Acute acrylonitrile poisoning accident

Acrylonitrile (CH2 = CHCN) is an important monomer in the organic synthesis industry and is a raw material for the manufacture of synthetic fibers, synthetic rubbers, plastics, and synthetic resins. It is oxidized by the ammoxidation of propylene, or derived from the direct combination of acetylene and hydrocyanic acid. It is a colorless, transparent liquid that is flammable, volatile, and 1.9 times heavier than air . After intentionally leaking accidents, acrylonitrile vapors gather at low levels and can easily be inhaled through the respiratory tract or absorbed by the skin and cause poisoning. Acrylonitrile can release cyanide after invading the human body, so its toxic effect is similar to that of hydrocyanic acid. In addition, acrylonitrile molecule itself is also toxic; it has anesthetic effect on the nervous system, especially has a direct inhibitory effect on the respiratory center, on the skin The mucous membrane has a certain stimulating effect.

Cases

1. ACCIDENTS

June 12, 1980 at 10 am, a county of chemical spinning workshop, a workers' hands holding a large glass jar filled with acrylonitrile (more than ten thousand milliliters), when accidentally dropped the glass on the stairs The bottle was broken and acrylonitrile was sprinkled on the ground. 14 workers in the same class flushed with water. Because the density of acrylonitrile is only 0.8 and it is lighter than water, it floats on the water and flows everywhere. It flows through the entire workshop, and workers stay on site for about 25 minutes. Due to the volatilization of acrylonitrile, the concentration of acrylonitrile in the air of the workshop was very high, and the taste of bitter apricot was extremely strong, resulting in all 14 acute poisonings with varying degrees of workers. The first example of onset at about 40 minutes after the accident, mainly as numbness, difficulty breathing, dizziness, headaches, heart palpitations and so on. One hour later the onset of the disease, the latest two patients was 14 hours after the accident .

2. After the rescue

(1) Establishing a rescue command group When the local county government learned that a poisoning accident had occurred, the leaders of the government and the leaders of the Industrial Bureau and the Health Bureau quickly arrived at the scene of the accident and formed a rescue command group with the leading comrades of the chemical plant. The poisoned patients were sent to the county hospital for emergency treatment.

(2) Rescuing local county hospitals to the relevant units None of the medical personnel knew what kind of chemical substances acrylonitrile was, nor did they know how to treat acute acrylonitrile poisoning. At that time, only a dozen poisoned patients could only be treated symptomatically. Some people also said that how serious acrylonitrile poisoning is, causing mental stress to the patient, and psychological pressure. Immediately after seeing this situation, the leading comrades of the rescue command group immediately decided to call for help from Harbin Medical University and the Provincial Occupational Disease Prevention and Treatment Center and called for help to the employees' hospital of large enterprises producing acrylonitrile in Jilin. After the above three units were called for help, they immediately organized experienced medical personnel to form a rescue medical team to rush to the County People's Hospital to conduct rescue treatment together with the provincial medical staff.

(3) Four major rescue measures In this accident, four measures were taken for the rescue of poisoned patients.

1 Detoxification. 1 % Methylene blue 10ml intravenously. Sodium thiosulfate 6.4g Soluble in 5 % glucose 250ml , intravenous drip. Repeated use for severely poisoned patients.

2 oxygen. All patients have dyspnea, so they use nasal cannula to inhale oxygen. Four patients with severe dyspnea were given respiratory center stimulant Kalamin.

3 exchange transfusion method. Severe bleeding of asters while entering fresh blood. Up to 1 case of blood excretion 1050ml , input fresh blood 1200ml .

4 supportive therapy. Cytochrome C , adenosine triphosphate, and large doses of vitamin C were added slowly to the veins in 10 % glucose solution. In addition, hepatoprotective treatment, such as liver tylo, vitamin B12 and so on.

(4) Treatment of rickets In the process of rescue, there were 5 female patients with rickets like seizures, mainly convulsions. Some also show dependence on oxygen, so long as the oxygen-supplying catheter is pulled out, it is difficult to breathe immediately, and it is very serious. After inserting the oxygen-suction catheter, it breathes quickly and smoothly, even if the oxygen flow rate is little.

These patients are mainly acupuncture therapy, while giving a small dose of sedative drugs such as stability and so on. In conjunction with doing ideological work, comforting patients, clarifying the truth, and resolving ideological concerns, we achieved very good results. Within 2 months these patients were discharged one after another. A few people went to a sanatorium after discharge to restore their health.

The information in this article comes from the Internet and was reorganized and edited by China Rescue Equipment Network.