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Biological Terrorist Agents
Published in Robert A. Burke, Counter-Terrorism for Emergency Responders, 2017
Because no antidote exists for abrin, the most important factor is avoiding abrin exposure in the first place. If exposure cannot be avoided, the most important factor is then getting the abrin off or out of the body as quickly as possible. Abrin exposure can be prevented when it is present in large quantities by wearing appropriate personal protective equipment. Abrin poisoning is treated with supportive care to minimize the effects of the poisoning. This care varies based on the route of exposure and the time since exposure. For recent ingestion, administration of activated charcoal and gastric lavage are both options. Using an emetic (vomiting agent) is not a useful treatment. In cases of eye exposure, flushing the eye with saline helps to remove abrin. Oxygen therapy, airway management, assisted ventilation, monitoring, IV fluid administration, and electrolyte replacement are also important components of treatment.
INTRODUCTION AND OVERVIEW OF PART 2
Published in Nicholas P. Cheremisinoff, Industrial Solvents Handbook, Revised And Expanded, 2003
Equipment: Rubber gloves; chemical resistant splash-proof goggles; rubber boots; chemical protective clothing for splash protection, chemical canridge type respirator or other suitable protection against vapor must be worn when working in poorly ventilated areas or where overexposure by inhalation could occur.; Symptoms Following Exposure: Personnel can be overexposed to this chemical by ingestion, absorption through the skin, or inhalation. The earliest symptoms of cyano-compound intoxication may be weakness, headaches, confusion, and occasionally nausea and vomiting. The respiratory rate and depth will usually be increased at the beginning and at later stages become slow and gasping. Blood pressure is usually normal, especially in mild or moderately severe cases, although the pulse rate is usually more rapid than normal; General Treatment for Exposure: INHALATION: Remove patient to fresh air; seek immediate medical attention. INGESTION: Call physician immediately. Until doctor arrives, take the following steps: a) Provide for inhalation by amyl nitrate vapor from ampules crushed in a handkerchief and held to nose of victim, b) Induce vomiting unless patient is unconscious. (Gastric lavage should be employed by or under the supervision of a physician), c) Keep patient warm and quiet until medical attention arrives. EYES: Immediately flush with targe volumes of fresh water for at least 15 minutes. SKIN: Wash thoroughly at once, without scrubbing, with large amounts of soap and water. OTHER: Exposed personnel should be checked periodically for chronic toxic effects; Toxicity by Inhalation (Threshold Limit Value): No data; Short-Term Exposure Limits: No data; Toxicity by Ingestion: LD,,, = 800 mgfkg (rat); Late Toxicity: No data; Vapor (Gas) Irritant Characteristics: No data; Liquid or Solid irritant Characteristics: No data; Odor Threshold: No data. Fire Hazards — Flash Point ("F): 167 CC, This material is combustible but burns with difficulty; Flammable Limits in Air (%): No data. Fire Extinguishing Agents: Foam, dry chemical, carbon dioxide; Fire Extinguishing Agents Not To Be Used: Water may be ineffective; Special Hazards of Combustion Products: Toxic hydrogen cyanide and oxides of nitrogen form; Behavior in Fire: No data; Ignition Temperature: No data; Electrical Hazard: No data; Burning Rate: Difficult to burn. Chemical Reactivity — Reactivity with Water: No reaction; Reactivity with Common Materials: Will attack some plastics; Stability During Transport: Stable; Neutralizing Agents for Acids and Caustics: Not pertinent; Polymerization: Not pertinent; Inhibitor of Polymerization: Not pertinent.
Pesticide exposure and poisoning in Brazil: Outcome severity, clinical manifestations and management of cases reported to a poison control center
Published in Archives of Environmental & Occupational Health, 2023
Josefa Cristina Pereira dos Santos, Joanina Bicalho Valli, Nixon Souza Sesse, Sarah Mackenzie Ross, Eliana Zandonade, Lorena Rocha Ayres, Karla Nívea Sampaio
The current study found gastric lavage was frequently performed in the initial treatment period. Yet, this measure was seldom recommended by the Poison center, which prioritized clinical observation, symptomatic treatment, and the use of activated charcoal. It was not possible to compare treatment measures adopted in the same patient because, for some cases, treatment history was not followed up, particularly in cases where exposure was nontoxic. It is clearly stated in best practices of clinical management of poisoned patients that gastric lavage should not be routinely employed because there are risks associated with this procedure that may complicate the patient’s condition.9,10,12,14,15 In fact, it has been well described that this procedure can significantly increase the hazard in pesticide poisoned patients.12 Additionally, gastric lavage is not recommended when the time from ingestion exceeds 60 min.9,10,12,14,15 Evidence shows that the time it takes for the patient to present to a treatment facility often exceeds this time window.18,51 Therefore, the high frequency of use of gastric lavage observed in the initial assistance offered to cases and the high frequency of nontoxic cases strongly suggests this procedure was unnecessary in many cases.