Arsine (AsH3) poisoning is a recognized industrial hazard (Buchanan, 1962), producing poisoning at less than 30ppm, aconcentration far belowthat at which its faint smell of garlic is detectable. Ocular exposures: Red staining of the conjunctiva may be an early sign of arsine poisoning. Arsine Gas. Some methods remove arsenic from the human body before it causes any damage. Two mildly affected individuals recovered quickly-without treatment but the third, who was severely poisoned, developed oliguric renal failure. Duane C Caneva, MD, MSc Senior Medical Advisor to Customs and Border Protection, Department of Homeland Security (DHS) Office of Health Affairs; Federal Co-Chair, Health, Medical, Responder Safety Subgroup, Interagency Board (IAB)Disclosure: Nothing to disclose. All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. Chemical poisoning -- Arsine: Introduction. Airway: Ensure the airway is patent and protected. NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. [Full Text]. Arsine (IUPAC name: arsane) is an inorganic compound with the formula As H 3.This flammable, pyrophoric, and highly toxic pnictogen hydride gas is one of the simplest compounds of arsenic. Chronic poisoning has a better outcome. 2017 Dec. 70 (6):787-797. If hemolysis is present, the patient/victim must be observed up to 72 hours for signs of renal failure. 2006 Sep. 46(9):1576-9. Some people may need to have their blood cleaned by a machine if their kidneys fail. The best way to treat the condition is to eliminate arsenic exposure. Methods. The effectiveness of this compound in the treatment of arsine poisoning falls off rapidly as the time interval between exposure and treatment is increased. Centers for Disease Control and Prevention. It is considered a possible chemical agent in chemical warfare. Arsenic is a natural semi-metallic chemical that is found all over the world in groundwater. Renal failure can be attributed to direct effect of arsine on renal tissue, heme-pigment nephropathy, or renal hypoxia secondary to massive hemolysis and decreased oxygen carrying capacity of the blood. 121(1):1-8. 2,3-dimercaptopropyl ethyl ether has been shown to be effective in the treatment of arsine poisoning in rabbits, monkeys and dogs when administered either intramuscularly or percutaneously. Request PDF | Treatment for acute arsine poisoning with blood purification | Dear Editor,Accidental exposure to arsine (AsH3) can lead to intravascular hemolysis, multiorgan damage, and death [1, 2]. Treatment of Arsine Poisoning . A thorough eye examination should be performed along with an ophthalmologist consultation if needed in patients with eye injuries. [Medline]. Chelating agents (eg, 2,3-dimercaptopropanol, British antilewisite [BAL]) have not been shown to be of benefit in acute arsine toxicity. Initiate diuresis to avoid heme-pigment nephropathy. Chemical protective clothing is usually not required since arsine gas is not directly absorbed through the skin. Patient/victims with suspected arsine (SA) exposure should be monitored for hemolysis up to 24 hours. Wilkinson SP, McHugh P, Horsley S, Tubbs H, Lewis M, Thould A, et al. Available at http://emergency.cdc.gov/agent/arsine/casedef.asp. the L.D.100. Acute kidney injury by arsine poisoning: the ultrastructural pathology of the kidney. Arsenic Exposure From Drinking Water and the Incidence of CKD in Low to Moderate Exposed Areas of Taiwan: A 14-Year Prospective Study. Acute exposure of inorganic arsenic or arsine gas can be extremely fatal and result in death in the absence of spontaneous remedial actions. Cases of poisoning, some of them fatal, have followed the accidental wettingof suchwastematerial. Treatment: There is no specific antidote for arsine. 2016 Dec. 48:214-224. The effectiveness of this compound in the treatment of arsine poisoning falls off rapidly as the time interval between exposure and treatment is increased. for: Medscape. 2017 Dec. 91 (12):3787-3797. 2013 Nov 1. MEDICAL TREATMENT: Warning: Arsenic chelating drugs are not effective for arsine (SA) poisoning and should not be administered. Treatment: There is no specific antidote for arsine. Treatment with … Whole blood exchange transfusion and hemodialysis have been recommended to treat severe acute arsine poisoning, but are associated with significant complications and sub-optimal outcomes. If available, the victim's electrolytes status, mainly potassium, and oxygenation status with ABG should be obtained. 2007 Sep. 45(6):721-7. Chemical poisoning -- Arsine: Arsine is a chemical used in the making of semiconductors and in the metal refining industry. In particular, paralytic shellfish poisoning and puffer fish poisoning can cause death within hours after consuming the toxins and may require immediate intensive care. According to the Agency for Toxic Substances and Disease Registry, the following are recommendations for prehospital care of arsenic exposure. Agency for Toxic Substances and Disease Registry. The recommended threshold limit in this country is 005ppm(Ministry ofLabour, 1966a, b). Ren Fail. • Dermal exposures:An abnormal pigmentation of the skin may be seen. Arsine poisoning treatment should focus on restoring RBC concentrations, maintaining renal function, electrolyte replacement and aggressive supportive care. 6. If arsenic poisoning occurs over a brief period of time, symptoms may include vomiting, abdominal pain, encephalopathy, and watery diarrhea that contains blood. Acta Haematol. Dermal exposures: An abnormal pigmentation of the skin may be seen. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Arsenic poisoning is a medical condition that occurs due to elevated levels of arsenic in the body. If you log out, you will be required to enter your username and password the next time you visit. Treatment is symptomatic and consists of measures to support respiratory, vascular, and renal function. 261586-overview
Patient/victims with suspected arsine (SA) exposure should be monitored for hemolysis up to 24 hours. 35(2):299-301. Several case reports have demonstrated the efficacy and benefits of exchange transfusion, to include both red blood cell exchange (RBC-E) and plasma exchange (PE). The Role of Chelation in the Treatment of Arsenic and Mercury Poisoning. There may be a garlicky odor of the breath. Four patients with acute arsine gas poisoning were admitted to the Sverdlovsk Regional Poisoning Treatment Centre during 2014–2015, three of them were involved into the same exposure. Treatment of arsenic poisoning in acute toxic poisonings needs to begin quickly; treatment involves removal of arsenic by dialysis, chelating agents, replacement of red blood cells, and if ingested, bowel cleansing. 2016 Aug. 1378 (1):143-157. J Med Toxicol. Renal damage from industrial arsine poisoning. 780176-overview
It is a nonirritating gas with a mild odor (odorless at low doses) that is used in the semiconductor and metals refining industries. Diseases & Conditions, encoded search term (Arsine Poisoning) and Arsine Poisoning, Anemia of Chronic Disease and Kidney Failure, Online Misinformation Fuels a FightOver Folic Acid, Higher Red-Cell Transfusion Limit for Preemies Offers No Survival, Developmental Benefit, Top 10 Gastroenterology Articles Provide Essential Guidance, Hidden Diagnoses: From Einstein to Luther, JFK to Evita, Don't Use N95 Masks for More Than 2 Days, Research Suggests, A 30-Year-Old Man With Hallucinations After a House Party, Lower Back Pain: NSAID + Muscle Relaxant No Better Than NSAID + Placebo, Add Delirium to Checklist of COVID-19 Symptoms in Seniors. Dry with clean towels and keep victim warm and quiet. Support zone personnel require no protective gear if the victim has been exposed only to arsine gas. There are no published guidelines specific to the treatment of arsine poisoning during pregnancy. This retrospective study evaluated the clinical and effects and arsenic clearance from the use of plasma exchange treatment of patients with acute arsine poisoning. Frostbite injuries may be irrigated with lukewarm water according to standard treatment. [18]. Exposure may result when arsenic containing metals (i.e., metal vats) undergo acid washes. 3(5983):559-63. The most important side effect is … Kosnett MJ. We do not retain these email addresses. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODMzNzQwLXRyZWF0bWVudA==. [12]. In cases of contact with liquid (compressed … Arsine poisoning symptoms, causes, diagnosis, and treatment information for Arsine poisoning (Chemical poisoning - Arsine) with alternative diagnoses, full-text book chapters, misdiagnosis, research treatments, prevention, and prognosis. Use of all-trans retinoic acid in combination with arsenic trioxide for remission induction in patients with newly diagnosed acute promyelocytic leukemia and for consolidation/maintenance in CR patients. Initially, there is painless hemoglobinuria, dizziness, weakness, nausea, vomiting, abdominal cramping and tenderness. Chowdhury R, Chowdhury S, Roychoudhury P, Mandal C, Chaudhuri K. Arsenic induced apoptosis in malignant melanoma cells is enhanced by menadione through ROS generation, p38 signaling and p53 activation. There are no published guidelines specific to the treatment of arsine poisoning during pregnancy. Treatment of arsine poisoning should include: (a) immediate blood exchange transfusion to replace the destroyed red blood cells, and also to remove arsenic and the hemoglobin-arsine complex; (b) the administration of therapeutic amounts of dimercaprol (BAL); and (c) dialysis should be started if the patient has suffered kidney damage. [Medline]. The treatment depends on the type and stage of the arsenic poisoning. [Medline]. Arsine poisoning treated by plasma exchangeYUGUO SONG, M.D. Data from patients with severe acute arsine poisoning, treated with plasma exchange from December 2000 to December 2005 were collected and analyzed. 1975 Sep 6. 1969 Jul. Br J Ind Med. Arsine (AsH3) poisoning is a recognized industrial hazard (Buchanan, 1962), producing poisoning at less than 30ppm, aconcentration far belowthat at which its faint smell of garlic is detectable. 2006 Dec. 98(12):1998-2001. The CDC case definition of arsine poisoning includes the following: [9] Suspected: A case in which a potentially exposed person is being evaluated by health care worker or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists. Arsine toxicity aboard the Asiafreighter. • Dermal exposures:An abnormal pigmentation of the skin may be seen. 4. Treatment is symptomatic and consists of measures to support respiratory, vascular, and renal function. The victim is transported to a medical facility as soon as possible. Please confirm that you would like to log out of Medscape. Follow local emergency management plan and protocols if intentional release of arsine is suspected. The chest radiograph showed peri-hilar congestive changes. We describe four cases of arsine exposure aimed to evaluate the effectiveness of extracorporeal arsenic removal in acute arsine gas poisoning. Ocular exposures: Red staining of the conjunctiva may be an early sign of arsine poisoning. Exchange transfusion is the treatment of choice for patients with severe hemolysis. Thank you for sharing this Journal of Pharmacology and Experimental Therapeutics article. Dermal exposures: An abnormal pigmentation of the skin may be seen. Arsine or Stibine Poisoning. 2,3-dimercaptopropyl ethyl ether has been shown to be effective in the treatment of arsine poisoning in rabbits, monkeys and dogs when administered either intramuscularly or percutaneously. Paresthesias and peripheral neuropathy are common symptoms of a work-related arsenic poisoning. 1990 Jul. J Natl Med Assoc. This treatment is believed to support the oxygen-carrying capacity of the blood, remove free hemoglobin, and remove arsine and arsenic dihydride residues. Treatment for acute arsine poisoning with blood ... ... Advertisement 63(1):25-34. Arsine, the most toxic form of arsenic, has some properties that may make it useful as a chemical warfare (CW) agent; it is a colorless, odorless, nonirritating gas that is 2.5 times denser than air. Disability: Assess the patient's neurological status. An incident is reported in which three men were accidentally poisoned by arsine (A s H 3) in an industrial chemical plant. Kermit D Huebner, MD, FACEP Research Director, Carl R Darnall Army Medical Center • Inhalation exposures: The signs and symptoms of acute poisoning are consistent with acute and massive hemolysis. Both intravenous mannitol and urinary alkalinization have anecdotal value. Chemical poisoning -- Arsine: Introduction. 4. [25] Support Us. Request PDF | Treatment for acute arsine poisoning with blood purification | Dear Editor,Accidental exposure to arsine (AsH3) can lead to intravascular hemolysis, multiorgan damage, and death [1, 2]. Inhalation exposures: The signs and symptoms of acute poisoning are consistent with acute and massive hemolysis. This website also contains material copyrighted by 3rd parties. 5. Diseases & Conditions, 2002
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