Medical First Aid Guide


Table 9: INHALATION OF CHEMICALS

Inhalation of chemicals may cause suffocation (asphyxia) due to:

  • Obstruction to breathing in the throat or the air passage through spasm of the air tubes or by swelling of the linings of the voice box due to irritant fumes;
  • Fluid in the lung air spaces caused by irritant fumes;
  • Poisoning of the blood which prevents the carriage or use of oxygen in the body caused by, for example, carbon monoxide and cyanide;
  • Poisoning of the mechanism of breathing in the chest (e.g. by organophosphate pesticides) or the brain (e.g. by chlorinated hydrocarbons);
  • Gases which do not support life because they replace oxygen in the atmosphere (e.g. carbon dioxide, nitrogen).

Vapours of volatile liquids often have a pleasant or disagreeable odour. They may cause lightheadedness, dizziness, headache or nausea.

A few gases have delayed corrosive effects on the lungs.

For advice on CPR in cases of suffocation: see table 2.

For advice on chemical hazards of fire: see appendix 9.

For advice on chemical hazards of welding: see appendix 9.

WARNING: Any casualty who has been gassed and has impaired consciousness must NOT be treated with morphine.

Signs and symptoms Treatment
Soreness of throat, hoarseness or cough
  • Remove the casualty from the polluted atmosphere, have him rinse his mouth and give one glass of water to drink.
Dry cough, mild breathlessness and wheezing
  • The casualty should be put to bed and placed in the high sitting-up position. Patient sitting position
Severe breathlessness and wheezing
  • If breathlessness or wheezing are present, give oxygen at a flow rate of 8 L per minute until symptoms resolve.
  • Additionally, administer by spacer device:
    200 μg salbutamol or 500 μg terbutaline and
    250 μg beclomethasone or 400 μg budenoside every 15 minutes for the first hour.
  • At the same time: RADIO FOR MEDICAL ADVICE.
  • If breathlessness and wheezing persist after the first hour, continue with oxygen and repeat administration of salbutamol/terbutaline and beclomethasone/budenoside every 2 hours for the next 10 hours, and then 4 times a day until symptoms resolve.
Severe breathlessness and frothy sputum, blue discoloration of the skin, anxiety and sweating (pulmonary oedema)
  • Casualties must be handled extremely carefully. All strain must be avoided.
  • RADIO FOR MEDICAL ADVICE.
  • Arrange for evacuation. The casualty will need to be transferred to a shore hospital as soon as possible.
Further advice on breathing difficulty: see appendix 9.
  • Give oxygen, salbutamol/terbutaline and beclomethasone/budenoside as above.
  • Use a sucker, if available, to get rid of the frothy secretions.
  • If the casualty is very breathless, give 50 mg furosemide (frusemide) by intramuscular injection to increase the urine output.
  • If symptoms persist, continue with oxygen and repeat administration of salbutamol/terbutaline and beclomethasone/budenoside every 2 hours for the next 10 hours, and then 4 times a day until symptoms resolve.
Fever, breathlessness, productive cough, increased pulse rate (over 110 per minute)
  • RADIO FOR MEDICAL ADVICE.
  • The casualty should be put to bed and placed in the high sitting-up position.
Further advice on diagnosis of breathing problems: see appendix 9.
  • Give 500 mg amoxicillin every 8 hours.

Note: Some are allergic to penicillins, including amoxicillin. In such cases, give 500 mg erythromycin 4 times daily.

  • If the patient is breathless, wheezing or blue, oxygen should be given continuously together with 200 μg salbutamol or 500 μg terbutaline 4 times daily by spacer device, until the symptoms and signs improve.

A patient who has had significant exposure or any symptoms related to exposure should be kept warm in bed and closely observed for 48 hours and RADIO MEDICAL ADVICE OBTAINED.

Table 8: Skin exposure to chemicals

Table 10: Ingestion of chemicals