Biological Studies of Combustion Atmospheres

1983 ◽  
Vol 1 (2) ◽  
pp. 118-144 ◽  
Author(s):  
D.A. Purser ◽  
W.D. Woolley

There is evidence supported by statistical information from fire deaths that many fire fatalities occur as a result of incapacitation of the victims by the toxic products given off during the early stages of fires, thereby preventing escape from the fire, rather than from direct exposure to heat or other factors. As an essential part of understanding these problems, a study has been made of the mechanisms of incapacitation resulting from exposures to atmospheres of ther mal decomposition products from polymeric materials. Under conditions ap proved by the Home Office Inspector, individual cynomolgus monkeys were ex posed to atmospheres increasing in separate experiments from very low smoke concentrations until early signs of physiological effects were detected. Measure ments were made of two kinds of physiological parameters: vital signs (respira tion, electrocardiography and respiratory blood gases) and parameters indicating effects on the nervous system (electroencephalography, auditory evoked poten tials, nerve conduction velocity). The atmospheres generated were designed to study the effects of hypoxia, hypercapnia, carbon monoxide, hydrogen cyanide and thermal decomposition products from wood, polyacrylonitrile, polyurethane foam, polypropylene, polystyrene and nylon produced under pyrolytic or ox idative conditions at a range of temperatures. The main findings were that the composition and hence the toxicity of the products from individual materials could vary considerably depending upon the different conditions of temperature and degree of oxygenation under which they were decomposed. However, despite the great complexity in chemical composition of the test atmospheres, the basic toxic effects on the animals were relatively simple, and for each in dividual atmosphere the toxicity was always dominated by one of these factors; carbon monoxide, hydrogen cyanide, or irritants. The role of each of these fac tors in causing incapacitation in real fires is discussed.

2019 ◽  
Vol 2 (1) ◽  
pp. 13-16
Author(s):  
Summiya Siddique Malik ◽  
Sadaf Saeed ◽  
Sumaira Kanwal

Objective: Study was conducted for 6 months in PIMS Hospital Islamabad. Data was collected on self-structured Questionnaire, Respiratory distress scoring, Objective tools of Arterial blood gases and vital signs with signed consent. Methodology: The subjects were randomly allocated in experimental and control groups. Baseline data was collected and re-collected on Day 0 and Day 7 respectively and assessed using non-probability convenient sampling technique. Both groups were given standard medical and nursing care. Results: The experimental group was given single treatment regimen i.e. Deep breathing exercises (with 5-10 repetitions of each DBE being possible onto patient for 15-30 minutes twice daily). The control group was given 10-15 cycles of ISM with prior steam inhalation and nebulization with salbutamol for a period of 15-20 minutes for 35-45 minutes twice daily for a period of 07 days. Conclusion: The experimental group results show that deep breathing exercises are significantly effective in improving post burn complications like pneumonia in patients suffering from second degree inhalation burns.


PEDIATRICS ◽  
1976 ◽  
Vol 58 (2) ◽  
pp. 177-183
Author(s):  
Edward S. Ogata ◽  
George A. Gregory ◽  
Joseph A. Kitterman ◽  
Roderic H. Phibbs ◽  
William H. Tooley

We determined the incidence of pneumothorax in 295 infants (mean birthweight, 1,917 gm) with the respiratory distress syndrome (RDS) treated according to the same protocol. Fifty-five infants (mean birthweight, 1,594 gm) developed pneumothorax (incidence, 19%); incidence varied with severity of RDS and intensity of respiratory assistance. Pneumothorax occurred in 3.5% (2 of 58) of infants who received no assisted ventilation and in 11% (14 of 124) of infants who received continuous positive airway pressure (CPAP) as the only form of assisted ventilation; the difference between these two groups is not significant. Forty-nine infants initially treated with CPAP later required mechanical ventilation with positive end-expiratory pressure (PEEP). Pneumothorax occurred in 12 of the 49 (24%) and in 21 of 64 (33%) of those infants initially treated with PEEP; the incidence of pneumothorax for both these groups was significantly higher than for those treated with no assisted ventilation or CPAP only. To assess the value of frequent measurement of vital signs, blood gas tensions, and pH in the recognition of pneumothorax, we analyzed these variables by the cumulative sum statistical technique. We noted the following significant changes associated with pneumothorax: arterial blood pressure, heart rate, and respiratory rate decreased in 77% of cases; pulse pressure narrowed in 51% of cases; Po2 decreased in 17 of 20 cases in which ventilatory settings were constant for at least three hours prior to pneumothorax. However, pH and PCO2 showed no consistent changes. Frequent measurements of vital signs and Po2 aid in the early diagnosis of pneumothorax.


2019 ◽  
Author(s):  
Stephanie T Weiss ◽  
Kathryn W Weibrecht

This review looks at the potential causes, diagnoses, and possible treatments for three asphyxiant gases: carbon monoxide, hydrogen cyanide, and hydrogen sulfide, Exposure to these gases can lead to central nervous system depression, unconsciousness, and death due to tissue hypoxia. These gases are among the most common causes of fatalities related to toxic gas poisoning, with carbon monoxide responsible for 36% and hydrogen sulfide 7.7%. It is necessary to remove victims affected by poisoning immediately from the source of the toxic gas, administer oxygen, and assess their stability. As symptoms of these gases can differ widely, ranging from broad and unspecific to highly morbid, and may require different levels of care, the correct diagnosis should also rely on inferences from the patient history and the context of the admission, including evidence of fire and chemical reactions. Normobaric oxygen and hyperbaric oxygen are the two main treatments for carbon monoxide, although studies have been inconclusive in regards to the effectiveness of hyperbaric oxygen. The Cyanokit (containing hydroxocobalamin) is considered to be more effective for hydrogen cyanide when compared with the Cyanide Antidote Kit due to the former’s low toxicity and high effectiveness. Hydrogen sulfide is often used as a suicide agent, the mortality of which is close to 100%. Figures show the mechanisms by which the asphyxiant gases carry out their negative effects on the human body. Tables show the half-life of carboxyhemoglobin with oxygen therapy and a comparison between the Cyanide Antidote Kit and the Cyanokit. This review contains 3 figures, 13 tables, and 44 references.  Keywords: Inhalation, poisoning, carbon monoxide, cyanide, methemoglobin, carboxyhemoglobin, hydrogen sulfide, smoke


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Federico Piccioni ◽  
◽  
Andrea Droghetti ◽  
Alessandro Bertani ◽  
Cecilia Coccia ◽  
...  

Abstract Introduction Anesthetic care in patients undergoing thoracic surgery presents specific challenges that require a multidisciplinary approach to management. There remains a need for standardized, evidence-based, continuously updated guidelines for perioperative care in these patients. Methods A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, was established to develop recommendations for anesthesia practice in patients undergoing elective lung resection for lung cancer. The project addressed three key areas: preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventive Services Task Force criteria. Results Recommendations for intraoperative care focus on airway management, and monitoring of vital signs, hemodynamics, blood gases, neuromuscular blockade, and depth of anesthesia. Recommendations for postoperative care focus on the provision of multimodal analgesia, intensive care unit (ICU) care, and specific measures such as chest drainage, mobilization, noninvasive ventilation, and atrial fibrillation prophylaxis. Conclusions These recommendations should help clinicians to improve intraoperative and postoperative management, and thereby achieve better postoperative outcomes in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Qianshen Zhang ◽  
Jason Macartney ◽  
Lita Sampaio ◽  
Karel O'Brien

Objective. To review experience of the transport and stabilization of infants with CDH who were treated with high frequency jet ventilation (HFJV).Study Design. Retrospective chart review was performed of infants with antenatal diagnosis of CDH born between 2004 and 2009, at Mount Sinai Hospital Toronto, Ontario, Canada. Detailed information was abstracted from the charts of all infants who received HFJV.Results. Of the 55 infants, 25 were managed with HFJV at some point during resuscitation and stabilization prior to transport. HFJV was the initial ventilation mode in six cases and nineteen infants were placed on HFJV as rescue therapy. Blood gases procured from the umbilical artery before and/or after the initiation of HFJV. There was a significant difference detected for both PaCO2(P=0.0002) and pH (P<0.0001). The pre- and posttransport vital signs remained stable and no transport related deaths or significant complications occurred.Conclusion. HFJV appears to be safe and effective providing high frequency rescue therapy for infants with CDH failing conventional mechanical ventilation. This paper supports the decision to utilize HFJV as it likely contributed to safe transport of many infants that would not otherwise have tolerated transport to a surgical centre.


1993 ◽  
Vol 19 (3) ◽  
pp. 540-543
Author(s):  
Makoto Akiyoshi ◽  
Satoru Hisaki ◽  
Takashi Fukuda ◽  
Eiji Obata ◽  
Koji Ando

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