Tiandi first and outline the precautions when testing ammonia
(1) Remove pollution.
If the patient is only exposed to ammonia and has no irritation of the skin and eyes, there is no need to remove the contamination. If you are exposed to liquid ammonia and your clothes are contaminated, take off your clothes and put them in a double plastic bag.
If the eyes are in contact or the eyes are irritating, rinse with plenty of water or saline for more than 20 minutes. If eyelids occur during rinsing, slowly drop 1-2 drops of 0.4% oxybuprocaine and continue to rinse thoroughly. If the patient wears contact lenses and is easily removed without damaging the eyes, the contact lenses should be removed.
Rinse the contacted skin and hair with plenty of water for more than 15 minutes. Care should be taken to protect your eyes when flushing your skin and hair.
(2) Patient recovery.
Patients should be immediately removed from the contaminated area to fresh air and the patient should be resuscitated in three steps (airway, breathing, circulation).
Airway: Ensure that the airway is not blocked by tongue or foreign objects.
Breathing: Check if the patient is breathing. If there is no breathing, use a pocket mask to provide ventilation.
Circulation: Check the pulse, if there is no pulse, cardiopulmonary resuscitation should be performed.
(3) Initial treatment.
There is no specific antidote for ammonia poisoning, and supportive treatment should be used.
If the contact concentration is ≥500ppm, and symptoms of eye irritation and pulmonary edema appear, it is recommended to take the following measures: first spray dexamethasone 5 times (using a metered dose inhaler), then spray twice every 5 minutes until you reach the emergency room of the hospital. until.
If the contact concentration is ≥ 1500 ppm, a venous access should be established and 1.0 g of methyl-prednisolone or an equivalent amount of steroids should be administered intravenously. (Note: The role of corticosteroids has not been confirmed in clinical controlled studies.)
For ammonia inhalers, humidified air or oxygen should be given. If there are symptoms of hypoxia, oxygen should be given.
If the breathing is distressed, tracheal intubation should be considered. When the patient's condition cannot be performed for tracheal intubation, a circumflex cartilage incision should be performed if conditions permit. For patients with bronchospasm, bronchodilators can be sprayed.
If the skin is exposed to ammonia, it will cause chemical burns. It can be treated according to thermal burns: appropriate rehydration, analgesics, body temperature, covered with a disinfectant pad or clean sheets. If the skin is exposed to high pressure liquid ammonia, pay attention to frostbite.
Inadvertently give milk to drink, avoid gastric lavage when there is corrosion.
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