Preventing Carbon Monoxide Poisoning Fact Sheet

Total Page:16

File Type:pdf, Size:1020Kb

Preventing Carbon Monoxide Poisoning Fact Sheet January 2009 Preventing Carbon Monoxide Poisoning Information for Older Adults and Their Caregivers o you know that from being absorbed into the carbon monoxide body, which can damage tissues (CO) is the most and result in death.3 common cause of Dpoisoning death in the United What Are the States? Unintentional CO poisonings are responsible for Symptoms of CO about 500 deaths and 15,000 Poisoning? visits to emergency rooms For most people, the first Fact Fact Sheet annually. Older adults over signs of exposure to low 65 years of age are especially concentrations of CO vulnerable to unintentional include mild headache and CO poisoning due to their breathlessness upon moderate high frequency of pre-existing exercise. Continued or acute Everyone is at medical conditions.1 While CO exposure can lead to flu-like risk of being alarms can save lives, fewer symptoms including more than one third of American severe headaches, dizziness, poisoned by carbon homes have them installed.2 tiredness, nausea, confusion, monoxide exposure. irritability, and impaired judgment, memory and Older adults What Is Carbon coordination.4 CO is called the Monoxide (CO)? with pre-existing “silent killer” because if these CO is an odorless, colorless early signs are ignored, a person conditions, such gas that can cause illness and may lose consciousness and be as chronic heart death. It is produced whenever unable to escape the danger. any fuel such as natural gas, disease, anemia, propane, gasoline, oil, kerosene, You May Be Symptom or respiratory wood or charcoal is burned. Devices that produce CO include Free and Still Exposed problems, are even cars, boats, gasoline engines, to Unsafe CO Levels more susceptible stoves and heating systems. CO Breathing low concentrations of from these sources can build up CO may not result in obvious to the effects of this in enclosed or semi-enclosed symptoms of CO poisoning, odorless, colorless spaces. When people inhale yet exposure to low levels CO, the toxic gas enters the of CO can cause long-term gas. bloodstream and blocks oxygen health damage, even after the CO source is removed. These health effects victims and 40% of black victims became include long-term neurological damage such as poisoned as a result of indoor burning of learning and memory impairments, emotional charcoal briquettes.10 and personality effects, and sensory and motor disorders.5 If You Experience Symptoms You Think Could Be from CO Who Is at Risk from CO Poisoning: Poisoning? n Get fresh air immediately. Open doors and People of all ages are at risk for CO poisoning. windows and turn off stoves, ovens, heaters Persons living with chronic heart disease, and similar appliances and leave the house. anemia, or respiratory problems are more n susceptible to its effects.6 Older adults more Call a poison center immediately at 1-800- frequently have these pre-existing conditions, 222-1222. The poison experts there will let which lower their tolerance and increase the you know if you need to seek further medical risk of a fatal exposure.7 CO poisoning can attention. also be highly dangerous for unborn children, greatly increasing the risk of fetal death and To Prevent CO Poisoning, developmental disorders.8, 9 Remember I CAN B: More Common among Minorities n Install CO alarms near sleeping areas. n Check heating systems and fuel-burning A study conducted in Washington State among appliances annually. minority populations showed that Hispanic populations had a four times greater risk and n Avoid the use of non-vented combustion black populations had a three times greater appliances. risk than white populations for CO poisoning. n Never burn fuels indoors except in devices The most common source of CO poisoning such as stoves or furnaces that are made for among those populations was burning charcoal safe use. briquettes. Approximately 66% of Hispanic n Be Attentive to possible symptoms of CO poisoning. Other Tips for Preventing CO Poisoning: Red n Keep gas appliances properly adjusted. Blood n Consider purchasing a vented space heater Cell Oxygen when replacing a non-vented one. n Use proper fuel in kerosene space heaters. n Install and use an exhaust fan vented to the outdoors over gas stoves. n Open flues when using the fireplace. Carbon n Choose properly-sized wood stoves that are Oxygen Oxygen Monoxide certified to meet EPA emission standards. (vital to life) (deadly fumes) Ensure wood stove doors fit tightly. n Have your heating system and chimney inspected and cleaned by a qualified technician annually. n Make sure all interior fuel-burning appliances are in good condition and have proper How to Tell the Difference ventilation. between CO Poisoning n Never idle the car in the garage, even if the garage door is open to the outside. and the Flu n Use portable generators outside and far Since many of the symptoms of away from buildings. Never use portable CO poisoning are similar to those generators on balconies or near doors, vents of the flu, you may not think that or windows. Never use portable generators CO poisoning could be the cause. near to where you sleep or your family Symptoms could be the result of sleeps. CO poisoning when: n Never use a charcoal grill indoors, even in a n You feel better when you are fireplace. away from your home. n Propane heaters or heaters using other n More than one person in the home fuels placed in enclosed hunting and fishing gets sick at the same time (it shanties, should be vented to the outside. usually takes several days for the n Never heat your home with a gas oven. flu to pass from person to person). n Family members who are most affected spend the most time in Carbon Monoxide Alarms the home. n Symptoms occur or get worse shortly after turning on a fuel- burning device or running a vehicle in an attached garage. n Indoor pets also appear ill, exhibiting symptoms such as drowsiness and lethargy (human flu viruses are not transmitted to battery operated pets). electric plug-in wall/ceiling unit n Generalized aching, low-grade fever, or swollen lymph nodes (these are typical of a cold CO Alarms or flu).12 Half of all unintentional CO poisoning deaths could be prevented with the use of CO alarms. Alarms should be Underwriters Laboratories (UL) approved and are generally available at local hardware stores.11 The cost is minimal Don’t let buying a CO alarm lull you into a and in view of the possibility that it may save false sense of security. CO alarms should only the lives of you and your family it is a bargain. be considered a back-up for proper use and Install a CO alarm on every floor of your home maintenance of your fuel-burning appliances. and within hearing range of each sleeping area. CO alarms are not designed for low-level CO Carefully follow manufacturers’ instructions for monitoring and there have been questions their placement, use, and maintenance. Unlike about whether CO alarm standards are smoke alarms, CO alarms may expire after protective enough, especially for sensitive groups several years. such as older adults.13 4 The U.S. Environmental Protection Agency (EPA), Indoor Aging Adults and Environmental Environments Division (6607J) Office of Air and Radiation, Health Issues “Protect Your Family and Yourself from Carbon Monoxide Poisoning,” October 1996. http://www.epa.gov/iaq/pubs/ EPA’s Aging Initiative is working to protect the coftsht.html health of older adults from environmental 5 Delayed Neuropathology after Carbon Monoxide hazards through risk management and Poisoning Is Immune-Mediated, Stephen R. Thom, Veena prevention strategies, education and research. M. Bhopale, Donald Fisher, Jie Zhang, Phyllis Gimotty and Robert E. Forster, Proceedings of the National Academy of For more information about EPA’s Aging Sciences of the United States of America, Vol. 101, No. 37 Initiative, visit www.epa.gov/aging (Sep. 14, 2004), pp. 13660-13665. Printed copies of this fact sheet can be ordered EPA. 2000. Air Quality Criteria for Carbon Monoxide. at: http://www.epa.gov/aging/resources/ U.S.EPA, National Center for Environmental Assessment. June, 2000. EPA 600/P-99/001F. factsheets/order.htm 6 Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, “Carbon Additional Resources Monoxide Poisoning: Questions and Answers,” July 2006. http://www.cdc.gov/co/faqs.htm Your Local Poison Center 7 CPSC. 2004. Non-Fire Carbon Monoxide Deaths n 1-800-222-1222 Associated with the Use of Consumer Products: 2001 Annual Estimates. U.S. Consumer Product Safety n Internet: www.aapcc.org Commission, Division of Hazard Analysis, May 13, 2004. 8 Raub, J. A., M. MathieuNolf, N. B. Hampson, and S. U.S. Environmental Protection Agency R. Thom. Carbon Monoxide Poisoning - a Public Health Carbon Monoxide Perspective. TOXICOLOGY (145):1-14, (2000).) http://www.epa.gov/iaq/co.html 9 Liu, S. Krewski, D., Shi, Y, Chen, Y, and R.T. Burnett. 2003. Association between gaseous ambient air pollutants CDC and adverse pregnancy outcomes in Vancouver, Canada. Environmental Health Perspectives. 111:1773-1778. Carbon Monoxide 10 Ralston, J.D. and N.B. Hampson. 2000. Incidence of http://www.cdc.gov/co/ severe unintentional carbon monoxide poisoning differs across racial/ethnic categories. Public Health Reports. Consumer Product Safety Commission 115:46-51. U.S. Department of Health and Human Services. Home Heating Equipment Safety 11 Yoon, S., Macdonald, S., Parrish, G. 1998. Deaths from unintentional carbon monoxide poisoning and potential for www.cpsc.gov/cpscpub/pubs/heatpubs.html prevention with carbon monoxide detectors. JAMA. 279(9): 685-687 Carbon Monoxide Alarms 12 U.S.
Recommended publications
  • Hypothermia Brochure
    Visit these websites for more water safety and hypothermia prevention in- formation. What is East Pierce Fire & Rescue Hypothermia? www.eastpiercefire.org Hypothermia means “low temperature”. Washington State Drowning When your body is exposed to cold tem- Prevention Coalition Hypothermia www.drowning-prevention.org perature, it tries to protect itself by keeping a normal body temperature of 98.6°F. It Children’s Hospital & tries to reduce heat loss by shivering and Regional Medical Center In Our Lakes moving blood from your arms and legs to www.seattlechildrens.org the core of your body—head, chest and and Rivers abdomen. Hypothermia Prevention, Recognition and Treatment www.hypothermia.org Stages of Hypothermia Boat Washington Mild Hypothermia www.boatwashington.org (Core body temperature of 98.6°— 93.2°F) Symptoms: Shivering; altered judg- ment; numbness; clumsiness; loss of Boat U.S. Foundation dexterity; pain from cold; and fast www.boatus.com breathing. Boat Safe Moderate Hypothermia www.boatsafe.com (Core body temperature of 93.2°—86°F) Symptoms: Semiconscious to uncon- scious; shivering reduced or absent; lips are blue; slurred speech; rigid n in muscles; appears drunk; slow Eve breathing; and feeling of warmth can occur. mer! Headquarters Station Sum Severe Hypothermia 18421 Old Buckley Hwy (Core body temperature below 86°F) Bonney Lake, WA 98391 Symptoms: Coma; heart stops; and clinical death. Phone: 253-863-1800 Fax: 253-863-1848 Email: [email protected] Know the water. Know your limits. Wear a life vest. By choosing to swim in colder water you Waters in Western Common Misconceptions Washington reduce your survival time.
    [Show full text]
  • Manganese and Its Compounds: Environmental Aspects
    This report contains the collective views of an international group of experts and does not necessarily represent the decisions or the stated policy of the United Nations Environment Programme, the International Labour Organization, or the World Health Organization. Concise International Chemical Assessment Document 63 MANGANESE AND ITS COMPOUNDS: ENVIRONMENTAL ASPECTS First draft prepared by Mr P.D. Howe, Mr H.M. Malcolm, and Dr S. Dobson, Centre for Ecology & Hydrology, Monks Wood, United Kingdom The layout and pagination of this pdf file are not identical to the document in print Corrigenda published by 12 April 2005 have been incorporated in this file Published under the joint sponsorship of the United Nations Environment Programme, the International Labour Organization, and the World Health Organization, and produced within the framework of the Inter-Organization Programme for the Sound Management of Chemicals. World Health Organization Geneva, 2004 The International Programme on Chemical Safety (IPCS), established in 1980, is a joint venture of the United Nations Environment Programme (UNEP), the International Labour Organization (ILO), and the World Health Organization (WHO). The overall objectives of the IPCS are to establish the scientific basis for assessment of the risk to human health and the environment from expos ure to chemicals, through international peer review processes, as a prerequisite for the promotion of chemical safety, and to provide technical assistance in strengthening national capacities for the sound management
    [Show full text]
  • HISTORY of LEAD POISONING in the WORLD Dr. Herbert L. Needleman Introduction the Center for Disease Control Classified the Cause
    HISTORY OF LEAD POISONING IN THE WORLD Dr. Herbert L. Needleman Introduction The Center for Disease Control classified the causes of disease and death as follows: 50 % due to unhealthy life styles 25 % due to environment 25% due to innate biology and 25% due to inadequate health care. Lead poisoning is an environmental disease, but it is also a disease of life style. Lead is one of the best-studied toxic substances, and as a result we know more about the adverse health effects of lead than virtually any other chemical. The health problems caused by lead have been well documented over a wide range of exposures on every continent. The advancements in technology have made it possible to research lead exposure down to very low levels approaching the limits of detection. We clearly know how it gets into the body and the harm it causes once it is ingested, and most importantly, how to prevent it! Using advanced technology, we can trace the evolution of lead into our environment and discover the health damage resulting from its exposure. Early History Lead is a normal constituent of the earth’s crust, with trace amounts found naturally in soil, plants, and water. If left undisturbed, lead is practically immobile. However, once mined and transformed into man-made products, which are dispersed throughout the environment, lead becomes highly toxic. Solely as a result of man’s actions, lead has become the most widely scattered toxic metal in the world. Unfortunately for people, lead has a long environmental persistence and never looses its toxic potential, if ingested.
    [Show full text]
  • Highly Selective Addition of Organic Dichalcogenides to Carbon-Carbon Unsaturated Bonds
    Highly Selective Addition of Organic Dichalcogenides to Carbon-Carbon Unsaturated Bonds Akiya Ogawa and Noboru Sonoda Department of Applied Chemistry, Faculty of Engineering, Osaka University, Abstract: Highly chemo-, regio- and/or stereoselective addition of organic dichalcogenides to carbon-carbon unsaturated bonds has been achieved based on two different methodologies for activation of the chalcogen-chalcogen bonds, i.e., by the aid of transition metal catalysts and by photoirradiation. The former is the novel transition metal-catalyzed reactions of organic dichalcogenides with acetylenes via oxidative addition of dichalcogenides to low valent transition metal complexes such as Pd(PPh3)4. The latter is the photoinitiated radical addition of organic dichalcogenides to carbon-carbon unsaturated bonds via homolytic cleavage of the chalcogen-chalcogen bonds to generate the corresponding chalcogen-centered radicals as the key species. 1. Introduction The clarification of the specific chemical properties of heteroatoms and the development of useful synthetic reactions based on these characteristic features have been the subject of continuing interest (ref. 1). This paper deals with new synthetic methods for introducing group 16 elements into organic molecules, particularly, synthetic reactions based on the activation of organic dichalcogenides, i.e., disulfides, diselenides, and ditellurides, by transition metal catalysts and by photoirradiation. In transition metal-catalyzed reactions, metal sulfides (RS-ML) are formed as the key species, whereas the thiyl radicals (ArS•E) play important roles in photoinitiated reactions. These species exhibit different selectivities toward the addition process to carbon-carbon unsaturated compounds. The intermediates formed in situ by the addition, i.e., vinylic metals and vinylic radicals, could successfully be subjected to further manipulation leading to useful synthetic transformations.
    [Show full text]
  • Cyanide Poisoning and How to Treat It Using CYANOKIT (Hydroxocobalamin for Injection) 5G
    Cyanide Poisoning and How to Treat It Using CYANOKIT (hydroxocobalamin for injection) 5g 1. CYANOKIT (single 5-g vial) [package insert]. Columbia, MD: Meridian Medical Technologies, Inc.; 2011. Please see Important Safety Information on slides 3-4 and full Prescribing Information for CYANOKIT starting on slide 33. CYANOKIT is a registered trademark of SERB Sarl, licensed by Meridian Medical Technologies, Inc., a Pfizer company. Copyright © 2015 Meridian Medical Technologies, Inc., a Pfizer company. All rights reserved. CYK783109-01 November/2015. Indication and Important Safety Information……………………………………………………………………………….………..…..3 . Identifying Cyanide Poisoning……………………………………………………………………………………………………………….…………….….5 . How CYANOKIT (hydroxocobalamin for injection) Works……………………………………………………………….12 . The Specifics of CYANOKIT…………………………………………………………………………………………………………………………….………17 . Administering CYANOKIT………………………………………………………………………………………………………………………………..……….21 . Storage and Disposal of CYANOKIT…................................................................................................................................26 . Grant Information for CYANOKIT……………………………………………………………………………………………………………………....30 . Full Prescribing Information………………………………………………………………………………………………….………………………………33 Please see Important Safety Information on slides 3-4 and full Prescribing Information for CYANOKIT starting on slide 33. CYANOKIT (hydroxocobalamin for injection) 5 g for intravenous infusion is indicated for the treatment of known or suspected cyanide poisoning.
    [Show full text]
  • Poisoning (Pdf)
    n Poisoning n What puts your child at risk Poisoning is a common and often serious emer- gency in children. Poisoning most often occurs of poisoning? when toddlers and preschoolers find poisons in Crawling infants and toddlers are at highest risk! Most the home and eat or drink them. If you have an poisonings occur in children under age 5. infant or toddler, you need to “poison-proof” your home and make a plan for what to do if poisoning Poisoning is much less common at ages 6 and older. occurs. Teenagers may poison themselves in suicide attempts or while attempting to get “high.” Not poison-proofing your home! Ninety percent of poisonings in children occur at home. What types of poisoning occur in children? How can poisoning be prevented? The average home contains many products that could Poison-proof your home by putting away all medicines, cause poisoning in a young child. Many common medica- household cleaners, and other possible poisons. All of tions can be harmful when taken in large doses. Infants these products should be locked up or put away where and toddlers are at risk of poisoning because they love to your child cannot see or find them. (Remember, toddlers explore their environment and will put almost anything in love to climb!) their mouths. Teach your child never to put anything but food or drink “ ! If you have an infant or toddler, it is essential to poison- into his or her mouth. Never tell your child that medicine ” proof your home so that your child cannot find and eat is “candy.” or drink anything harmful.
    [Show full text]
  • WHO Guidance on Management of Snakebites
    GUIDELINES FOR THE MANAGEMENT OF SNAKEBITES 2nd Edition GUIDELINES FOR THE MANAGEMENT OF SNAKEBITES 2nd Edition 1. 2. 3. 4. ISBN 978-92-9022- © World Health Organization 2016 2nd Edition All rights reserved. Requests for publications, or for permission to reproduce or translate WHO publications, whether for sale or for noncommercial distribution, can be obtained from Publishing and Sales, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi-110 002, India (fax: +91-11-23370197; e-mail: publications@ searo.who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
    [Show full text]
  • The Hazards of Nitrogen Asphyxiation US Chemical Safety and Hazard Investigation Board
    The Hazards of Nitrogen Asphyxiation US Chemical Safety and Hazard Investigation Board Introduction • Nitrogen makes up 78% of the air we breath; because of this it is often assumed that nitrogen is not hazardous. • However, nitrogen is safe to breath only if it is mixed with an appropriate amount of oxygen. • Additional nitrogen (lower oxygen) cannot be detected by the sense of smell. Introduction • Nitrogen is used commercially as an inerting agent to keep material free of contaminants (including oxygen) that may corrode equipment, present a fire hazard, or be toxic. • A lower oxygen concentration (e.g., caused by an increased amount of nitrogen) can have a range of effects on the human body and can be fatal if if falls below 10% Effects of Oxygen Deficiency on the Human Body Atmospheric Oxygen Concentration (%) Possible Results 20.9 Normal 19.0 Some unnoticeable adverse physiological effects 16.0 Increased pulse and breathing rate, impaired thinking and attention, reduced coordination 14.0 Abnormal fatigue upon exertion, emotional upset, faulty coordination, poor judgment 12.5 Very poor judgment and coordination, impaired respiration that may cause permanent heart damage, nausea, and vomiting <10 Inability to move, loss of consciousness, convulsions, death Source: Compressed Gas Association, 2001 Statistics on Incidents CSB reviewed cases of nitrogen asphyxiation that occurred in the US between 1992 and 2002 and determined the following: • 85 incidents of nitrogen asphyxiation resulted in 80 deaths and 50 injuries. • The majority of
    [Show full text]
  • Carbon Monoxide (CO), Known As the Invisible Killer, Is a Colorless
    FACT SHEET Program: Fire Equipment & Systems CARBON MONOXIDE DETECTORS – RESIDENTIAL UNITS Carbon monoxide (CO), known as the Invisible Killer, is a colorless, odorless, poisonous gas that results from incomplete burning of fuels such as natural gas, propane, oil, wood, coal, and gasoline. Exposure to carbon monoxide can cause flu-like symptoms and can be fatal. Residential buildings that contain fossil burning fuel equipment (i.e., oil, gas, wood, coal, etc.) or contain enclosed parking are required to have carbon monoxide detectors. What are the symptoms of CO poisoning? CO poisoning victims may initially suffer flu-like symptoms including nausea, fatigue, headaches, dizziness, confusion and breathing difficulty. Because CO poisoning often causes a victim's blood pressure to rise, the victim's skin may take on a pink or red cast. How does CO affect the human body? When victims inhale CO, the toxic gas enters the bloodstream and replaces the oxygen molecules found on the critical blood component - hemoglobin, depriving the heart and brain of the oxygen necessary to function. Mild exposure: Often described as flu-like symptoms, including slight headache, nausea, vomiting, fatigue. Medium exposure: Severe throbbing headache, drowsiness, confusion, fast heart rate. Extreme exposure: Unconsciousness, convulsions, cardio respiratory failure, death. Many cases of reported carbon monoxide poisoning indicate that while victims are aware they are not well, they become so disoriented, that they are unable to save themselves by either exiting the building or calling for assistance. Young children and household pets are typically the first affected. If you think you have symptoms of carbon monoxide poisoning or your CO alarm is sounding, contact the Fire Department (911) or University Operations Center (5-5560) and leave the building immediately.
    [Show full text]
  • Acute Poisoning: Understanding 90% of Cases in a Nutshell S L Greene, P I Dargan, a L Jones
    204 REVIEW Postgrad Med J: first published as 10.1136/pgmj.2004.027813 on 5 April 2005. Downloaded from Acute poisoning: understanding 90% of cases in a nutshell S L Greene, P I Dargan, A L Jones ............................................................................................................................... Postgrad Med J 2005;81:204–216. doi: 10.1136/pgmj.2004.024794 The acutely poisoned patient remains a common problem Paracetamol remains the most common drug taken in overdose in the UK (50% of intentional facing doctors working in acute medicine in the United self poisoning presentations).19 Non-steroidal Kingdom and worldwide. This review examines the initial anti-inflammatory drugs (NSAIDs), benzodiaze- management of the acutely poisoned patient. Aspects of pines/zopiclone, aspirin, compound analgesics, drugs of misuse including opioids, tricyclic general management are reviewed including immediate antidepressants (TCAs), and selective serotonin interventions, investigations, gastrointestinal reuptake inhibitors (SSRIs) comprise most of the decontamination techniques, use of antidotes, methods to remaining 50% (box 1). Reductions in the price of drugs of misuse have led to increased cocaine, increase poison elimination, and psychological MDMA (ecstasy), and c-hydroxybutyrate (GHB) assessment. More common and serious poisonings caused toxicity related ED attendances.10 Clinicians by paracetamol, salicylates, opioids, tricyclic should also be aware that severe toxicity can result from exposure to non-licensed pharmaco-
    [Show full text]
  • Clinical Management of Severe Acute Respiratory Infections When Novel Coronavirus Is Suspected: What to Do and What Not to Do
    INTERIM GUIDANCE DOCUMENT Clinical management of severe acute respiratory infections when novel coronavirus is suspected: What to do and what not to do Introduction 2 Section 1. Early recognition and management 3 Section 2. Management of severe respiratory distress, hypoxemia and ARDS 6 Section 3. Management of septic shock 8 Section 4. Prevention of complications 9 References 10 Acknowledgements 12 Introduction The emergence of novel coronavirus in 2012 (see http://www.who.int/csr/disease/coronavirus_infections/en/index. html for the latest updates) has presented challenges for clinical management. Pneumonia has been the most common clinical presentation; five patients developed Acute Respira- tory Distress Syndrome (ARDS). Renal failure, pericarditis and disseminated intravascular coagulation (DIC) have also occurred. Our knowledge of the clinical features of coronavirus infection is limited and no virus-specific preven- tion or treatment (e.g. vaccine or antiviral drugs) is available. Thus, this interim guidance document aims to help clinicians with supportive management of patients who have acute respiratory failure and septic shock as a consequence of severe infection. Because other complications have been seen (renal failure, pericarditis, DIC, as above) clinicians should monitor for the development of these and other complications of severe infection and treat them according to local management guidelines. As all confirmed cases reported to date have occurred in adults, this document focuses on the care of adolescents and adults. Paediatric considerations will be added later. This document will be updated as more information becomes available and after the revised Surviving Sepsis Campaign Guidelines are published later this year (1). This document is for clinicians taking care of critically ill patients with severe acute respiratory infec- tion (SARI).
    [Show full text]
  • TOXICOLOGY and EXPOSURE GUIDELINES ______(For Assistance, Please Contact EHS at (402) 472-4925, Or Visit Our Web Site At
    (Revised 1/03) TOXICOLOGY AND EXPOSURE GUIDELINES ______________________________________________________________________ (For assistance, please contact EHS at (402) 472-4925, or visit our web site at http://ehs.unl.edu/) "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy." This early observation concerning the toxicity of chemicals was made by Paracelsus (1493- 1541). The classic connotation of toxicology was "the science of poisons." Since that time, the science has expanded to encompass several disciplines. Toxicology is the study of the interaction between chemical agents and biological systems. While the subject of toxicology is quite complex, it is necessary to understand the basic concepts in order to make logical decisions concerning the protection of personnel from toxic injuries. Toxicity can be defined as the relative ability of a substance to cause adverse effects in living organisms. This "relative ability is dependent upon several conditions. As Paracelsus suggests, the quantity or the dose of the substance determines whether the effects of the chemical are toxic, nontoxic or beneficial. In addition to dose, other factors may also influence the toxicity of the compound such as the route of entry, duration and frequency of exposure, variations between different species (interspecies) and variations among members of the same species (intraspecies). To apply these principles to hazardous materials response, the routes by which chemicals enter the human body will be considered first. Knowledge of these routes will support the selection of personal protective equipment and the development of safety plans. The second section deals with dose-response relationships.
    [Show full text]