arsine poisoning treatment
Several dithiols are effective in saving the lives of rabbits, dogs and monkeys given doses of arsine ca. 2006 Sep. 46(9):1576-9. Treatment of arsenic poisoning in acute toxic poisonings needs to begin quickly; treatment involves removal of arsenic by dialysis, chelating agents, replacement of red blood cells, and if ingested, bowel cleansing. Full recovery may not … NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. Arsine or Stibine Poisoning. Am J Kidney Dis. Interestingly, the oxidative cytotoxicity potential of arsenic has been used as treatment for certain malignant cancers. Arsine poisoning treatment should focus on restoring RBC concentrations, maintaining renal function, electrolyte replacement and aggressive supportive care. J Natl Med Assoc. 2007 Sep. 45(6):721-7. The patient should be intubated if the airway is not patent or protected. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. 2016 Dec. 48:214-224. Arsine poisoning. Exposure to arsine gas can cause fatal hemolysis and multiorgan damage. Support personnel should always continue to manage ABCs, which includes supplementary oxygen and venous access. This website also contains material copyrighted by 3rd parties. Diseases & Conditions, 2002 3. Moisture reacts with aluminium arsenide in such dross with the generation of arsine. Arsine (AsH3) poisoning is a recognized industrial hazard (Buchanan, 1962), producing poisoning at less than 30ppm, aconcentration far belowthat at which its faint smell of garlic is detectable. This will require you to, Sign In to Email Alerts with your Email Address. [Medline]. Ren M Kinoshita, DO Resident Physician, Department of Emergency Medicine, Carl R Darnall Army Medical Center Dry with clean towels and keep victim warm and quiet. Renal damage from industrial arsine poisoning. the L.D.100. 6. 121(1):1-8. Arsine Gas. Arsenic is a natural semi-metallic chemical that is found all over the world in groundwater. The CDC case definition of arsine poisoning includes the following:  Suspected: A case in which a potentially exposed person is being evaluated by health care worker or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists. [Medline]. 1986 May. Certain dithiols will protect tissue respiration from inhibition by arsine and arsenite. Environ Toxicol Pharmacol. 19(1):133-43. Scombroid poisoning usually responds well to antihistamines (H1-receptor blockers, although H2-receptor blockers may also provide some benefit). If you log out, you will be required to enter your username and password the next time you visit. The effectiveness of this compound in the treatment of arsine poisoning falls off rapidly as the time interval between exposure and treatment is increased. Progress and treatment Liver function The jaundice faded rapidly. Toxicol Sci. This should be done in consultation with a clinical expert in arsenic poisoning treatment. If arsenic poisoning occurs over a brief period of time, symptoms may include vomiting, abdominal pain, encephalopathy, and watery diarrhea that contains blood. . Support Us. In the event of acute arsine exposure in a pregnant patient, maternal toxicity is likely to be a major determinant of risk to the fetus. Data from patients with severe acute arsine poisoning, treated with plasma exchange from December 2000 to December 2005 were collected and analyzed. Airway: Ensure the airway is patent and protected. How arsine exposure is treated Treatment consists of providing supportive medical care in a hospital setting. Consider using bronchodilators in patients with bronchospasm or racemic epinephrine aerosol in children with wheezing. Arsine (IUPAC name: arsane) is an inorganic compound with the formula As H 3.This flammable, pyrophoric, and highly toxic pnictogen hydride gas is one of the simplest compounds of arsenic. Fred Henretig, MD Director, Section of Clinical Toxicology, Professor, Medical Director, Delaware Valley Regional Poison Control Center, Departments of Emergency Medicine and Pediatrics, University of Pennsylvania School of Medicine, Children's HospitalDisclosure: Nothing to disclose. Patients occupationally over exposed to arsenic may want to discuss with employers their concerns regarding ways to prevent this hazardous exposure. Arsine poisoning symptoms, causes, diagnosis, and treatment information for Arsine poisoning (Chemical poisoning - Arsine) with alternative diagnoses, full-text book chapters, misdiagnosis, research treatments, prevention, and prognosis. Two mildly affected individuals recovered quickly-without treatment but the third, who was … The exception is exposure to compressed liquid gas that may cause frostbite injury to the skin or eyes. 5. Long-term exposure can result in thickening of the skin, darker skin, abdominal pain, diarrhea, heart disease, numbness, and cancer. Acute exposure of inorganic arsenic or arsine gas can be extremely fatal and result in death in the absence of spontaneous remedial actions. Arch Environ Health. Wilkinson SP, McHugh P, Horsley S, Tubbs H, Lewis M, Thould A, et al. If hemolysis is present, the patient/victim must be observed up to 72 hours for signs of renal failure. Arsine (AsH3) poisoning is a recognized industrial hazard (Buchanan, 1962), producing poisoning at less than 30ppm, aconcentration far belowthat at which its faint smell of garlic is detectable. Metabolism and toxicity of arsenicals in mammals. Arsenite can reversibly bind to sulfhydryl groups which are believed to cause dilation and increased permeability of capillaries. The effectiveness of this compound in the treatment of arsine poisoning falls off rapidly as the time interval between exposure and treatment is increased. Arsenite's affinity for thiols, more predominately, dithiols leads to favorable transfer of arsenite to the chelating agent, dithiol 2,3-dimercaptosuccinic also known succimer. Some methods remove arsenic from the human body before it causes any damage. Rael LT, Ayala-Fierro F, Carter DE. Fowler’s solution remained a treatment for many conditions well into the 20th century and is listed along with arsenic trioxide and sodium arsenate in the 1914 edition of the American Medical Association’s Handbook of Useful Drugs as treatment for skin cancer, chronic inflammatory skin disorders, malaria, syphilis and protozoal diseases. We are looking for partners and donors to assist. The aluminium reacts with the impurities and floats to the surface as dross which is skimmed off. 261586-overview Mild arsine poisoning unaccompanied by oliguria may remain unrecognized and should therefore be considered in the differential diagnosis of any patient presenting with haematuria or jaundice, particularly if his occupation brings him in contact with acids and metals. Arch Toxicol. Chemical poisoning -- Arsine: Introduction. Teitelbaum DT, Kier LC. We describe four cases of arsine exposure aimed to evaluate the effectiveness of extracorporeal arsenic removal in acute arsine gas poisoning. Contact the blood bank and hematologist regarding exchange transfusion. Acta Haematol. http://emergency.cdc.gov/agent/arsine/casedef.asp, https://www.atsdr.cdc.gov/MMG/MMG.asp?id=1199&tid=278, Association of Military Surgeons of the US, Society of United States Air Force Flight Surgeons. It is considered a possible chemical agent in chemical warfare. 5. Interestingly, the oxidative cytotoxicity potential of arsenic has been used as treatment for certain malignant cancers. Chowdhury R, Chowdhury S, Roychoudhury P, Mandal C, Chaudhuri K. Arsenic induced apoptosis in malignant melanoma cells is enhanced by menadione through ROS generation, p38 signaling and p53 activation. Make sure your boat is naturally ventilated. In cases of contact with liquid (compressed gas), gently wash frosted skin with water; gently remove clothing from affected area. If hemolysis is present, the patient/victim must be observed up to 72 hours for signs of renal failure. the L.D.100. 2013. Method. Treatment of Arsine Poisoning . [Medline]. When the individual presents with symptoms of arsine gas exposure, this is usually also related to an occupational accident. Patient/victims with suspected arsine (SA) exposure should be monitored for hemolysis up to 24 hours. The chest radiograph showed peri-hilar congestive changes. Arsine is the gaseous and the most toxic form of the element, arsenic. Because of the possible danger of central nervous system damage caused by the injection of this compound into a vein, the percutaneous route of administration is to be preferred. In particular, paralytic shellfish poisoning and puffer fish poisoning can cause death within hours after consuming the toxins and may require immediate intensive care. Norepinephrine should be considered in cases of resistant shock. Hypotension should be addressed with infusion of normal saline or lactated Ringer solution. J Med Toxicol. Ocular exposures: Red staining of the conjunctiva may be an early sign of arsine poisoning. There are no published guidelines specific to the treatment of arsine poisoning during pregnancy. There’s no specific method used to treat arsenic poisoning. see more details, are treated with aluminium, while molten in order to purify them. OBJECTIVE: Severe acute arsine poisoning (SAAP) complicated by multiple organ dysfunction syndrome is a critical clinical illness. The prognosis of Naphthalene Poisoning is dependent on the amount of substance consumed, time between exposure and treatment, severity of the symptoms, as well as general health status of the patient If the individual can recover from the symptoms, with appropriate medication and prompt medical support, the outcome can be good. Chlorine poisoning is a medical emergency. Renal damage from industrial arsine poisoning. 2017 Dec. 70 (6):787-797. 2,3-dimercaptopropyl ethyl ether has been shown to be effective in the treatment of arsine poisoning in rabbits, monkeys and dogs when administered either intramuscularly or percutaneously. Four patients with acute arsine gas poisoning were admitted to the Sverdlovsk Regional Poisoning Treatment Centre during 2014–2015, three of them were involved into the same exposure. Contact us. [13, 14, 15, 16, 17] RBC-E and PE may have a synergistic effect with better outcome than RBC-E alone. Arsine toxicity aboard the Asiafreighter. The limited efficacy of conventional drug therapy prompted us to investigate the application of hybrid blood purification treatment (HBPT) to … Whole blood haemoglobin was 11 -7 g/100 ml with a plasma haemoglobin of 2-5 g/100 ml. OBJECTIVE: Severe acute arsine poisoning (SAAP) complicated by multiple organ dysfunction syndrome is a critical clinical illness. Arsenic poisoning is a medical condition that occurs due to elevated levels of arsenic in the body. Support zone personnel require no protective gear if the victim has been exposed only to arsine gas.