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Chemwatch:4650.13 Page 3 of 18 Issue Date:11/12/2018 Version No:7.1.1.1 API Pond Ammonia Test Solution#1 Print Date:06/21/2019 Seek medical attention without delay;if pain persists or recurs seek medical attention. Removal of contact lenses after an eye injury should only be undertaken by skilled personnel. If skin contact occurs: Immediately remove all contaminated clothing,including footwear. Skin Contact Flush skin and hair with running water(and soap if available). Seek medical attention in event of irritation. If fumes or combustion products are inhaled remove from contaminated area. Lay patient down.Keep warm and rested. Prostheses such as false teeth,which may block airway,should be removed,where possible,prior to initiating first aid Inhalation procedures. Apply artificial respiration if not breathing,preferably with a demand valve resuscitator,bag-valve mask device,or pocket mask as trained.Perform CPR if necessary. Transport to hospital,or doctor. IF SWALLOWED,REFER FOR MEDICAL ATTENTION,WHERE POSSIBLE,WITHOUT DELAY. For advice,contact a Poisons Information Centre or a doctor. Urgent hospital treatment is likely to be needed. In the mean time,qualified first-aid personnel should treat the patient following observation and employing supportive measures as indicated by the patient's condition. If the services of a medical officer or medical doctor are readily available,the patient should be placed in his/her care and a copy of the SDS should be provided.Further action will be the responsibility of the medical specialist. If medical attention is not available on the worksite or surroundings send the patient to a hospital together with a copy of Ingestion the SDS. Where medical attention is not immediately available or where the patient is more than 15 minutes from a hospital or unless instructed otherwise: INDUCE vomiting with fingers down the back of the throat,ONLY IF CONSCIOUS.Lean patient forward or place on left side(head-down position,if possible)to maintain open airway and prevent aspiration. NOTE:Wear a protective glove when inducing vomiting by mechanical means. Most important symptoms and effects, both acute and delayed See Section 11 Indication of any immediate medical attention and special treatment needed for salicylate intoxication: Pending gastric lavage,use emetics such as syrup of Ipecac or delay gastric emptying and absorption by swallowing a slurry of activated charcoal.Do not give ipecac after charcoal. Gastric lavage with water or perhaps sodium bicarbonate solution(3%-5%).Mild alkali delays salicylate absorption from the stomach and perhaps slightly from the duodenum. Saline catharsis with sodium or magnesium sulfate(15-30 gm in water). Take an immediate blood sample for an appraisal of the patient's acid-base status.A pH determination on an anaerobic sample of arterial blood is best. An analysis of the plasma salicylate concentration should be made at the same time.Laboratory controls are almost essential for the proper management of severe salicylism. In the presence of an established acidosis,alkali therapy is essential,but at least in an adult,alkali should be withheld until its need is demonstrated by chemical analysis.The intensity of treatment depends on the intensity of acidosis.In the presence of vomiting,intravenous sodium bicarbonate is the most satisfactory of all alkali therapy. Correct dehydration and hypoglycaemia(if present)by the intravenous administration of glucose in water or in isotonic saline.The administration of glucose may also serve to remedy ketosis which is often seen in poisoned children. Even in patients without hypoglycaemia,infusions of glucose adequate to produce distinct hyperglycaemia are recommended to prevent glucose depletion in the brain.This recommendation is based on impressive experimental data in animals. Renal function should be supported by correcting dehydration and incipient shock.Overhydration is not justified.An alkaline urine should be maintained by the administration of alkali if necessary with care to prevent a severe systemic alkalosis.As long as urine remains alkaline(pH above 7.5), administration of an osmotic diuretic such as mannitol or perhaps THAM is useful,but one must be careful to avoid hypokalaemia.Supplements of potassium chloride should be included in parenteral fluids. Small doses of barbiturates,diazepam,paraldehyde,or perhaps other sedatives(but probably not morphine)may be required to suppress extreme restlessness and convulsions. For hyperpyrexia,use sponge baths. The presence of petechiae or other signs of haemorrhagic tendency calls for a large Vitamin K dose and perhaps ascorbic acid.Minor transfusions may be necessary since bleeding in salicylism is not always due to a prothrombin effect. Haemodialysis and haemoperfusion have proved useful in salicylate poisoning,as have peritoneal dialysis and exchange transfusions,but alkaline diuretic therapy is probably sufficient except in fulminating cases. [GOSSELIN,et.al.:Clinical Toxicology of Commercial Products] The mechanism of the toxic effect involves metabolic acidosis,respiratory alkalosis,hypoglycaemia,and potassium depletion.Salicylate poisoning is characterised by extreme acid-base disturbances,electrolyte disturbances and decreased levels of consciousness.There are differences between acute and chronic toxicity and a varying clinical picture which is dependent on the age of the patient and their kidney function.The major feature of poisoning is Continued...