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          First aid of methyl bromide poisoning
          Diagnostic criteria for poisoning:

             Irritation symptoms appear to the eye and upper respiratory tract in methyl bromide fumigation environment: simple blisters appear after skin contact with methyl bromide; dizziness, fatigue, sickness and other symptoms of nerve system appear, but with fewer symptoms and, to a lesser extent , which will recover in 24 hours of disengagement. In this case, hen the patient need to Be listed as observation object.

              Significant dizziness, headache, fatigue, loss of appetite, sickness, vomiting, coughing, chest tightness and other symptoms appear after several hours to several days’ incubation period after contacting with methyl bromide, along with emergence of drowsiness, staggering gait, faltering words or diplopia; mild breathing difficulty, a small amount of dry and wet rales could be heard in the lung,; blood bromine may arise, and a small amount of prote-in may appear in urine. In this case the patient can be diagnosed as mildly poisoned.

              In addition to the clinical manifestations of mildly poisoned, there appears brain edema, such as coma, convulsions or epilepsy in a continuous state; pulmonary edema; renal failure; shock and other symptoms. In this case, the patient can be diagnosed as severely poisoned.

          Treatment principles:

          1.Immediately escape from the scene, replace the contaminated clothing, use 2% sodium bicarbonate solution or soap water for cleaning if the skin is polluted.

          2. The observed patient should be observed for 24 hours, and dealt appropriately according to the situation. Poisoned patients should be kept in bed for rest and kept quite. Observe for 24 ~ 48 hours, in order to detect the changes of conditions in early stage.

          3.When poisoning occurs, the test result of blood bromine and the concentration of methyl bromide in the scene provides with referential value to the diagnosis. The common blood bromine level is below 25 mo1/L, generally, blood bromine > 62.5 mol/L (50mg/L) is a dangerous level, and poisoning symptoms appear when reaching 187.5 mol/L.

          4. Symptomatic treatment and supportive care should be taken as a major method in treatment. Dealing with the damage of nerve system, pulmonary edema or acute renal failure,etc caused by poisoning in an early and active manner. Principles of treatment and nursing care is the same as the Department of Internal Medicine.

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