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 Printable version |
Update on poisoning from smoke inhalation |
Environnement, Risques & Santé. Volume 1, Number 4, 241-9, Septembre - Octobre 2002, Synthèses
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 Résumé
Article gratuit
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Author(s) : BRUNO MEGARBANE, DJAMILA CHAIBA, FREDERIC BAUD |
Summary : Smoke inhalation causes systemic and mucosal toxicity due to the asphyxiant and irritant properties of toxic gases produced during combustion in fires. The most important are carbon monoxide (CO) and cyanide (CN), which cause a syndrome of oxygen deprivation and gas poisoning. The precise role of other toxic gases is still unclear. Transitory loss of consciousness or coma may result from the inhalation of either CO or CN. Apnea, significant lactic acidosis and severe cardiovascular disturbances are consistent with smoke inhalation induced-CN poisoning. CO concentration in the blood, measured from samples obtained at the fire scene, correlates well with the severity of clinical disorders. A plasma lactate concentration 6 10 mmol/L is a sensitive and specific marker of CN poisoning. Irritant gas poisoning causes ocular and/or respiratory mucosal injuries. These complications are diagnosed by clinical examination, completed with various specific tests. Dysphonia is always a sign of severe poisoning. The clinical course of victims without burns may be marked by delayed or late-onset respiratory and/or neurological complications. Symptomatic treatment involves primarily oxygen administration and treatment of acute respiratory failure. Tracheal intubation should be considered in patients with early dysphonia and dyspnea. Hyperbaric oxygen should be considered depending on the severity of oxygen deprivation in tissues and asphyxiant gas poisoning. Hydroxocobalamin is a safe and effective first-line antidote for cyanide poisoning. |
Keywords : smoke inhalation injury ; carbon monoxide poisoning ; cyanides ; oxygen inhalation therapy. |
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