Carbon monoxide: modern concepts to the treatment of acute poisonings (literature review)

2021 ◽  
Vol 29 (5) ◽  
pp. 17-24
Author(s):  
Aleksandr Nikolaevich Grebenyuk ◽  
Vladimir Nikolaevich Bykov
Keyword(s):  
Carbon Monoxide ◽  
Medical Care ◽  
Rapid Development ◽  
First Aid ◽  
The Body ◽  
Toxic Encephalopathy ◽  
Bibliographic Databases ◽  
Symptomatic Therapy ◽  
Co Poisoning ◽  
Oxygen Inhalation

Introduction. Carbon monoxide (CO) is one of the most common causes of chemical injuries and the main toxic factor in the people death in fires. The mechanism of the toxic effect of CO, associated with the formation of carboxyhemoglobin and the development of hypoxia, determines the rapid development of the clinical picture of acute intoxication and the need for emergency first aid and medical care to the poisoned. Material and methods. Literature sources, summarized in the bibliographic databases eLIBRARY.RU, PubMed and Scopus, were the material for analysis. Results. First aid is based on quickly removing the victim from the fire zone or other area with a high concentration of CO and providing him with oxygen as soon as possible. During medical evacuation, it is necessary to carry out continuous inhalation of 80-100% oxygen, to ensure rest and warmth of the victim. In the emergency department of the hospital, oxygen inhalation and maintenance therapy should be continued, clinical and laboratory diagnostic measures aimed at assessing the severity of intoxication, identifying complications and concomitant pathology should be performed. In the case of severe CO poisoning, medical care continues to be provided to the victims in the intensive care unit or in the oxygen-barotherapy unit. The main antidote for CO poisoning is oxygen, which can be used in two versions - normobaric or hyperbaric oxygenation. As a pharmacological antidote to CO, zinc bisvinylimidazole diacetate (acizol) which can accelerate the breakdown of carboxyhemoglobin, improve the oxygen-binding and gas-transport properties of blood, as well as the dissociation of oxyhemoglobin in tissues is used. Along with antidotes, an important role in the treatment of CO poisoning is played by pathogenetic and symptomatic therapy aimed at the prevention and treatment of toxic encephalopathy, brain edema, cognitive dysfunction, toxic myocardiodystrophy and arrhythmia, prevention of pneumonia, correction of the acid-base state, compensation of the energy needs of the body, etc. Conclusion. Further improvement of existing means and methods for the treatment of intoxication, the development and introduction of new antidots into medical practice will increase the effectiveness of therapeutic measures, reduce the number of deaths and disabilities after acute poisoning with carbon monoxide.

Management of carbon monoxide poisoning

2016 ◽  
Author(s):  
Djillali Annane ◽  
B. Jérôme Aboab
Keyword(s):  
Carbon Monoxide ◽  
Clinical Symptoms ◽  
Carbon Monoxide Poisoning ◽  
The Body ◽  
Poor Correlation ◽  
Oxygen Carriers ◽  
Co Poisoning ◽  
Body Tissues ◽  
Broad Variety ◽  
Morbid Conditions

CO poisoning is the commonest cause of toxic death. Carbon monoxide is colourless, odourless, and tasteless, and is produced under various conditions. When people inhale CO, the gas diffuses rapidly to the body and replaces oxygen at the level of haemoglobin, myoglobin, and other oxygen carriers. Subsequently, CO causes oxygen deprivation of all body tissues. CO also induces oxidative stress and systemic inflammation. After CO poisoning a broad variety of symptoms may occur. Survivors of CO poisoning often present with persistent neurological sequels or develop delayed neurological symptoms. There is poor correlation between carboxyhaemoglobin levels and clinical symptoms. The presence of coma, underlying co-morbid conditions and need for mechanical ventilation are the main prognostic factors. Management includes prompt extraction from the toxic environment and breathing 100% oxygen, although the role and practicalities of hyperbaric oxygen therapy remain controversial.

scholarly journals Комплексное лечение больных ревматоидным миокардитом коров

2019 ◽  
pp. 44-46
Author(s):  
A.V. Timakov ◽  
T.K. Timakova
Keyword(s):  
Biochemical Parameters ◽  
Inflammatory Process ◽  
Clinical Symptoms ◽  
Rapid Development ◽  
Underlying Disease ◽  
The Body ◽  
Symptomatic Therapy ◽  
Portal Circulation ◽  
Hematological And Biochemical Parameters ◽  
Sick Animal

Ревматоидный миокардит у коров протекает остро и характеризуется быстрым развитием клинических симптомов, поражает соединительную ткань сердечнососудистой системы (эндокард, миокард, реже перикард) и крупные суставы. Проявляется как осложнение при инфекционных и гемоспоридиозных болезнях, интоксикациях химическими и медикаментозными ядами, а также при аутоинтоксикациях вследствие поражения кишечника, почек. Воспалительный процесс развивается под воздействием токсинов основного заболевания. Всё это ведёт к нарушению портального кровообращения, развитию застоя крови в печени, кишечнике, легких. Как следствие возникает одышка, цианоз, отёки (начинаются на нижних частях тела), резкие нарушения ритма. Общее состояние больного животного резко ухудшается, и на фоне токсикоаллергических состояний могут возникать артриты. У коров могут быть послеродовые осложнения. В крови отмечают несоответствие гематологических и биохимических показателей. Своевременная диагностика и комплексное лечение коров с использованием средств патогенетической и симптоматической терапии позволяют восстановить нарушенные функции организма и продуктивность животных.Rheumatoid myocarditis in cows follows acute and is characterized by the rapid development of clinical symptoms, affects the connective tissue of the cardiovascular system (endocardium, myocardium, less often the pericardium) and major joints. It is come out as a complication of infectious and hemosporidial diseases, intoxication with chemical and drug poisons as well as during autointoxication due to bowel and kidney damage. The inflammatory process develops under the influence of toxins of the underlying disease. All this leads to a violation of the portal circulation, the development of blood stagnation in the liver, bowel, lungs. As a result, apnoea, cyanosis, edema (start on the lower parts of the body), sharp rhythm disturbances occur. The general condition of the sick animal is deteriorating dramatically and arthritides can occur in the course of toxicoallergic conditions. Cows can have postpartum complications. There is a discrepancy between hematological and biochemical parameters in the blood. Timely diagnosis and complex treatment of cows with the use of pathogenetic and symptomatic therapy can restore impaired body functions and animal productivity.

scholarly journals Medical care provision at the venue of the weightlifting event of the Tokyo 2020 Olympic Games

2021 ◽  
Author(s):  
Kohei Ashikaga ◽  
Kihei Yoneyama ◽  
Kuniaki Hirayama ◽  
Tatsuhiro Suzuki ◽  
Ryota Muroi ◽  
...  
Keyword(s):  
Medical Care ◽  
Olympic Games ◽  
Body Part ◽  
First Aid ◽  
The Body ◽  
Medical Examination ◽  
Medical Services ◽  
Medical Attention ◽  
Medical Procedures ◽  
Body Parts

Abstract Purpose This study aimed to investigate the medical care provided at the venue of the weightlifting event of the Tokyo 2020 Olympic Games. Methods We retrospectively evaluated athletes who availed of medical services at the venue during the weightlifting event of the Tokyo 2020 Olympic Games. In total, 194 athletes participated in the weightlifting competition. Injuries and illnesses were classified into cases handled without physician or cases requiring medical examination by a physician. These were tabulated for each examination location (athlete medical station, field of play [FOP], first-aid station of training floor or warm-up area). Results Throughout the event, a cumulative total of 132 people used the venue medical services. Nine athletes required medical attention at the athlete medical stations. Of these nine cases, six occurred on the training floor. In the FOP, nine athletes were examined. Two experienced light-headedness, two had knee pain, and the rest had other symptoms. No athletes wanted to undergo medical examination at the athlete medical station. 89 medical procedures were performed in the first-aid station on the training floor, including 52 tapings and 37 ice compressions, and the most frequent body part which needed treatment was the knee, followed by the fingers. At the first-aid station on the match floor, 25 medical procedures were performed, including 17 ice compressions, 5 haemostasis, and 4 tapings. The body parts that most frequently needed treatment were the fingers, knees, and lower legs. Conclusion Several athletes needed treatment; however, only a few required medical care from a physician.

scholarly journals Отруєння фосфорорганічними сполуками: варіанти перебігу, діагностична та лікувальна тактика бригади екстреної (швидкої) медичної допомоги

2017 ◽  
Author(s):  
R. M. Liakhovych ◽  
M. Ya. Dzus ◽  
Ya. M. Kitsak ◽  
O. H. Necyuk
Keyword(s):  
Medical Care ◽  
Clinical Picture ◽  
Cholinesterase Activity ◽  
Organophosphorus Compounds ◽  
Clinical Manifestations ◽  
The Body ◽  
Emergency Medical Care ◽  
Oxygen Inhalation ◽  
Emergency Medical ◽  
Wide Range

Introduction. The article discusses the variety of organophosphorus compounds, ways of their intake, characteristic clinical manifestations and the modern algorithm of pre-hospital therapy in the practice of the emergency medical care brigade (EMC). The relevance of this problem lies in the fact that the total mass poisoning are poisoning with organophosphorus compounds (OPhC), because they are widely used in agriculture, industry and medicine. These compounds have a wide range of activity against pests of agricultural crops.The aim of the study – to improve quality of diagnostics and administering of quality first medical aid by the EMC workers to the patients poisoned with phosphoorganic comounds.Materials and Methods. The main pathogenetic mechanism of action organophosphorus compounds is inhibition of cholinesterase activity – the enzyme which hydrolyzes acetylcholine and plays an important role in the process of synaptic transmission of the nerve impulse in cholinergic formations. Inhibition of cholinesterase activity leads to the cessation or reduce the breakdown of acetylcholine, which leads to the accumulation of the latter and excessive excitement they cholinergic system. Poisoning by organophosphorus compounds leads to the formation of cholinesterase, which loses the ability to hydrolyze acetylcholine, and very slowly recovers its activity.Results and Discussion. Studies showed that the clinical picture of the effect of different organophosphorus compounds on the human body is the manifestation from the сentral or peripheral cholinergic systems. The rate of development of clinical manifestations depends on the mechanisms of admission of the poison into the body.If the poison gets through the respiratory tract, to the fore, appear symptoms of respiratory disorders, oral – digestive tract, through the skin – muscular fibrillation. Further, regardless of the mechanisms of penetration of organophosphorus compounds in the body, in the clinical picture of acute poisoning are manifested symptoms of affection of Central nervous system (the autonomic centers of the hypothalamic structures), eyes (miosis, decreased visual acuity, accommodation spasm), cardiovascular system (vegetative-vascular dystonia, myocardial), alimentary canal (hypersalivation, colic, dyskinesia of the intestine, biliary tract, toxic hepatitis), respiratory (bronchospasm, bronchure), skeletal muscles (convulsions).Conclusions. Given the polymorphism of clinical manifestations of the poisoning and its complications is vital the familiarization of the brigade of emergency medical care these conditions and provide skilled pre-hospital medical care. Through this comprehensive pre-hospital emergency medical care is the use of amilnitrite, in the presence of apnea or with significant respiratory failure – artificial lung ventilation and inhalation of oxygen. With the weakening of cardiac activity should use the solution of cordiamin subcutaneously, but when the vascular collapse – oxygen inhalation and subcutaneous injection of norepinephrine. Antidote therapy requires the introduction of 20 ml of chromosone intravenous, further – 30 % sodium hyposulfite intravenously. 

PROVIDING MEDICAL CARE TO PATIENTS WITH BURNS IN AN EMERGENCY

2021 ◽  
pp. 56-59
Author(s):  
Г.А. Турсынбаева ◽  
У.Т. Багысбаева
Keyword(s):  
Medical Care ◽  
First Aid ◽  
The Body ◽  
Clinical Death ◽  
Chemical Burns ◽  
Significant Deterioration ◽  
Respiratory Disorders ◽  
Medical Evacuation ◽  
Reduction Of Mortality ◽  
The Cost

В данной статье рассмотрены основные действия при оказании медицинской помощи больным с ожогами на этапах медицинской эвакуации. Актуальность проблемы обусловлена тем, что своевременное оказание первой помощи пострадавшим предупреждает ухудшение состояния организма, что в значительной степени влияет на снижение летальности, инвалидности и сроков временной утраты трудоспособности больных и пострадавших, существенно снижает расходы на их лечение и реабилитацию [В.И. Хрупкин, 2000; Е.И. Бялик, 2001]. Особенное значение медицинская помощь на догоспитальном этапе приобретает при выраженных нарушениях кровообращения и дыхания, клинической смерти, кровотечении, переломах, термических и химических ожогах, когда неоказание помощи или запаздывание ее быстро приводит к значительному ухудшению состояния организма и даже смерти [В.А. Михайлович, А.Г. Мирошниченко, 2005; С.А. Сумин, 2005]. This article describes the main actions in providing medical care to patients with burns at the stages of medical evacuation. The urgency of the problem is due to the fact that timely first aid to victims prevents the deterioration of the body, which significantly affects the reduction of mortality, disability and the timing of temporary disability of patients and victims, significantly reduces the cost of their treatment and rehabilitation [V. I. Brilkin, 2000; E. I. Bialik, 2001]. Medical care at the prehospital stage is particularly important in cases of severe circulatory and respiratory disorders, clinical death, bleeding, fractures, thermal and chemical burns, when failure to provide assistance or its delay quickly leads to a significant deterioration of the body's condition and even death [V. A. Mikhailovich, A. G. Miroshnichenko, 2005; S. A. Sumin, 2005].

scholarly journals Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning in Italy: Retrospective Validation of a Data Collection Tool for the Italian Registry of Carbon Monoxide Poisonings (IRCOP)

2020 ◽  
Vol 17 (2) ◽  
pp. 574
Author(s):  
Lidio Maffi ◽  
Matteo Paganini ◽  
Giuliano Vezzani ◽  
Antonios Soumelis ◽  
Enrico M Camporesi ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Data Collection ◽  
Hyperbaric Oxygen ◽  
Carbon Monoxide Poisoning ◽  
The Body ◽  
Co Poisoning ◽  
Data Collection Tool ◽  
Hyperbaric Oxygen Treatment ◽  
Oxygen Treatment ◽  
Co Intoxication

Background: Carbon Monoxide (CO) poisoning is a frequent cause of intoxication. However, CO poisoning incidence is globally underreported, as well as its features, especially in Italy. The aim of this study was to investigate such characteristics of CO intoxication and foster the creation of the Italian Registry of Carbon Monoxide Poisonings. Methods: A data collection tool was developed and organized in five sections: Patient’s characteristics; CO intoxication modality; emergency medical service and emergency department; hyperbaric facility; outcomes. The tool was validated through a retrospective analysis, including CO intoxicated patients treated in 14 Italian hyperbaric facilities between 2015 and 2016. Results: A total of 1383 patients were included. The high completion ratio (85%) of the collection tool suggests its feasibility in practical terms. CO intoxications were mostly accidental (93.64%) and caused by solid fuel (48.59%). There was not a uniform application of hyperbaric oxygen treatment protocols, but most of the patients were adequately treated at least at 2.5 ATA for more than 60 min (44.97%). Conclusion: This analysis provided new information that was previously unavailable in this country. Furthermore, this tool proved to be a valid base for future registry aiming to consolidate the body of knowledge about CO intoxications in Italy.

scholarly journals Smart Wearable Sensors Based on Triboelectric Nanogenerator for Personal Healthcare Monitoring

Micromachines ◽  
2021 ◽  
Vol 12 (4) ◽  
pp. 352
Author(s):  
Ruonan Li ◽  
Xuelian Wei ◽  
Jiahui Xu ◽  
Junhuan Chen ◽  
Bin Li ◽  
...  
Keyword(s):  
Medical Care ◽  
Health Monitoring ◽  
Wearable Sensors ◽  
The Elderly ◽  
The Body ◽  
Assessment System ◽  
Triboelectric Nanogenerator ◽  
Personal Healthcare ◽  
Healthcare Monitoring ◽  
Smart Wearable

Accurate monitoring of motion and sleep states is critical for human health assessment, especially for a healthy life, early diagnosis of diseases, and medical care. In this work, a smart wearable sensor (SWS) based on a dual-channel triboelectric nanogenerator was presented for a real-time health monitoring system. The SWS can be worn on wrists, ankles, shoes, or other parts of the body and cloth, converting mechanical triggers into electrical output. By analyzing these signals, the SWS can precisely and constantly monitor and distinguish various motion states, including stepping, walking, running, and jumping. Based on the SWS, a fall-down alarm system and a sleep quality assessment system were constructed to provide personal healthcare monitoring and alert family members or doctors via communication devices. It is important for the healthy growth of the young and special patient groups, as well as for the health monitoring and medical care of the elderly and recovered patients. This work aimed to broaden the paths for remote biological movement status analysis and provide diversified perspectives for true-time and long-term health monitoring, simultaneously.

scholarly journals Virtual Archaeology of Death and Burial: A Procedure for Integrating 3D Visualization and Analysis in Archaeothanatology

2021 ◽  
Vol 7 (1) ◽  
pp. 540-555
Author(s):  
Hayley L. Mickleburgh ◽  
Liv Nilsson Stutz ◽  
Harry Fokkens
Keyword(s):  
Spatial Information ◽  
3D Visualization ◽  
Rapid Development ◽  
Three Dimensional ◽  
3D Models ◽  
The Body ◽  
Test Case ◽  
Archaeology Of Death ◽  
Human Burials ◽  
3D Information

Abstract The reconstruction of past mortuary rituals and practices increasingly incorporates analysis of the taphonomic history of the grave and buried body, using the framework provided by archaeothanatology. Archaeothanatological analysis relies on interpretation of the three-dimensional (3D) relationship of bones within the grave and traditionally depends on elaborate written descriptions and two-dimensional (2D) images of the remains during excavation to capture this spatial information. With the rapid development of inexpensive 3D tools, digital replicas (3D models) are now commonly available to preserve 3D information on human burials during excavation. A procedure developed using a test case to enhance archaeothanatological analysis and improve post-excavation analysis of human burials is described. Beyond preservation of static spatial information, 3D visualization techniques can be used in archaeothanatology to reconstruct the spatial displacement of bones over time, from deposition of the body to excavation of the skeletonized remains. The purpose of the procedure is to produce 3D simulations to visualize and test archaeothanatological hypotheses, thereby augmenting traditional archaeothanatological analysis. We illustrate our approach with the reconstruction of mortuary practices and burial taphonomy of a Bell Beaker burial from the site of Oostwoud-Tuithoorn, West-Frisia, the Netherlands. This case study was selected as the test case because of its relatively complete context information. The test case shows the potential for application of the procedure to older 2D field documentation, even when the amount and detail of documentation is less than ideal.

scholarly journals Intensive Care in a Patient with Toxic Epidermal Necrolysis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
J. Wallenborn ◽  
M. Fischer
Keyword(s):  
Adverse Drug Reaction ◽  
Medical Care ◽  
Toxic Epidermal Necrolysis ◽  
Marked Improvement ◽  
Pain Therapy ◽  
The Body ◽  
Rapid Progression ◽  
Volume Management ◽  
Multiresistant Bacteria ◽  
Mucosal Involvement

Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose. This prevented further progression of the TEN. Despite marked improvement in skin findings, the ICU stay was prolonged by a complex analgosedation, transient kidney failure, volume management, positioning therapy, and vegetatively impeded weaning. Moreover, there was colonization with multiresistant bacteria (MRSA and VRE). Nonetheless, the patient could be restored to health and was released after four weeks. Infliximab seems to be effective in the treatment of TEN, especially in cases of rapid progression. Moreover, patients with TEN are difficult to handle in intensive-medical care, whereby attention should especially be paid to sufficient pain therapy, and the positioning of the patient is a particular challenge.

The use of chatbots as supportive agents for people seeking help for drug and alcohol addiction: A systematic review. (Preprint)

2021 ◽  
Author(s):  
Lisa Ogilvie ◽  
Jerome Carson ◽  
Julie Prescott
Keyword(s):  
Mixed Methods ◽  
Healthcare Setting ◽  
The Body ◽  
Alcohol Addiction ◽  
Bibliographic Databases ◽  
Ethical Implications ◽  
Qualitative Work ◽  
Meta Analyses ◽  
Future Work ◽  
Drug And Alcohol

BACKGROUND The use of chatbots in healthcare is an area of study receiving increased academic interest. As the knowledge base grows, the granularity in the level of research is being refined, seeing more targeted work in specific areas of healthcare, for example, chatbots for anxiety and depression, cancer care, and pregnancy support. This paper focuses on the targeted application of chatbots in drug and alcohol addiction. OBJECTIVE The aim of this paper is to systematically review and summarise the research conducted on the use of chatbots in the field of addiction, specifically the use of chatbots as supportive agents for those who suffer from drug and alcohol addiction. METHODS A systematic search of bibliographic databases using the broad search criteria of “chatbot and addiction,” identified papers for screening. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Mixed Methods Appraisal Tool were used, which resulted in the quality assessment and review of 5 papers. RESULTS Although the body of research in this field is limited, what has been published shows promising results. A combination of quantitative, qualitative, and mixed methods studies were reviewed, among which statistically significant findings were reported on the efficacy of chatbots targeted at drug and alcohol addiction. These findings were also substantiated in the qualitative work reviewed. A strong message of caution was conveyed however on the ethical implications of using chatbots to afford support to addicted individuals. CONCLUSIONS The literature reviewed shows that more work is needed to appreciate solutions that leverage existing data, such as big data available from social media, or that which is accessed by prevalent market leading chatbots. It also highlighted ethical concerns over the use of a non-human agent to afford support to those with drug and alcohol addiction. It was reported however, that statistically significant results were returned for ‘bespoke’ chatbots in this area of healthcare, setting a promising foundation for future work.

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