Chlorine ethanol (Ethylene Chlorohydrin) Grape vernalize the acute poisoning of the pharmaceutical

The willow occupies the abundant doctor

Case

In the the morning of the somth, this centre receives the telephone consultation of a emergency call doctor of Changhua county; A woman 56 years old drank the next bowl of agriculture chemical at nine o'clock in the morning, but there is not any composition to label on the bottle, just confirmed to be the grape and vernalized the pharmaceutical chlorine ethanol under inquiring in detail. The patient does not originally have obvious symptom, but after this centre offers the possible toxic materials, the patient presented the shock and went into a coma immediately, although would transfer to the first aid of large hospital at once, but still declare the death because first aid is invalid finally, drink from agriculture chemical to death, time is less than three hours.

Retrospect
Since the establishment of the 75th year of the Republic of China this centre, all cases of calling to consult because the chlorine ethanol is poisonned, adding up to 16, among them there are two materials incomplete and unable to follow the trail of; Leave in more than 14 cases, four commit suicide, eight drink by mistake, you are kept in touch or sucked by the skin at work; The age is distributed since 2 years old to 70 years old. Among the 14 case these, six people within 24 hours namely death (short 3 hours most) ,Quantity that drink its one, one bowl at most most. Eight other people, quantity drunk is not a lot (smaller than one) Or only there is a small amount of skin that is kept in touch or sucked, so totally resume after treating. But like this, these eight people have a kidney function or the influence of the liver function more or less, even produce the acute kidney failure.

Function

Chlorine ethanol (Ethylene Chlorohydrin) The synonym name is 2- Chloro-Ethanol, Glycol Chlorohydrin, Chloroethylowy, ¦Â - Chloroethyl Alchohol and grape vernalize pharmaceutical No.1,etc., mixed and taken shape in water by Chlorohydrin and Ethylene, it is the by product after Ethylene Oxide is evaporated too. Can be regarded as the vernalization pharmaceutical of the potato and grape on agriculture as solvent, lubricant,etc. on industry, but toxicity is great, easy to cause to poison, it is not the legal agriculture chemical products that used. The packaging on the market is put for the transparent colourless water liquid 500 c.c.s, user in the little bottle, add the red pigment partial shipment its more in order to as the hypertoxic sign.

Toxicity
Clayton, to 1982 report, after brain to cause acute poisoning main death reason, heart toxicity and neural muscle cause the malicious symptom to coincide. Its supersession result Chloracetaldehyde will suppress TCA cycle in the human body (Tricarboxylic Acid Cycle) Function,considered to be the thing cause mainly by function not poisonous it rotate. In addition, chlorine ethanol (Ethylene Chlorohydrin) Can and skin keep in touch but send to the poison via take orally, suck, take orally minimum to cause death dosage, is it report adult oral 20ml to to have once (345mg/Kg) And then, in the death on the third day, a child two years old dies after only obeying 1-2ml in addition.

Clinical symptom
Chlorine ethanol cause influence to people and central nervous system, heart blood-vascular system, liver, kidney, stomach dish, skin and eyes of animal used as test, acute to may is it breathe suppress and death and have any organ pathological changes find to cause when exposing. Chlorine ethanol in to quite fine absorption have skin, can pierce through general rubber glove and clothes cause malicious.
Facial features: The chlorine ethanol has very strong irritating to eyes, nasal cavity and throat mucous membrane, can cause the vision to lose when being serious.
Heart blood-vascular system: Will cause the change, blood pressure dropping and heart of the speed of heartbeat because of the sex shock,etc..
Respiratory system: Can cause to may appear lung hydroncus, lung collapse or lung is it ooze liquid,etc. to organize at being depleted, clinical respiratory system.
Neurology respect: The patient may behave uncooperatively, dizzy, consciousness is unclear, feel strong straightforward convulsion, twitches, brain hydroncus, has a headache, the rough sense of hand, reflecting disappear, unable etc.ing of the unusual, hand.
Stomach way symptom: Disgusting, vomit, stomach or the upper abdomen will pain etc. Dr.eye: and happen.
Liver: Will consume Glutathione in the liver, may make the supersession ferments of some medicines not activate too, the liver bleeds, the cell destroys and necrosises etc..
Kidney: Can cause such symptoms as blood in the urine, slight albuminuria, much urine,etc., may cause renal tubule swelling, kidney to changes the sex but makes the urea nitrogen and elimination function of the electrolyte unusual too, even cause and bleed.
Skin: Chlorine ethanol have irritating to skin and mucous membrane, skin cause malicious to might not can cause irritating, once reported the chronic skin and contacted the death of causing.
Treat

Basically, should notice whether the patient's biological phenomena is steady at first? Is sureness breathed and does not hinder? Breathe artificially and auxiliarily in case of necessity, notice again whether the blood amount of circulation is enough? This kind of support treatment should be classified as the first preferentially. In six death cases that we collect, though there are not any symptoms at the beginning, but made blood pressure, shock, critically ill phenomenon without breathing,etc. immediately, some die until first aid invalid, and a other one to it lives to be 24 hours too. So, the keeping really the first important task of biological phenomena. Other as if wash the stomach, should go on in the shortest time after taking orally.

Chlorine ethanol is it have detoxifying pharmaceutical is it detoxify to suitable for, unable to come to monitor its thickness from urine or blood special to poison. Should monitor to ABG, Chest X-ray, lung function, blood pressure and respect of blood amount of circulation mainly, must pay attention to the changes of the liver, kidney function too in addition.

On the other hand, once reports used the ethanol to make and was poisonned the degree reducing, it may be that the ethanol compete with the chlorine ethanol when go for hydrogenation, make poisonous Chloracetaldehyde produce and reduce, and lower toxicity. But this is only an animal laboratory report, have not been admitted yet in the human respect. But in the case that we follow the trail of, once one accepted this kind of treatment and survived, have also made blood pressure, acute kidney failure, breathed to suppress, go into a coma etc. during that time; So, treat the method that the chlorine ethanol is poisonned with the ethanol, is still worth our continuing going for discussion thoroughly.