Postmortem examination cases of cyanide poisoning A biological hazard.

Hydrocyanic acid and various cyanides are relatively common poisons both in suicide, accident and occasionally homicide. Acute poisoning with cyanide is most often self administered as the swift and sure action is generally known. Accidental poisoning from inhalation of vapours due to fires in buildings or by the free gas liberated from some commercial processes is also known to occur. The preparations are rarely used with homicidal intent. Whatever be the manner of poisoning, in medical settings the persons involved in postmortem examination of cases of death of cyanide poisoning are exposed to significant degree of cyanide remaining in the body cavities and tissues of the deceased. This risk is not only for the persons attending postmortem examination but also for the first respondents like police, rescue persons and also persons extending emergency care both outside and within hospital. Hydrocyanic acid is rapidly absorbed from all mucous surfaces and even from unabraded skin .Hence attending a case of cyanide poisoning involves a hazard of inhalation of cyanide gas from the victim The hazards involved in such situations are briefly reviewed.

Social and environmental aspects of kerosene poisoning in children in Jeddah

The main objective of the present study was to identify the social and enviornmenal aspects of kerosene poisoning in children, at King Abdulaziz Hospital [KAH], Jeddah. An open-ended questionnaire to the attending member of the family; by the attending physician in emergency was carried out in the emergency department KAH, during the period from April 1992 to May 1995. Kerosene poisoning was observed to be more common in children aged 1-3 years [86.5%], living in overcrowded homes [89.5%], with poor facilities [83.5%], and in homes where kerosene was stored in beverage containers easily accessible to the children, 80.5% of the families sought medical help within the first 2 hours after ingestion. Knowledge of toxic nature of kerosene was lacking in most of the families. The study indicated that kerosene poisoning was common in children of families living in overcrowded homes with minimum facilities, in which kerosene was easily accessible to children. Public awareness is needed to educate the families of the hazards of kerosene poisoning

Intoxicaciones agudas graves: uso de la hemocarboperfusion / Use of hemocarboperfusion in severe acute intoxications

Las intoxicaciones agudas graves por medicamentos, especialmente aquellas con fines suicidas, constituyen en la actualidad una problemática de interés para las instituciones médicas de nuestro país. Las mismas se presentan con una incidencia de 100 intoxicaciones agudas por 100 000 habitantes; son reportadas por D. Nicholson unos 5 millones de casos al año en Estados Unidos llegando a fallecer el 0,1 %. Para las Unidades de Cuidados Intensivos estos pacientes alcanzan del 3 al 10 % de los ingresos. En un período de ocho meses fueron ingresados en la Unidad de Cuidados Intensivos del Hospital Militar Central "Dr. Carlos J. Finlay" 21 pacientes con diagnósticos de intoxicación aguda grave, llegando a constituir el 8,9 % de ingresos en dicho período. A 10 de los pacientes se les aplica como proceder terapéutico principal la hemocarboperfusión, totalizando 13 sesiones de tratamiento. Predomina el sexo femenino y edad superior a los 30 años. Los 10 pacientes presentaron coma de diferentes gradaciones, siendo siempre de grados III al V. El tiempo promedio de duración del coma fue de 30,5 horas; no hubo fallecidos. Las complicaciones detectadas fueron pocas y de fácil manejo. Los psicofármacos y entre éstos los barbitúricos, fueron los más frecuentemente empleados