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Dichloroethane,


Carbon tetrachloride, trichlorethylene belong to the group of chlorinated hydrocarbons widely used as solvents in many industries, in households for gluing plastic products, cleaning clothes, etc. The toxic effect of these substances is associated with narcotic effects on the nervous system, severe dystrophic changes in the liver and kidneys . The most toxic is dichloroethane. The lethal dose when taken inward is 20 ml. Poisoning is possible when entering the poison inside, through the respiratory tract, skin.
There are four leading clinical syndromes:
Toxic damage to the central nervous system manifests itself in the early periods after poisoning in the form of dizziness, unstable gait, pronounced psychomotor agitation. In severe cases, a coma develops, a frequent complication of which is a violation of breathing as a type of mechanical asphyxia (bronchorrhoea, tongue laxity, abundant secretion of saliva).
Syndrome of acute gastritis and gastroenteritis, in which there is repeated vomiting with a significant admixture of bile, in severe cases a frequent loose stool flaky with a specific odor.
The syndrome of acute cardiovascular failure is manifested by a persistent drop in blood pressure with a lack of pulse on the peripheral arteries and is usually observed against a background of psychomotor agitation or coma. In some cases, the fall in blood pressure is preceded by a short-term increase in it and a sharp tachycardia. The development of cardiovascular failure is characteristic of dichloroethane poisoning and is a prognostically poor factor, as it usually ends in a lethal outcome within the first 3 days.
Syndrome of acute toxic hepatitis with the phenomena of hepatic-renal insufficiency. Toxic hepatitis develops in most patients on day 2-3 after poisoning. The main clinical manifestations are liver enlargement, spastic pain in the liver, icterus sclera and skin. Impaired renal function is manifested by the development of albuminuria of various degrees. In some patients, acute kidney failure (azotemia, uremia) occurs in the first week after poisoning, which is more typical for carbocarbon poisoning.
Inhalation poisoning with dichloroethane and carbon tetrachloride can give a severe clinical picture, the action of carbon tetrachloride vapor often develop hepatic-kidney failure. Causes of death: early - cardiovascular insufficiency (1-3 days) and late coma, uremia.
First aid and treatment during coma is exactly the same as in alcohol poisoning, as in both cases there is a deep anesthesia with respiratory, circulatory and acidosis ("acidification of the blood"). The defeat of the kidneys is the same as similar violations when poisoning with antifreeze (see Poisoning by alcohol and its surrogates). To restore the function of the liver appoint vitamins B, C, glucocorticoids, insulin with glucose, treatment is carried out in the hospital in the late period after poisoning.