How to Identify a Case of Arsenic Poisoning

Arsenic is an element and is highly poisonous both in elemental form and in compounds, although it is much more common in compounds. Arsenic's inorganic compounds are generally more poisonous than the organic ones, and it cannot be broken down or otherwise destroyed because it is a stable element. The following steps will help you identify and treat a case of arsenic poisoning.

Difficulty: Challenging

Instructions

1. Remove the patient from the contaminated environment if poisoning from arsine gas is suspected. Remove all contaminated clothing and begin an exchange transfusion if necessary.

2. Look for the symptoms. Arsenic kills by massive disruption of the digestive system with 70 to 180 milligrams being the average fatal dose in a non-acclimated adult. Symptoms from low level exposure include diarrhea, nausea, vomiting and a tingling sensation in the extremities. Long term exposure can darken the skin and cause corns or warts.

3. Begin general supportive measures when arsenic poisoning has been confirmed. Administer isotonic intravenous fluids. Once the patient has been adequately hydrated, vasopressors such as dopamine and norepinephrine may be used.

4. Begin specific treatment. Decontaminate the stomach by gastric lavage, not induced vomiting. Chelation may be accomplished with Dimercaprol or British anti-lewisite (BAL). Chelation may also include penicillamine.

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