal drugs, plant and animal poisons, chemical compounds, alcohol and drugs, and nicotine on human organs and systems. The doctor must understand the specifics of military, aviation, forensic, and even space toxicology, and know the toxicokinetics and toxicodynamics of all known poisons on the planet.

What diseases does a toxicologist treat?

A toxicologist treats acute and chronic poisoning (intoxication) - pathological conditions that are associated with the impact of some poison on the human body. The role of poison can be played by almost any chemical substance that is capable of provoking a disorder of vital functions and creating a danger to human viability. As a rule, the culprit of poisoning is toxic substances that have entered, or are entering, the body from outside.

Poisoning may be accompanied by:

• toxic effects on the liver;
• toxic damage to the urinary system (kidneys);
• cardiac dysfunction;
• respiratory dysfunction;
• brain damage.

Toxicologist's Advice

Household poisoning most often occurs after consuming poor-quality food products, medicines, after using household chemicals and fertilizers, and also when working with preparations containing mercury. Less common are poisonings with heavy metals, alcohols, narcotics, and carbon monoxide.

A toxicologist's advice on preventing intoxication may be as follows:

• You cannot use medications if their expiration date has expired;
• You should not mix medications with alcohol, or increase the dosage of medications on your own;
• Methyl alcohol must not be used for any purposes other than technical ones;
• ethyl alcohol is not recommended for internal use;
• Household chemicals may contain quite aggressive substances, so such products should be used strictly for their intended purpose;
• after working with household and other chemicals, it is necessary to ventilate the room well and wash your hands;
• You should not eat expired foods or canned foods with swollen lids;
• wash vegetables and fruits;
• It is better to buy vegetables and fruits in season: fresh fruits contain much less nitrates than greenhouse fruits or those with a long shelf life;
• You should not eat mushrooms unless you are sure of their origin and whether they have been cooked properly;
• avoid buying ready-made meals: salads, meat and fish products;
• Do not store medicines or household chemicals next to food products;
• keep children away from places where medicines and household chemicals are stored;
• Do not store food products in containers that previously contained chemicals.

Another common poisoning, carbon monoxide, deserves special mention. Such poisoning is not uncommon during fires, when working in a garage or transport hangar with poor air access. Carbon monoxide poisoning can also occur when there is a problem with the heating system in the room.

Every person should know and be able to provide feasible first aid in case of carbon monoxide poisoning:

• provide the victim with an influx of fresh air;
• cover the victim to avoid hypothermia;
• apply a swab with ammonia to the respiratory organ;
• if breathing has stopped or is impaired, artificial ventilation should be performed;
• ensure delivery of the victim to any nearest medical facility.

Remember: in any critical situation related to poisoning, a toxicologist specialist will always be able to help and stop the intoxication, which will avoid serious and extremely undesirable complications.