Poisoning, accidental with

Although iron is not an environmental poison, accidental intoxication with ferrous salts used to treat iron deficiency is a frequently encountered source of poisoning in young children, iron is discussed further in Chapter 53. 

OP insecticide-induced intermediate syndrome (IMS) was reported for the first time in human patients in Sri Lanka in 1987 (Senanayake and Karalliede, 1987). Since then, this syndrome has been diagnosed in OP-poisoned patients in South Africa (1989), Turkey (1990), Belgium (1992), the United States (1992), Venezuela (1998), France (2000), and elsewhere. IMS is usually observed in individuals who have ingested a massive dose of an OP insecticide either accidentally or in a suicide attempt. IMS is clearly a separate clinical entity from acute toxicity and delayed neuropathy. A similar syndrome has also been observed in dogs and cats poisoned maliciously or accidentally with massive dosc.s of certain OPs. OPs that are known to cause IMS include bromophos, chlorpyrifos, diazinon, dicrotophos, dimethoatc, fenthion, malathion, merphos, methamidophos, methyl parathion, monocrotophos, omethoate, parathion, phosmet, and trichlorfon. These compounds and IMS are discussed further in Chapter 26. 

Other sources of hazard arise from the handling of such chemicals as concentrated acids, alkalis, metallic sodium and bromine, and in working with such extremely poisonous substances as sodium and potassium cyanides. The special precautions to be observed will be indicated, where necessary, in the experiments in which the substances are employed, and will also be supplied by the demonstrator. The exercise of obvious precautions and cautious handling will in most cases reduce the danger to almost negligible proportions. Thus, if concentrated sulphuric acid should be accidentally spilled, it should be immediately washed with a liberal quantity of water or of a solution of a mild alkali. 

The leagent may also be prepared by dissolving 1 ml. of phenylhydrazine in a solution of 1 ml. of glacial acetic acid and 10 ml. of water. This procedure is not so convenient as that from the solid hydrochloride becaiise of the poisonous character of phenylhydrazine (both liquid and vapour). If the liquid is accidentally spilled on the skin, wash it at once with dilute acetic acid, followed by soap and water. 

Nitrobenzene (and many other liquid organic compoimds containing nitrogen) is appreciably toxic and its vapour should not be allowed to escape into the atmosphere of the laboratory the delivery tube of the condenser should pass well into the mouth of the receiver flask. The liquid is also a skin poison if it Is accidentally spilled on the skin, it should be removed by washing with a litt e methylated spirit, followed by soap and warm water. 

CAUTION, Doth the vapour and the liquid dimethyl sulphate are highly poisonous. Inhalation of the vapour may lead to giddiness and even to more serious results. The cold liquid is easily absorbed through the skin, with toxic results. If the dimethyl sulphate is accidentally splashed upon the hands, wash immediately... 

Mononitrothiophene is an active poison. The accidental contact of an ethereal solution with the skin has produced painful blisters. In case of accident the compound should be removed from the exposed surface by washing with alcohol. 

Emetics are used to cause vomiting to empty the stomach rapidly when an individual has accidentally or intentionally ingested a poison or drug overdose Not all poison ingestions or drug overdoses are treated with emetics. 

In case of accidental or intentional poisoning, contact the nearest poison control center before using or giving this drug. Not all poisoning can be treated with this drug. 

Tiess D, Wegener R, Tamme A. 1982. [A case of accidental parathion-methyl (Wofatox) poisoning with lethal result]. Deutsch Gesundheitswes 37 1540-1542. (German)... 

Similarly, convulsive seizures and a sustained epileptic state persisted after stomach contents were pumped and activated charcoal and anticonvulsive medication were administered in a 43-year-old man who ingested approximately 260 mg/kg endosulfan (Boereboom et al. 1998). At 4 days after exposure, the man was pronounced brain dead, and autopsy revealed cerebral hernia from massive cerebral edema. Eight additional accidental and/or intentional cases of acute poisoning with endosulfan resulting in adverse neurological effects have been reported in more recent studies, six by Blanco-Coronado et al. (1992), one by Lo et al. (1995), and one by Pradhan et al. (1997) two out of the eight resulted in death. Tonic-clonic convulsions were seen in the Blanco-Coronado et al. (1992) cases, whereas Lo et al. (1995) reported the development of muscle fasciculations and episodes of convulsions in their case. In the case reported by Pradhan et al. (1997), the patient had consumed about 75 mL of hquid endosulfan (35% w/v). In this case, in addition to tonic-clonic seizures and myoclonic jerks, the patient developed... 

Oral poisoning after accidental phenol ingestion has caused fulminant central nervous system depression, hepatorenal and cardiopulmonary failure [20]. No hepatorenal or central nervous system toxicities with properly performed chemical peels have been reported in the literature [21]. 

Organophosphate Ester Hydraulic Fluids. Human studies of exposure to organophosphates are primarily those of acute, accidental poisonings with tricresyl phosphate (Goldstein et al. 1988 Senayanake and Jeyaratnam 1981 Srivastava et al. 1990). 

Signs of cyanide poisoning were exhibited by a man accidentally sprayed with acrylonitrile. 

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