Immediate symptoms

Keep away from open flame and sparks, no smoking 

Applies to flammable gases and liquids with a flash point below 55 C, and to solids which (i) ignite readily even at low oxygen levels, or (ii) can form flammable gases on contact with moisture. 

Applies to all other combustible substances. Open flame includes hot surfaces with a temperature above the autoignition point of the substeince. 

Applies to substances which react violently with the other substance(s) listed (with risk of fire/explosion). Sheets for substances with a low autignition point also bear a warning regarding contact with hot surfaces. 

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Concentrations of nickel carbonyl as low as 30 ppm in air for 30 min may be lethal for humans. Individuals exposed to these high concentrations show immediate symptoms of dizziness, headache, shortness of breath, and vomiting. These early symptoms generally disappear in fresh air, but delayed symptoms may develop 12—36 h later. These latter symptoms include shortness of breath, cyanosis, chest pain, chills, and fever. In severe exposure cases. 

No immediate symptoms, but longterm risk of chest and abdominal cancers and lung diseases. 

No immediate symptoms but estimated to contribute to between 7,000 and 30,000 lung cancer deaths each year. Smokers are at higher risk of developing radon-induced lung cancer. 

The nurse must report symptoms of succinimide overdosage immediately. Symptoms of overdosage in dude confuson, sleepiness, unsteadiness flaccid muscles slow shallow respirations nausea, vomiting, hypotension, absent reflexes nd CNS depression leading to coma. It is important to report symptoms to the primary health care provider immediately. Therapeutic serum blood levels of ethosuximide (Zarontin) range from 40 to 100 mcg/mL... 

Some patients may exhibit anxiety related to the symptoms of their disorder, as well as concern about relief of their symptoms. The patient should be reassured that although relief may not be immediate, symptoms should begin to decrease or even disappear in a few weeks. 

Delayed. Although immediate symptoms may follow exposure to a high concentration of DP, a delay of 3 h or more may elapse before exposure to a low concentration causes any ill effect. 

Pulmonary effects are usually delayed from 2 to 24 hours. Exposure to very high concentrations may produce immediate symptoms. Generally, the more rapid the onset of symptoms, the more grave the prognosis. 

The accidental release of several tons of MIC in 1984 at Bhopal, India, resulted in a very heavy death toll (approximately 1850) and, in survivors, significant impairment of health. Immediate symptoms were difficulty in breathing, skin and eye irritation, vomiting, and unconsciousness. Only a few deaths were recorded in the first few hours, with the maximum number of fatalities occurring between 24 and 72 hours. The predominant cause of death was cardiac arrest following severe pulmonary edema. Lung function abnormalities have persisted years after exposure. Ophthalmic effects included lacrimation, lid edema, photophobia, and ulceration of the corneal epithelium. A follow-up study 3 years after exposure showed excess irritation, eyelid infection, cataract, and a decrease in visual acuity, but corneal erosion was resolved. ... 

Because the most common cause of angina is atherosclerotic disease of the coronaries (CAD), therapy must address the underlying causes of CAD as well as the immediate symptoms of angina. In addition to reducing the need for antianginal therapy, such primary management has been shown to reduce major cardiac events such as myocardial infarction. 

MITOMYCIN CYTOTOXICS-VINCA ALKALOIDS t risk of abrupt onset of pulmonaiy toxicity in 3-6% of patients, when two courses of these drugs are administered concurrently Mechanism is uncertain possible additive pulmonary toxic effects Monitor clinically and with lung function tests for pulmonary toxicity. Advise patients to report immediately symptoms such as shortness of breath and wheezing... 

Extraperitoneal perforation and leakage of barium may cause few immediate symptoms, but delayed endo-toxic shock can develop some 12 hours later, often causing death. Bowel infarction can also result. Barium granulomata can occur, causing painful masses, rectal strictures, or ulcers. On proctoscopy, an ulcer with a whitish base can mimic a carcinoma. In one rare case, perforation of a barium enema into a sigmoid abscess was followed by intravasation into the portal venous system (11). 

The authors suggested that this reaction had been due to a dextran-induced anaphylactic reaction, but were uncertain as to the cause of these observations, as they were not accompanied by immediate symptoms of shock. It is unclear if this case was caused by an antibody reaction. 

The accidental contamination of chicken feed with dioxin contaminated fat in Europe shows how food exposure could occur. Because dioxin does not cause immediate symptoms, authorities did not discover the contamination for months in 1999, and Europeans probably consumed the dioxin in chicken meat and eggs sold that year. One lesson learned from this event is that physicians and public health officials need to recognize and report unusual or suspicious health problems in animals as well as humans (1). The 1999 West Nile virus epidemic in birds and humans in New York City reinforced this lesson. Fortunately, biological and chemical contamination of public water supplies will usually pose little risk due to dilution by the large volume of water. 

Table 3.5 (25,26) summarizes the clinical presentation of exposure to sulfur and nitrogen mustards. Sulfur and nitrogen mustards affect primarily the eyes, skin and respiratory tract. Most exposed patients will not have immediate symptoms, and will not... 

Agents can produce both local and systemic effects. Assume that exposure to solids, liquids, or vapors from agents is hazardous and will potentially cause death within minutes after exposure. However, effects from some agents do not appear for up to 24 hours after exposure. Lack of immediate symptoms should not be taken as evidence that individuals have not been exposed. Some agents are carcinogenic. 

Immediate symptoms may include giddiness, headache, lightheadedness, and dizziness. After a latency period, symptoms may include chills, headache, malaise, weakness, dizziness, difficult breathing, abdominal pain, nausea, vomiting, jaundice, bloody urine, and coma. 

Exposure to low concentrations may not produce immediate effects. However, the severity of poisoning is not related to the presentation or magnitude of immediate symptoms. Symptoms may include eye and airway irritation, tearing, shortness of breath, coughing, wheezing, chest tightness, and delayed pulmonary edema. If halogens have been released, there may be redness of the skin, chemical bums or even thermal burns. 

In addition to the desire for immediate symptom improvement, prevention of mastoiditis and meningitis has been suggested as a reason to prescribe immediate antibiotic treatment for acute otitis media. The rates of mastoiditis in the Netherlands, Norway, and Denmark (all countries in which delayed therapy has been adopted) and those in Canada, the United States, Austraha, and the United Kingdom were compared. The delay of antibiotic use resulted in an increase from about 2 to 4 cases of mastoiditis per 100,000 children per year, accompanied by about 1600 fewer children per 100,000 experiencing antibiotic side effects. Of note, in the Netherlands, only 1.1% of infections caused by S. pneumoniae are penicUhn-resistant. 

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