Beware! Someone fainted from poisoning while cleaning the toilet and was admitted to the ICU. Be careful when using disinfectants

Doctors remind: Be careful when using disinfectants

Chlorine is a gas widely used in the field of disinfection and sterilization, but it is also a highly toxic gas. Be careful when using such items in your life. If you accidentally inhale it, it can easily lead to poisoning. Recently, the Emergency Center of the Provincial Hospital of Traditional Chinese Medicine received a patient who was "chlorine poisoning" at home. Soon after the poisoning, he was admitted to the emergency EICU due to respiratory failure.

In early May this year, 60-year-old Mr. Wang (a pseudonym) who lives in Nanjing, put some effervescent disinfectant tablets into the water while cleaning the toilet at home in order to clean it more thoroughly and disinfect it. However, he was irritated by the smell that was emitted instantly. Soon after, he began to have difficulty breathing and fainted on the ground. "Fortunately, I returned in time. When I opened the door, the whole room was filled with a pungent smell..." Mr. Wang's family members still feel scared when talking about this incident.

"When the patient first arrived at the emergency room, although he was still conscious, he had difficulty breathing, coughed and felt uncomfortable, coughed up white sputum, felt nauseous and felt chest tightness and pain." Wang Yijun, director of the emergency department of the Provincial Hospital of Traditional Chinese Medicine, said that based on the disinfectant tablets brought by the family and the clinical manifestations, Mr. Wang should have been "chlorine poisoning." In the emergency room, the medical staff treated the patient with expectorant, acid suppression and stomach protection, but the patient's symptoms did not improve significantly. The pulse oxygen saturation was 77%, which was a manifestation of severe respiratory failure, and he was transferred to the emergency room for treatment.

In the emergency room, the patient was listless, had obvious shortness of breath, and a rapid respiratory rate. Chest CT showed diffuse lesions in both lungs. Medical staff gave him high-flow nasal oxygen therapy and methylprednisolone for anti-inflammatory treatment, but considering the patient's aspiration pneumonia (chlorine poisoning), acute respiratory distress syndrome, and respiratory failure, they communicated with his family and admitted him to the emergency EICU for further treatment.

After 5 days of active treatment, the patient was successfully weaned from the ventilator and extubated. Chest CT scan showed a few inflammation and fibrosis in both lungs, and the absorption was significantly reduced compared with before. After respiratory rehabilitation exercises, Mr. Wang was cured and discharged after 10 days of hospitalization. According to Hua Shengyi, a doctor in the emergency EICU, the patient's disease progressed very quickly. It took less than half a day from chlorine poisoning to respiratory failure in the EICU. Fortunately, he was sent to the hospital for rescue in time, otherwise the consequences would be disastrous.

"Chlorine is a yellow-green, highly corrosive, toxic gas that is easily soluble in water and widely used in the chemical and plastic industries, etc." Li Jinjin, director of the hospital's emergency EICU, said that the reason why chlorine can be used for disinfection is that after chlorine is dissolved in water, it can generate hypochlorous acid, which has disinfecting properties. Hypochlorous acid has extremely strong oxidizing properties and can destroy bacterial cell walls and cell membranes. It can also destroy protein synthases in microbial pathogens, ultimately leading to bacterial death and achieving the purpose of sterilization. However, chlorine is also a highly toxic gas with a strong irritating odor. When a large amount of chlorine is inhaled in a short period of time, it will cause systemic diseases with acute respiratory damage as the main feature, which is called "chlorine poisoning."

Most of the effervescent disinfectant tablets are chlorine-containing disinfectant tablets, which are mostly used for rinsing and disinfecting swimming pools, floors, toilets, tableware, clothes, etc. The chlorine-containing effervescent disinfectant tablets used by Mr. Wang are exactly this type. Although this type of disinfectant tablet is convenient and effective, the general product will indicate the use of the product, "One disinfectant effervescent tablet dissolved in 1000ml of water is equivalent to a bottle of disinfectant with a concentration (containing chlorine 500mg/L)". According to family members, Mr. Wang did not read the instructions carefully and put more than 30 chlorine-containing effervescent disinfectant tablets in the water at one time, resulting in chlorine poisoning. Fortunately, the hospital's timely and effective treatment avoided the tragedy.

Guo Tao, director of the hospital's emergency department, reminded that the main cause of chlorine poisoning is exposure to chlorine in occupation, environment, and life, which causes the human body to inhale chlorine and lead to poisoning. Chlorine poisoning is not common in daily life. Chlorine poisoning is mainly manifested by dyspnea, choking, chest tightness, nausea and other symptoms. In severe cases, the patient may die in a short time. Once chlorine poisoning occurs, it should be taken seriously. First of all, you should quickly leave the environment with chlorine and go to a place with fresh air circulation. Wash the contaminated eyes and skin with plenty of water in time, and send to the doctor for treatment in time. At the same time, we should strengthen safety education, improve operating procedures, use detergents according to the instructions, do not mix with other cleaning products at will, keep the room ventilated when using, and enhance personal protection awareness.

Correspondent Ma Yun; Reporter Ji Kan