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GBZ80-2002 English PDF

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GBZ80-2002: Diagnostic Criteria of Occupational Acute Monomethylamine Poisoning
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Basic data

Standard ID GBZ 80-2002 (GBZ80-2002)
Description (Translated English) Diagnostic Criteria of Occupational Acute Monomethylamine Poisoning
Sector / Industry National Standard
Classification of Chinese Standard C60
Classification of International Standard 13.1
Word Count Estimation 6,636
Date of Issue 4/8/2002
Date of Implementation 6/1/2002
Quoted Standard GBZ 51-2002; GBZ 54-2002; GB/T 16180
Summary This standard specifies the diagnostic criteria for acute occupational poisoning methylamine and principles. This standard applies to occupational acute monomethylamine poisoning diagnosis and treatment of non-acute occupational poisoning may also refer to the implementation of a methylamine.

GBZ80-2002: Diagnostic Criteria of Occupational Acute Monomethylamine Poisoning

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Diagnostic Criteria of Occupational Acute Monomethylamine Poisoning ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational acute monomethylamine poisoning Released in.2002-04-08 2002-06-01 Implementation Issued by the Ministry of Health of the People's Republic of China

Foreword

Article 6.1 of this standard is recommended and the remainder is mandatory. According to the "People's Republic of China Occupational Disease Prevention Law" to develop this standard. Since the implementation of the standard date, the original standard GB 17056-1997 inconsistent with this standard, the standard shall prevail. In contact with a methylamine in the professional activities, can cause acute monomethylamine poisoning. To protect the physical health of monomethylamine contacts, To facilitate its poisoning prevention and control work, the development of this standard. Appendix A to this standard is an informative appendix. This standard is proposed and centralized by the Ministry of Health of the People's Republic of China. This standard by the Shanghai Chemical Industry and Disease Prevention and Control Hospital is responsible for drafting, Shangrao District of Jiangxi Province Health Bureau, Shangrao District People's Medical Hospital, Shangrao City First People's Hospital, Shangrao County People's Hospital, Shanghai Railway Bureau Shangrao Railway Hospital to participate in the drafting. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational acute monomethylamine poisoning Occupational acute monomethylamine poisoning is in the short-term occupational activities inhalation of a large amount of monomethylamine gas, causing the respiratory system Damage as the main performance of the systemic disease, often accompanied by eye and skin burns.

1 Scope

This standard specifies the diagnostic criteria and principles of occupational acute methamine poisoning. This standard applies to the diagnosis and treatment of occupational acute methamine poisoning, non-occupational acute monomethylamine poisoning can also refer to carried out.

2 normative reference standard

The terms of the following documents are hereby incorporated by reference into this standard. Any date that references the date of the document All subsequent amendments (excluding corrigenda) or revisions do not apply to this standard, however, The parties to the agreement are able to use the latest version of these documents. Those who do not mind the date of the reference file, its latest The version applies to this standard. GBZ 51 Occupational chemical skin burns diagnostic criteria GBZ 54 Occupational chemical eye burns diagnostic criteria Identification of Occupational Injury and Occupational Disease Disability in Staff and Workers GB/T 16180

3 diagnostic principles

According to the exact history of exposure to methylamine, the typical clinical manifestations of acute respiratory system damage, chest X-ray performance, Combined with blood gas analysis and other test results, refer to the scene of labor hygiene survey data, comprehensive analysis, and exclude other causes Caused by similar diseases, can be diagnosed.

4 stimulus response

After exposure to a transient eye and upper respiratory tract irritation symptoms, no positive signs of the lungs, chest X-ray examination no abnormal hair Now.

5 Diagnostic and grading standards

5.1 mild poisoning Eye and upper respiratory tract irritation, conjunctiva, pharyngeal hyperemia, edema; once to twice the inspiratory dyspnea Of the laryngeal edema; chest X system performance in line with acute tracheal - bronchitis or bronchial inflammation. 5.2 moderate poisoning Those who have one of the following conditions can be diagnosed as moderate poisoning. a) laryngeal edema with three degrees of inspiratory dyspnea; b) chest X-ray performance in line with acute bronchial pneumonia or interstitial pulmonary edema. Blood gas analysis often mild to moderate hypoxemia. 5.3 severe poisoning Where any of the following circumstances, can be diagnosed as severe poisoning. a) suffocation due to severe laryngeal edema or bronchial mucosal necrosis; b) chest X-ray performance in line with alveolar pulmonary edema; c) acute respiratory distress syndrome (ARDS); d) sudden death; e) complicated by severe pneumothorax, mediastinal emphysema, subcutaneous emphysema or atelectasis. Blood gas analysis often severe hypoxemia. 5.4 Eye or skin burns Light, moderate and severe acute poisoning can be associated with eye or skin burns, the diagnostic grading with reference to GBZ 54 or GBZ 51.

6 Principles of handling

6.1 Principles of treatment 6.1.1 Field processing. Immediately move away from the site to the upper windward zone, remove contaminated clothing, and immediately use a lot of mobile clear Water thoroughly rinse contaminated skin, eye rinse time for at least 10 min. Stimulate the responders need bed rest, generally close observation 48 h, and give the necessary inspection and treatment. 6.1.2 to keep the airway open, can be given inhalation of drugs, bronchial antispasmodic agents, to defoamers (such as 10% dimethyl Silicone oil). If necessary, should be done early tracheotomy. Pay attention to postural drainage, encourage patients to emit necrotic mucosal tissue. 6.1.3 Reasonable oxygen therapy. According to the disease to choose the appropriate oxygen method, inhalation oxygen concentration (FiO2) should not exceed 60%. Companion There is acute carbon dioxide retention, while actively improving the ventilation at the same time, given the regulation of oxygen concentration, so that oxygen saturation (SaO2) More than 90%; if inhalation of high concentrations of oxygen, can be given positive pressure ventilation (PEEP), PEEP pressure less than 0.49 kPa (5 cmH2O). 6.1.4 early, adequate, short-term application of glucocorticoids, moderate and severe poisoning can be combined with scopolamine drugs. 6.1.5 early strict limit of the amount of fluid, control infusion rate, to maintain urine output greater than 30 mL/h if necessary, plus diuretic Agent. Correct acid, alkalosis and electrolyte imbalance. 6.1.6 active prevention and treatment of complications. 6.1.7 eye, skin burn treatment, refer to GBZ 54 or GBZ 51. 6.2 Other treatments Mild, moderate poisoning treatment after short-term rest, health recovery can be arranged after the original work; severe poisoning should be transferred from the original work, And according to the situation of health recovery to decide to rest or arrange work; if sequelae, refer to GB/T 16180 of the relevant articles Processing.

7 Correctly use the instructions in this standard

See Appendix A (informative).

Appendix A

(Informative) Correctly use the instructions in this standard A.1 monomethylamine aqueous solution can be gasified in the form of gas through the respiratory tract inhalation, so this standard is also applicable to the aqueous solution of methylamine Due to skin burns associated with inhalation poisoning. A.2 Aminoamine acute poisoning laryngeal edema caused by inspiratory dyspnea at four degrees. Once; quietly without breathing difficulties, activities or Crying show breathing breathing difficulties; second. quiet also have mild "three levy", the activities increased, but does not affect the sleep Sleep, and no irritability; three degrees. breathing difficulties are obvious, "three concave" significant, and there are irritability, not easy to Sleep; four degrees. in addition to three times the performance of dyspnea, there are restless, hands and feet tamper, a cold sweat, pale or cyanosis, Finally coma until the heartbeat stops. A.3 The diagnostic grading proposed in this standard is based on the degree of respiratory damage as the main basis, the stimulus response is not acute poisoning Domain. Once to twice the inspiratory dyspnea of laryngeal edema and acute bronchitis for the diagnosis of the starting point of the disease. A.4 blood gas analysis PaO2 determination of the diagnostic criteria for the classification of indicators, hypoxemia sub-three. mild [PaO2 less than 10.7kPa (80 mmHg)], moderate [PaO2 less than 8 kPa (60 mmHg)], and severe [PaO2 less than 5.3 kPa (40 mmHg)]. To determine the severity of hypoxia, should be combined with clinical manifestations, and for dynamic observation, remove the technical error. A.5 poisoning occurs diffuse alveolar pulmonary edema, a large number of secretions of nasal and nasal discharge; coma with cyanosis; three to Four degrees of breathing breathing should be timely for tracheotomy. A.6 The initial focus of the course of the disease is to prevent laryngeal edema and pulmonary edema; some patients are prone to recurrence of disease, pulmonary edema control After the need to closely observe, and actively prevent secondary infection in the lungs, airway mucosal detachment and other complications. A.7 The disease treatment no specific antidote, commonly used non-specific antagonist adrenal cortex hormones. Moderate and severe poisoning can be linked Combined with scopolamine drugs, such as scopolamine 0.3 ~ 0.6 mg/time or 654-2 10 ~ 20 mg/times, intravenous administration, Should be early medication and reach a certain therapeutic dose, but do not emphasize to achieve scopolamine, in principle, the first dose after the small, the first time interval Short after long. A.8 drug aerosol inhalation is one of the essential methods of treatment, commonly used atomization liquid composition is. dexamethasone 5 mg ten celebrations Methomycin 80,000 u +654-2 10 mg furosemide 20 mg saline 50 ~ 100 mL, ultrasonic atomization inhalation, each 10 ~ 20 mL, the interval time according to the severity of the decision. Can also be placed in the oral cavity of the atomization device artificial spray. If the patient is missing Oxygen obvious or disturbance of consciousness, ultrasonic atomizer can be connected to the oxygen bottle, with oxygen into the ultrasonic atomization solution. Also available hormones Preparation of pulmicort, pulsed ketone spray inhalation; β2 agonist 0.5% salbutamol solution 1mL or terbutaline Solution 1mL aerosol inhalation; cholinergic blocker 0.5% ipratropium bromide solution 1mL atomization inhalation. A.9 should pay attention to the symptoms of systemic poisoning first aid, but also can not ignore the eye and skin burns local treatment. To one Methylamine aqueous solution caused by skin II °. Burn area greater than or equal to 20% or III °. Burn area greater than or equal to 10% or head and face Burns, should be alert to a methylamine can be absorbed by the skin to increase poisoning, even if the early symptoms of the respiratory system is not obvious, but also routine Chest X-ray, blood gas analysis and other checks, pay attention to observe the respiratory symptoms and changes in lung signs, if necessary, to give preventive treatment.

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