Poisoning From Gasses

Question 1

What is the first step in managing poisoning from gases, solvents, smoke, or fumes?

Answer 1

Ensure scene safety

Question 2

What symptoms should be assessed for carbon monoxide (CO) poisoning?

Answer 2

Headache, nausea, vomiting, chest tightness, shortness of breath, tachycardia, confusion, falling level of consciousness, dysrhythmias, cardiac arrest

Question 3

At what carboxy-haemoglobin level should oxygen be administered to a patient suspected of CO poisoning?

Answer 3

Greater than 10%

Question 4

How should oxygen be administered to a patient with suspected CO poisoning?

Answer 4

Via a reservoir mask at 10 litres/minute

Question 5

When should nebulised bronchodilators be administered?

Answer 5

If clinical signs of bronchospasm are prominent

Question 6

What backup is required if a patient has significantly abnormal vital signs?

Answer 6

Backup from a Paramedic

Question 7

What is the recommended action if a patient has a GCS less than 10?

Answer 7

Request backup from a CCP

Question 8

What should be done if CO poisoning is suspected and the patient is symptomatic?

Answer 8

Transport to an ED by ambulance

Question 9

What is the usual recommendation for transport to an ED after exposure to solvents or fumes?

Answer 9

Transport is not required unless there are signs of abnormal physiology

Question 10

What are common symptoms of carbon monoxide (CO) poisoning?

Answer 10

Headache, nausea, vomiting, chest tightness, shortness of breath, tachycardia, confusion, falling level of consciousness, dysrhythmias, cardiac arrest

Question 11

What is a reliable method to measure carboxy-haemoglobin levels?

Answer 11

Using a CO-oximeter

Question 12

What symptoms are commonly associated with exposure to solvents and/or fumes?

Answer 12

Headache, nausea, vomiting, dizziness, shortness of breath, irritation of the eyes, nose, mouth or throat

Question 13

How long do symptoms from solvent or fume exposure usually take to resolve?

Answer 13

1-2 hours

Question 14

What should be done if a patient exhibits signs of pulmonary oedema after chlorine gas exposure?

Answer 14

Transport to an ED if there are signs of abnormal physiology

Question 15

What is the primary effect of hydrogen sulphide (H2S) poisoning?

Answer 15

Impairment of oxygen utilisation at a mitochondrial level

Question 16

What indicates a potential H2S poisoning scenario?

Answer 16

A sulphurous odour, signs warning of danger, taped doors/windows, a container with chemicals

Question 17

What are initial steps if H2S poisoning is suspected?

Answer 17

Do not enter the enclosed space, request urgent assistance, call on the patient to exit if conscious

Question 18

What is the most appropriate method of decontamination for a patient with chemical exposure?

Answer 18

A shower of approximately three minutes’ duration

Question 19

What should be done if a patient is unconscious due to H2S poisoning?

Answer 19

Wait for FENZ or HAZMAT personnel with breathing apparatus

Question 20

What should be removed from a patient before transport if contaminated with chemicals?

Answer 20

Clothing, leaving underwear on

Question 21

True or False: Off gassing of dangerous levels of gas from a patient has been documented.

Answer 21

False

Question 22

What is the role of cyanide antidotes in H2S poisoning?

Answer 22

They may have a role in treatment if immediately available

Question 23

What should be done in the case of cardiac arrest following H2S poisoning?

Answer 23

Resuscitation should usually commence unless there is a clear reason not to