Dichlo Ratan (Ethylene Chloride, Ethylene Dichloride).

Dichloroethane has a selective psychotropic (narcotic), neuro-, hepato-, nephrotoxic, local irritant effect. The toxic metabolite is chloroethanol. Symptoms of intoxication appear in the first 3 hours.

Upon admission - nausea, persistent vomiting mixed with bile, blood, pain in the epigastric region, salivation, liquid flaky stool with the smell of dichloroethane, scleral hyperemia, severe weakness, headache, psychomotor agitation, coma, exotoxic shock (1-2nd day), on the 2-3rd day the development of toxic hepatopathy (pain in the right hypochondrium, enlarged liver, jaundice), nephropathy, hepatorenal failure, hemorrhagic diathesis (stomach, nosebleeds).

In case of inhalation poisoning - headache, dizziness, drowsiness, dyspepsia, hypersalivation, toxic hepatopathy, nephropathy. In case of contact with skin - dermatitis, bullous rashes.

The lethal dose when taken orally is about 10-20 ml.

Treatment:

1. Abundant repeated gastric lavage through a tube, followed by the introduction of activated charcoal and petroleum jelly (150-200 ml) into the stomach. Combined use of hemosorption, then hemodialysis, peritoneal dialysis; forced diuresis with blood alkalization in combination with other methods while maintaining normal blood pressure levels.

2. Antioxidant therapy: vitamin E (alpha-tocopherol) 1-2 ml 3-4 times a day intramuscularly, unithiol 10 ml of a 5% solution 3-4 times a day.

3. Treatment of exotoxic shock: infusion of solutions of polyglucin, rheopolyglucin, hemodez, 10-15% glucose solution with insulin, 4-8% sodium bicarbonate solution - the total volume of infusion therapy is up to 10-12 liters per day. On the first day - hormone therapy (prednisolone intravenously, up to 1000 mg per day).

Treatment of toxic coagulopathy: heparin (for mild poisoning 5,000 units per day for 1-2 days, for moderate poisoning 5,000-10,000 units per day for 3-4 days, for severe poisoning - 20,000-40,000 ED per day for 2-3 days).

Use of hepatoprotectors: cyanocobalamin (up to 1500 mcg), thiamine (4 ml of 5% solution), pyridoxine (4 ml of 5% solution) intramuscularly; glucose, cocarboxylase (100-150 mg), lipoic acid (20-30 mg/kg per day) IV, glutamic acid (400-800 ml per day), Essentiale (400-800 ml per day IV and 1000 mg per day orally).

For severe agitation - diazepam (2 ml of 0.5% IV solution).