First aid of benzene poisoning
Benzene is an excellent solvent, which is aromatic and widely used in industry, but it contains toxicity. Therefore, when used improperly or carelessly, it will often lead to poisoning or injury to users. It is narcotic and volatile at room temperature, which will make people unconsciously poisoned.
Benzene is the raw material of styrene, which can be used to synthesize rubber, carbonic acid (the intermediate of nylon resistor), synthetic disinfectant and paint remover, so it is related to adhesive manufacturing, coatings, artistic glass, artificial leather, auto workers, dry batteries, disinfectants, electroplating, beauticians, paints, pencil manufacturing, soap, solvents, waxes, shoe factories, rubber, herbicides and furniture workers.
High concentration of toxic reaction can inhibit the central nervous system and cause acute anesthetic reaction, which is not specific and exclusive. Symptoms can change from slight dizziness, headache and excitement to respiratory paralysis, convulsion or death, and can also cause an obvious drunken behavior, which industrial technicians call "benzene cream tincture". The patient showed euphoria, unsteady gait and mental confusion. Usually, acute benzene anesthesia can be completely recovered, unless the concentration and time of exposure have caused lesions.
clinical symptoms
acute poisoning
Acute benzene poisoning occurs after exposure to a large amount of benzene vapor, and its consciousness and other symptoms include:
It's an honor. Excitement, sweating, palpitations. Excitement is followed by drowsiness, fatigue, dizziness, nausea, headache, listlessness and memory loss. Respiratory irritation and pulmonary edema.
Gastrointestinal irritation, including vomiting, abdominal cramps and loss of appetite.
The skin appears erythema, blisters and punctate bleeding.
suffer from insomnia
Dazed and nervous. Abnormal sensation in hands and feet, such as numbness, tingling and tingling. Stumbling. Incoherent words. Face flushed.
If it is exposed continuously, it may lead to unconsciousness or even death due to respiratory paralysis.
Eat sth by mistake
Local irritation of mouth, throat, esophagus and gastric mucosa. Bronchitis, pneumonia and collapse may occur.
diagnose
Occupational history: ask in detail about the occupations you have engaged in and the chemicals you may be exposed to? Length of stay in the workplace? Do you have similar symptoms with your colleagues in the workplace?
Symptoms of neurasthenia: Most patients initially feel easily tired, weak, listless, headache, dizziness and memory loss.
Leukopenia: The white blood cell test is usually lower than 4000/ m3 mm, so it has been confirmed that more tests are needed.
treat cordially
acute poisoning
When in the workplace, immediately remove the patient from the scene, transport him to a place with fresh air, take off the contaminated clothes, remove the skin pollution of the patient and keep him warm.
When breathing is difficult, give artificial respiration and oxygen inhalation.
Give respiratory stimulants.
Epinephrine and ephedrine are forbidden.
Intravenous injection of glucose and vitamin C combined injection.
Patients with glucuronic acid anemia can be treated with rapid blood transfusion.
Oral benzene poisoning, gastric lavage with 3% activated carbon suspension, oral magnesium sulfate laxative.
Diagnostic criteria for occupational benzene poisoning
Occupational acute benzene poisoning is a systemic disease mainly manifested by central nervous system inhibition caused by workers inhaling large doses of benzene vapor in a short period of time during occupational activities. Occupational chronic benzene poisoning refers to a systemic disease with hematopoietic system damage as the main manifestation caused by workers' long-term exposure to benzene vapor in occupational activities.
1 range
This standard specifies the diagnostic criteria, diagnostic writing format and treatment principles of occupational benzene poisoning.
This standard applies to the diagnosis and treatment of poisoning caused by exposure to benzene in occupational activities. This standard can be used for benzene poisoning caused by exposure to industrial toluene, xylene and other chemicals containing benzene. This standard can also be used for the diagnosis of benzene poisoning caused by exposure to benzene in non-professional activities.
2 diagnostic principles
The diagnosis of acute benzene poisoning is based on inhaling a large amount of high-concentration benzene vapor in a short time, and the clinical manifestations are conscious. Only by excluding the changes in the central nervous system caused by other diseases can acute benzene poisoning be diagnosed. According to the degree of consciousness disorder, it is divided into mild and severe.
The diagnosis of chronic benzene poisoning is based on the occupational history of long-term close contact with benzene. The main clinical manifestations are hematopoietic inhibition and abnormal proliferation. The diagnosis of chronic benzene poisoning can refer to the investigation of working environment and the measurement data of benzene concentration in the air on the spot, and make a comprehensive analysis to exclude the hemogram changes caused by other reasons. Chronic benzene poisoning is divided into three grades according to the series and degree of blood cell involvement and whether there is malignant transformation or not.
3 observation object
Workers exposed to benzene found one of the following changes in blood test, and those who did not improve every 1 ~ 2 weeks within 3 months and could not find other reasons could be listed as observation objects.
A) The fluctuation range of white blood cell count is 4×109 ~ 4.5×109/L (4000 ~ 4500/mm3);
B) The platelet count fluctuates between 60× 109 and 80×109/L (60,000-80,000/mm3);
C) The red blood cell count of male is lower than 4×1012/L (4 million /mm3) and that of female is lower than 3.5×10/2/L (3.5 million/mm3); The quantitative hemoglobin of male is lower than 120g/L( 12g/dL), and that of female is lower than110g/l (1g/dl).
D) The peripheral blood cell count increases, and naive or abnormal blood cells appear.
4 Diagnostic and grading criteria
4. 1 acute benzene poisoning
4. 1. 1 acute mild poisoning
Dizziness, headache, nausea, vomiting, excitement, stumbling and other drunken States may occur after inhaling high-concentration benzene vapor for a short time, and may be accompanied by symptoms of mucosal irritation. The increase of breath benzene, blood benzene and urine phenol can be used as indicators of benzene exposure.
4. 1.2 Acute severe poisoning
After inhaling high concentration benzene vapor, fidgety, confusion, coma, convulsion, blood pressure drop and even respiratory and circulatory failure occur. The measured values of breath benzene, blood benzene and urine phenol increased, which can be used as indicators of benzene exposure.
4.2 Chronic poisoning
4.2. 1 chronic mild poisoning
If the white blood cell count is continuously or basically lower than 4× 109/L(4000/mm3) or the neutrophil count is lower than 2× 109/L(2000/mm3), check it every 1 ~ 2 weeks within 3 months. Often appear dizziness, headache, fatigue, insomnia, memory loss and other symptoms.
4.2.2 Chronic moderate poisoning
Most of them have chronic mild poisoning symptoms and are prone to infection and/or bleeding. Meet one of the following conditions:
A) White blood cell count is lower than 4× 109/L(4000/mm3) or neutrophil is lower than 2× 109/L(2000/mm3), accompanied by platelet count lower than 60×109/L (60000/mm3).
B) White blood cell count is lower than 3× 109/L(3000/mm3) or neutrophil is lower than1.5×109/L (1500/mm3).
4.2.3 Chronic severe poisoning
One of the following situations occurs:
A) pancytopenia;
B) aplastic anemia;
C) myelodysplastic syndrome;
D) leukemia.
5 handling principle
5. 1 handling principle
5. 1. 1 acute poisoning
The poisoned patient should be moved to fresh air quickly, and the clothes contaminated by benzene should be taken off immediately, and the contaminated skin should be washed with soapy water to keep warm. You should stay in bed in the acute stage. The principle of first aid is the same as that of internal medicine. Glucuronic acid can be used instead of adrenaline.
5. 1.2 Chronic poisoning
There is no specific antidote, and the treatment is mainly symptomatic treatment of blood diseases caused by hematopoietic system injury.
5.2 Other treatment
5.2. 1 Acute poisoning: After mild poisoning is cured, you can generally rest for 3 ~ 7 days before working. The rest time of severe poisoning should depend on the degree of recovery.
5.2.2 Chronic poisoning: Once diagnosed, you should be transferred from the post where you are exposed to toxic substances such as benzene. During the illness, work or rest should be arranged according to the illness. Mild poisoning can generally be engaged in light work or part-time work; Moderate poisoning according to the condition, appropriate arrangements for rest; Severe poisoning completely stopped.
5.2.3 Observation object: According to the occupational contraindications, it should be transferred from benzene operation post.