00:01
Carbon monoxide is a common toxic agent.
It's usually culprit in suicide attempts
where people will breath in exhaust fumes from a car.
00:12
Carbon monoxide has an affinity for hemoglobin about
two hundred times greater than oxygen.
00:19
The threshold limit for a human is about 25 ppm in 8 hours.
Now, consider that on a bad traffic day in LA,
you're going to hit 100 ppm. In Mumbai India, you'll hit
400 ppm. And in Shanghai, you'll hit 800 ppm.
00:37
So, you can see that there is a toxicity potential
in terms of the environment.
00:42
Carbon monoxide results in a significant amount of confusion.
Sometimes, you can have decreased visual acuity.
00:50
There is almost always tachycardia. There may be syncope,
and eventually will result in coma and death.
00:57
The classic sign of a carbon monoxide patient
are those rose cheeks.
01:03
You see a person come in, and they have those red rose cheeks,
and they look like they're just a little bit hyperemic,
almost always you can diagnose carbon monoxide
just by looking at them.
01:12
The first time you see a carbon monoxide poisoned patient,
you'll almost never missed the next diagnosis.
01:18
The treatment is always with oxygen.
01:21
Sulphur dioxide is an agent that is in the air
that sometimes can cause toxicity.
01:27
It forms sulfurous acid on contact with some
mucous membranes. 6 ppm will cause symptoms.
01:35
Generally, it's irratation of those mucous membranes. So, you
get conjunctival irritation and mucous membrane irritation.
01:42
A classic picture is a person with red eyes
and irritation of the nares or nasal cavity.
01:48
Long term exposure may lead to pulmonary edema.
01:52
And treatment is always supportive including
anti-inflammatories and high levels of oxygen.
01:57
Dioxin toxicity is an important consideration
on the chemical industry.
02:02
Many chemical agents rely on dioxin as an intermedia in
manufacturing. They are very poorly metabolized.
02:10
And why I mention it here today is because these dioxins
are very persistent in the environment.
02:16
They cause a wasting syndrome and they cause hepatotoxicity.
And they cause immune dysfunction and teratogenicity.
02:24
If you're practising it in an area,
where you start to see high levels of immune dysfunctions,
high levels of wasting and hepatotoxicity,
and even teratogenicity in a community,
the first thing you should be looking for
are dioxin levels in the environment.