Mercury poisoning symptoms
mercury ions - strong protoplasmic poison, shall be deposited in the liver and kidneys.Especially toxic inorganic mercury compounds: corrosive sublimate (mercury dichloride), cinnabar (mercury sulfide), calomel (mercury monochloride), mercury nitrate, mercuric amidochloride, oksitsianid mercury, mercury salicylate, mercury diiodide, etc .;organic compounds: Pest Control - etilmerkurhlorid, Granosan, merkuran;drugs: merkuzal, chlormerodrin, novurit, diotsid.The toxic dose of mercury dioxide -0,1-0,2 of a lethal dose of mercuric chloride, and diiodide diotsida mercury ingestion for adults is 0.5-4 g
Mercury and its compounds
Mercury and its compounds act through the respiratory system, digestive system, skin and mucous membranes.Acute poisoning may result from inhalation of vapors of metallic mercury or mercury-containing pesticides dust.Ingestion of metallic mercury does not usually lead to intoxication.mercury salts, and especially corrosive sublimate, can cause acute poisoning also by sucking with intact mucous membranes and skin.The body
long delayed mercury accumulating in the form of compounds with protein (albuminates) in various organs, mainly the liver and kidneys.From the body of mercury is released primarily by the kidneys, and some - glands of the digestive tract (salivary glands, liver, mucous membrane of the colon), and other glands, including milk.
Mercury and its compounds are highly toxic.Organic compounds are more toxic than inorganic.The toxicity of the latter depends on their solubility in water.Thus, mercury nitrate dichloride and more toxic than mercury sulfide and chloride.
Salivation, metallic taste in the mouth.An unpleasant specific smell from the mouth.White-gray necrotic raids on the mucous membrane of tongue, gums, throat and pharynx.Swelling of the larynx.
Burning pain in the mouth, pharynx, esophagus, stomach (epigastric), the colon.
Nausea.Profuse salivation (up to 1 liter of saliva a day with an unpleasant smell).Vomiting resistant, durable;vomit often mixed with blood.Diarrhea, stool thin, foul-smelling, with mucus and blood.Tenesmus.
progressive drop in cardiac activity, heart sounds dull.Bradycardia.Hypertensive syndrome with acute renal failure.
Kidneys - nekronefroz.Oliguria, through the upcoming phase of polyuria.Gipostenuriya.Albuminuria.Hematuria.Progression to oliguria anuria.Early onset of anuria most adversely, is a sign of sublimate kidney syndrome.
blood - concentration;azotemia;hyposalemia, hypochromic anemia.
cold sweat.Increased blood pressure.Uremia.Mercury dermatitis, drug reaction neurovascular origin.
Fainting.Convulsions.Death from uremia.
Please note that sodium chloride is passed per os at a poisoning mercury dichloride, significantly increases its solubility!
contraindicated: receiving per os acids, salty foods, castor oil (and fat), ethanol.No smoking - nicotine poisoning worsens during
Inhalation of mercury vapor leads to the prevailing changes in the central and autonomic nervous system.
headache, weakness.Stomatitis.Necrosis of the nasal mucosa.Perhaps gangrene or necrosis of the mandible.Changes in the kidneys - nekronefroz.Mercury fever.Polyneuritis.
mercurial stomatitis.Lacquered sip Kussmaul - lacquer-copper color of the soft palate and uvula.
excitement, violence, rage attacks.Encephalopathy.Cerebellar tremor fingers.Writers cramp.Colour reflex Atkins - Glow lens in the light of the slit lamp copper-red-brown color.
mercury detection - on a color reaction of urine: yellow appears when you add to it potassium iodide, followed by red color.
skin - eczema, rash, urticaria, exfoliative dermatitis.Stomatitis.Fever.Serum sickness.Shock.
1. Place the patient, remove the poison.The most radical and truly active way of treating mercury poisoning salts is possible early use of extracorporeal detoxification - hemosorption (you can start even in the prehospital phase), hemodialysis, peritoneal dialysis, lymphosorption.
3. Washing gastric gavage with water or with the addition of egg white (by 2 protein in 1 liter of water) or 30-50 g of sodium thiosulfate, 30-40 g or magnesium sulphate or magnesium oxide or antidote solution against metal (100: 4000) with a suspension of activated carbon (2 tablespoons per 1 liter of water), or skim milk.
4. After washing the probe inserted through the 0.25 liters of water with 2-3 tablespoons of magnesium sulfate and activated carbon.
5. Heavy drinking liquids (rosehip infusion, 5% glucose solution).Mucous unsalted soup.
6. High enema siphon (water with 0.1% solution of tannin or a suspension of activated charcoal or a decoction of chamomile with magnesium oxide).
7. Long administered intravenously isotonic sodium chloride solution, polyglukin, 5% glucose solution, infusion, to 4-5.5 liters / day;diuresis intravenous boost of up to 200 mg per day of Lasix.
8. Simultaneously administered intravenous ascorbic acid (up to 1 g / day) and thiamine hydrobromide (0.025 g / day).When bleeding - vitamin K (menadione), 1 ml of 1% solution or intramuscularly in tablets of 0.015 g 2-3 times a day.Constant reception Rutoside (vitamin E) of 0.02 g
9. When expressed chloropenia - sodium chloride (10 to 15 ml of a 10% solution 1-2 times a day intravenously).
10. Active struggle with acute renal failure and uremia!
11. Repeated massive bloodletting with exchange transfusions odnogruppnoy fresh citrated blood (up to 1 liter per session).
12. If necessary - cardiac agents intravenously - or strofantin Korglikon.
13. Analeptics, cardiovascular agents - caffeine (2 mL of a 10% solution subcutaneously) kordiamin (1-2 mL), sulfokamfokain;mezaton;noradrenaline in 5% glucose solution intravenously in the collapse.
14. Tracheostomy edema of the larynx, tracheal intubation;on the testimony - controlled breathing.
15. When stomatitis - moxibustion sores 10% solution of chromic acid or silver nitrate.Mouthwash solutions of potassium permanganate (1: 5000) or hydrogen peroxide (1: 500).
16. Hydrocortisone (125 mg i.m.), prednisone (0,005 g 4-6 times a day).Diphenhydramine (0.05 g per os or by injection).
17. Syndromic therapy:
18. Emergency hospitalization in hemodialysis.Transporting the machine "emergency" on a stretcher.During the evacuation to continue to provide medical care.
Pesticides Granosan (etilmerkurhlorid) tserezan, Abava, falizan and similar representatives of organomercury compounds are more toxic than mercury dichloride (mercuric chloride) and other inorganic mercury compounds.These toxins affect the enzyme system by blocking the activity of the sulfhydryl groups of proteins.They are deposited in the brain and spinal cord, lung, liver, kidney, stomach wall and intestine, the bone marrow.
defeat of the nervous system is composed of a serial combination of asthenic syndrome, and encephalopathy syndrome polinevriticheskogo with polinevriticheskim syndrome.
transition from one syndrome to another is accomplished according to the severity of the poisoning three stages:
Initially, patients complain of headache, dizziness, weakness, fatigue, lethargy, insomnia, unstable mood, decreased performance, impotence.
Later on the background of further progression of symptoms or at the same time they raised bursting, aching pain in the legs, feeling of crawling "chills", woodiness in the body, neuralgia lumbosacral area, skin hypersensitivity.Appear red dermographism, hyperhidrosis (sweating) hands and skin folds;marbling of the skin.Tremor of fingers.
In the most severe cases of the disorder appear speech and swallowing, thirst.Staggering gait, nystagmus, abnormal reflexes, paresis.
body temperature decreases.
skin - dermatitis may occur, even burn (long, poorly healing).
Mucous membranes are inflamed, but unlike poisoning inorganic compounds of mercury stomatitis and gingivitis are not expressed.
Gastrointestinal tract - thirst, salivation, a kind of metallic taste in the mouth, nausea, vomiting mucus mixed with blood.Approximately 1 / s diarrhea cases occur;mucoid feces with blood.
epigastric pain and around the navel.The weakness of the sphincters;involuntary urination and defecation.Hepatomegaly, decreased antitoxic liver function.
Heart - complaints about compression, stabbing chest pain, palpitations, shortness of breath when walking and exercising.Cardiac deaf (characterized by persistent muted tones!), Sometimes auscultated systolic murmur at the apex.
bradycardia, heart lability.Asymmetry of blood pressure.Hypotension.Capillaroscopic ascertained change the tone of the capillaries.Type pulse dystonic reactions and blood pressure response to exercise.
Electrocardiogram - reducing the voltage of the T wave, the QRS complex alteration, increase in systolic index, slowing intraventricular conduction.
urine - polyuria beginning with i- and gipostenuriey then oliguria.Microalbuminuria, microhematuria, mikroleyko-tsiguriya.The daily urine revealed a large amount of mercury - 100-500 mg.
blood - leukocytosis, small monocytes, neutrophilia, elevated erythrocyte sedimentation rate.
1. Complete rest, warming the patient.Remove poison antidotes enter.
2. Gastric lavage with plenty of water (10-12 liters) with the addition of activated carbon (2 tablespoons per 1 liter of water) or 100-150 ml of 5% solution unitiola or antidote Strzhizhevskogo.Then introduce saline laxative 30 g of magnesium sulfate dissolved in 150 ml of water.
4. The most effective is a combination of extracorporeal detoxification (hemodialysis) with the antidotal therapy (especially with oligo-anuria).
5. Forced diuresis - intravenous drip of 1-1.5 liters of isotonic sodium chloride solution, 1-1.5 liters of 5% glucose solution 500ml polyglucin, gemodeza and simultaneous intravenous administration of 80-160 mg or 80-100 Lasixg mannitol.Neostigmine
6. - 1 ml of 0.05% solution subcutaneously 3-4 times per day.Injections of vitamins B1, B12, cocarboxylase.Introduction lipoic acid.
7. Syndromic treatment of nephropathy, hepatopathy, cardiac and vascular insufficiency.
8. Emergency hospitalization in the Department of toxicological or therapeutic department - intensive care and resuscitation.