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GBZ71-2013 English PDF

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GBZ71-2013: Diagnosis of occupational acute chemical poisoning -- General rules
Status: Valid

GBZ71: Evolution and historical versions

Standard ID	Contents [version]	USD	STEP2	[PDF] delivered in	Standard Title (Description)	Status	PDF
GBZ 71-2013	English	279	Add to Cart	3 days [Need to translate]	Diagnosis of occupational acute chemical poisoning -- General rules	Valid	GBZ 71-2013
GBZ 71-2002	English	319	Add to Cart	3 days [Need to translate]	Diagnostic Criteria of Occupational Acute Chemicals Poisoning (General Rules)	Obsolete	GBZ 71-2002

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Standard similar to GBZ71-2013

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Basic data

Standard ID	GBZ 71-2013 (GBZ71-2013)
Description (Translated English)	Diagnosis of occupational acute chemical poisoning -- General rules
Sector / Industry	National Standard
Classification of Chinese Standard	C60
Classification of International Standard	13.100
Word Count Estimation	12,199
Older Standard (superseded by this standard)	GBZ 71-2002
Quoted Standard	GB/T 16180; GBZ 77
Regulation (derived from)	Health-Communication (2013) 1
Issuing agency(ies)	Ministry of Health of the People's Republic of China
Summary	This standard specifies the occupational acute chemical poisoning diagnosis and treatment principles. This standard applies to the diagnosis and treatment due to exposure to chemicals that cause acute poisoning in professional activities.

GBZ71-2002: Diagnostic Criteria of Occupational Acute Chemicals Poisoning (General Rules)

---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
(Occupational acute chemical poisoning diagnostic criteria (General)) ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational acute chemical poisoning (general) Diagnostic Criteria of Occupational Acute Chemical Poisoning (General Rules) 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 16852.1 -1997 inconsistent with this standard, subject to this standard. The rules set out in this series of rules, involving the diagnosis of occupational acute chemical poisoning, these rules used to protect The unity of the diagnostic system of occupational acute chemical poisoning, whether known or concealed by the cause, The damage to the target organ caused by poisoning can be diagnosed in accordance with the rules set forth in this standard. In the "occupational acute chemical poisoning diagnostic criteria" under the general heading, including the following 10 parts. each part The scope of the definition will be stated in the preface and the introduction to each section. Part 1. diagnosis of occupational acute chemical poisoning (general); Part 2. diagnostic rules for occupational acute occult chemical poisoning; Part 3. diagnostic criteria for occupational acute toxic multi - organ dysfunction syndrome; Part 4. diagnostic criteria for occupational acute chemical death; Part 5. diagnostic criteria for occupational acute toxic neurological diseases; Part 6. diagnostic criteria for occupational acute toxic respiratory diseases; Part 7. diagnostic criteria for occupational acute toxic liver disease; Part 8. diagnostic criteria for occupational acute toxic nephropathy; Part 9. diagnostic criteria for occupational acute toxic heart disease; Part 10. diagnostic criteria for occupational acute toxic blood system diseases. 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 Sixth People's Hospital, the Chinese Center for Disease Control and Occupational Health and poisoning control is responsible for Grass; Shanghai Chemical Industry Occupational Disease Prevention and Control Hospital, Shanghai Institute of Occupational Health and Occupational Disease Prevention and Control, Chinese Preventive Medicine College standards office to participate in the drafting. This standard is interpreted by the Ministry of Health of the People's Republic of China. Occupational acute chemical poisoning diagnosis (general) Occupational acute chemical poisoning refers to the workers in the professional activities, short-term absorption of large doses of occupational chemicals Causing poisoning.

1 Scope

This standard specifies the general principles of occupational acute chemical poisoning diagnosis. This standard is applicable to the diagnosis and treatment of acute poisoning caused by occupational exposure to occupational hazards in occupational activities. In the absence of occupational activities due to the general poison caused by the diagnosis of acute poisoning, can also refer to this standard.

2 normative reference documents

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. Identification of Occupational Injury and Occupational Disease Disability in Staff and Workers GB/T 16180 Rules for the diagnosis of occupational acute occult chemical poisoning

3 diagnostic principles

According to the exact occupation history, including exposure to occupational poison species, contact and lead to a large number of short-term The reasons for the absorption, and the emergence of the corresponding clinical manifestations of acute poisoning, excluding other causes caused by similar diseases, side Can be diagnosed.

4 observation object

Short-term exposure to large doses of toxic substances, or contact with a long incubation period after the poison, although no obvious clinical table Present, or only mild symptoms and failed to confirm the acute poisoning, to be further medical care, as the object of observation.

5 Diagnostic and grading standards

5.1 mild poisoning The presence of exposure to toxic substances due to the corresponding target organ (system) mild poisoning damage clinical manifestations. 5.2 moderate poisoning The severity of poisoning is between mild and severe poisoning. 5.3 Severe poisoning One of the following conditions can be diagnosed as severe poisoning. a) the occurrence of the corresponding target organ (system) dysfunction caused by the absorption of toxic substances; b) the occurrence of multiple organ (system) dysfunction caused by the absorption of toxic substances; c) acute poisoning left a serious sequelae.

6 Principles of handling

6.1 on-site rescue a) rescued the scene, to the safe area; b) take urgent measures to maintain vital signs; c) eye pollution should be timely, full rinse with water; d) remove the contaminated clothing, immediately washed with a lot of water thoroughly stained skin; e) after emergency treatment, immediately sent to the hospital, on the way to continue to do the necessary rescue, and record the condition. 6.2 cause of treatment a) prevent the poison from continuing to absorb; b) to exclude the body has been absorbed poison or its metabolites such as the application of metal complexing agent, blood purification therapy; c) special effects antidote. for the pathogen caused by pathophysiological changes in the body, reversing its toxic effects, to detoxification of. 6.3 symptomatic treatment a) to eliminate or reduce the damage caused by the main system (organ) caused by toxicological changes; b) the application of non-specific antagonistic drugs; c) to maintain the body environment balance; d) Reduce patient suffering. 6.4 support treatment a) improve the body's resistance to disease; b) psychological treatment; c) rehabilitation treatment. 6.5 Preventive treatment a) to prevent the possible occurrence of various diseases; b) properly handle treatment of contradictions. 6.6 others a) traditional Chinese medicine; b) good care.

7 Correctly use the instructions in this standard

See Appendix A (informative).

Appendix A

(Informative) Correctly use the instructions in this standard A.1 The scope of application of this standard The essence of this standard for the diagnosis of acute occupational poisoning principles, applicable to a variety of occupational poisoning caused by acute poisoning clinic Break, grading and handling. It is more appropriate to poison poisoning without diagnostic criteria. Subacute poisoning clinical manifestations, treatment and acute poisoning is basically the same, it is acute poisoning areas. Both contact The length of time is different, but it is difficult to use the specific time to divide the line, so this standard is not a sub-acute poisoning. Such as has issued a national occupational acute chemical poisoning diagnostic criteria and treatment principles, the clinical application of the standard Mainly, if necessary, the relevant items in this standard can be used as a reference. This standard is for non-occupational acute poisoning reference applications. A.2 The diagnostic principles of this standard According to the toxic effects of the poisoned species, the principle of dose-effect relationship, combined with the time factors of exposure and incidence The main indicators of comprehensive analysis, to identify the cause (poison) and disease (acute poisoning) causal relationship, as a diagnostic The main basis. Etiology. According to occupational history, on-site labor hygiene survey, biological material testing, clear contact with toxic species, the scene Conditions and invasive routes, the estimated dose of absorption, etc .; such as exposure to more than one poison or other hazards, should be considered The effect of the joint effect. Disease. from the clinical manifestations, auxiliary examination, etc., to determine the nature and severity of the disease. According to the cause, disease information, comprehensive analysis, come to preliminary comments, and do a differential diagnosis. The focus is. a) whether the time and incidence of poisoning is consistent with the pathogenesis of acute poisoning; b) whether the toxic effects of toxicants are consistent with the patient's clinical manifestations; c) whether the estimated absorbed dose is substantially consistent with the severity of the disease. In the comprehensive analysis, various factors that affect the clinical manifestations of acute poisoning should be considered, such as patient sex, age, health Health and nutritional status, allergies and so on. It should also be noted that the poison contains impurities or contact with the poison under certain conditions Reaction to produce another poison and so on. In some cases, the pathogen is not clear enough, or lack of toxic effects of the information, if necessary, do field simulation Test or toxicological tests, etc., to provide diagnostic basis. Deaths should try to do autopsies as soon as possible to obtain pathological diagnosis, and there are Help improve the quality of rescue work in the future. When the autopsy as much as possible to determine the main organs of toxic substances. A.3 grading standards A.3.1 acute occupational poisoning grading standards are based on the severity of the poisoning to divide, the classification of rescue, guidance and treatment The ability to identify the work, assess the dangers of this accident and so on. A.3.2 According to the clinical manifestations of acute occupational poisoning, reference to the toxicity of toxicants can be divided into three, two or not grading. A.3.3 mild acute poisoning for the diagnosis of acute poisoning starting point, because this standard covers a wide range, it is impossible to make a specific diagnosis Broken indicators, the application can be based on specific clinical circumstances, can also refer to the relevant standards of the standard. A.3.4 If the clinical manifestations can not reach the diagnostic starting point, according to the situation diagnosed as inhalation reaction, stimulate the reaction. A.3.5 At the initial stage of the rescue, according to the patient's main clinical manifestations at that time, combined with possible progression of the disease Line preliminary classification diagnosis, easy to emergency treatment. In the multi-person acute poisoning emergency rescue, grading is an important organization and medical treatment Treatment measures. A.3.6 Final diagnosis of acute occupational poisoning (including graded diagnosis) should be done at the time of patient medical treatment, when discharged or died After the assessment. A.3.7 Nomenclature of diagnosis. should include the nature of the poisoning, type, severity, pathogenic chemical species and so on. Main target organ Injury and severity, complications, sequelae, etc. should also be included. A.4 on-site rescue Site rescue is the first important part of the rescue work. Good on-site rescue can win the time for further treatment Make good condition. To be done on-site rescue properly, fast, effective and successful, the key is to rescue those who have the ability to respond Qualified training, and the necessary equipment, it is usually very important to prepare the work. In the event of multiple acute poisoning, should be set up temporary rescue command organization, short-term control of the scene environment and chaos, Maintain order, emergency and proper treatment of critically ill patients, general patients and contacts. This grading treatment has its own focus, characteristics, but also close contact with each other, timely adjustment, so that limited human and material development Play the biggest role. A.5 cause of treatment Etiology of treatment is the main measure to remove the cause of the rescue; A.5.1 To prevent the absorption of toxicants. Various measures are taken to remove any poison that has not yet been absorbed or to prevent poison Receive Some of these measures, although relatively simple, but the early removal of toxic substances than the body into the body after the toxic effects, and then take detoxification, Special effects drugs or other treatment of the effect of large damage to the body, the input of human resources, material resources, it must not be because of the general The rescue routine and neglect, should be implemented seriously early. A.5.2 to exclude the body has absorbed the toxic and its metabolites. a) rational application of metal complexing agent; b) blood purification therapy. its instruments, methods, etc. constantly updated, progress quickly, according to the toxic species and characteristics, selected Choose the appropriate method, early application. A.5.3 special effects antidote. there are indicators as early as possible application. A.6 symptomatic treatment For the damage caused by poison has taken preventive measures, with or without special effects antidote, symptomatic treatment in the rescue accounted for very important position. A.6.1 To eliminate or reduce poisonous lesions such as cerebral edema, pulmonary edema or liver and kidney damage in major systems or organs to control The lesion deteriorates and the condition improves. A.6.2 non-specific antagonist drugs refers to glucocorticoids, mercapto-containing drugs and anti-free drugs, such drugs are very More toxic damage caused by a certain degree of antagonism, but not specific, according to the specific circumstances, the rational use. A.6.3 maintenance of the body environment balance. in acute poisoning, maintenance of water, electrolyte, acid-base balance, prevention and timely correction Is hypoxic state, are very important treatment measures to create a better environment, to promote the damage to the organ recovery. A.7 support treatment Supportive treatment is through various measures to improve the body's resistance. Due to the occurrence of acute poisoning, often the spirit of the patient is subject to great shock, psychological stimulation, trauma, but also Can produce all kinds of ideological pressure, the treatment of adverse factors. So should do a good job of psychological treatment to reduce its mental stress, increase Strong confidence in the fight against the disease, fully with the medical measures, adverse factors for the favorable factors, which is particularly important in many people poisoning. At the same time to do the ideological work of their families, so that in the whole course can cooperate with, collaboration. Serious illness, coma patient family thinkers Is particularly important. These work to the hospital concerned, the relevant organizations and other co-operation in order to proceed smoothly. A.8 Preventive treatment Prophylactic treatment is based on the characteristics of poisonous drug poisoning characteristics, combined with clinical manifestations to be analyzed, foresee the disease may Changes that take targeted measures to prevent them from occurring or mitigate their severity and prevent the formation of vicious cycles. If the treatment of spears Shield, according to the objective condition, analysis of the pros and cons of various treatment measures, properly handled. Reasonable preventive treatment in the control of the disease Development can play a great role, to combine the disease targeted. A.9 Other treatments Chinese medicine in acute poisoning treatment, can play a great role. In addition to some drugs such as salvia miltiorrhiza, With the experience, the other can be implemented according to the principle of syndrome differentiation. Nursing work throughout the rescue process is very important, in some cases the key to success or failure, should take the Measures to ensure the quality of nursing work. A.10 The general treatment principle The body is an organic whole, acute poisoning, although a system or organ lesions more prominent, but are systemic diseases; The system, organ disease will also affect each other, so throughout the course of the disease must be guided by the overall treatment. Treatment side The case should be based on clinical manifestations combined with a variety of checks to develop, not only based on a test result to decision. Etiology, symptomatic, Support and preventive treatment, are interrelated and indivisible. Diagnosis, treatment of clinical thinking, it is necessary to have the principle, But also with the specific circumstances to analyze, to be realistic. For patients with severe poisoning, conditional as much as possible to strengthen the monitoring of income Ward, to strengthen the observation, timely rescue to create better conditions. Monitoring indicators may be based on specific circumstances. A.11 Identification of labor capacity Identification of labor capacity is based on the patient's health recovery, identification of their ability to work, the nature of the future work, strength, Working hours, etc., make reasonable arrangements. Its specific content, in addition to the above principles, can refer to the People's Republic of China Ministry of Labor, Ministry of Health to develop GB / T 16180. A.12 health check requirements The requirements, methods and specific items of the health check may be based on the type of exposure to the poison. Health check should be based on our country already Promulgated the law on the prevention and treatment of occupational diseases and the relevant laws and regulations, strict implementation. A13 professional contraindications Occupational contraindications for different poisons should be formulated according to the nature of each poison.

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