Accidental inhalation injury of phosgene gas leading to acute respiratory distress syndrome

Abstract

Irritant gas exposure may lead to significant respiratory distress as is seen in the present case of 25 year old male worker who suffered accidental phosgene inhalation. He remained asymptomatic for six hours but later landed up in Acute Respiratory Distress Syndrome in the hospital and required ventilatory support. No investigative feature is diagnostic of the nature of irritant gas. Similarly there is no antidote available to the phosgene. Only timely administered supportive management may lead to successful outcome.

Phosphine inhalation, case series of domestic unintentional poisoning commonly used as anti-bed bug chemical from a low income country

“…8 From target animals to human victims; previous studies state that phosphine gas is the most widely used fumigant against pests and a key element in food security worldwide. 5 In developing countries like Sri Lanka, poisoning is one of the leading top ten causes of hospital deaths. 9 There was a dramatic increase in poisoning cases and deaths caused by suicidal ingestion in India during 1990s, particularly in sub-urban and rural parts of Northern India.…”

“…Variety of possibilities available includes intravenous MgSO 4 , N-acetylcysteine, pralidoxime, or trimetazidine, as well a combination of insulin and glucose administration along with hyperventilation as there is no antidote present as of today. 5 Airway protection is of utmost importance along with cardiac support and monitoring until the phosphine is excreted out from the body, specific management of phosphine gas poisoning is to reduce its absorption and cellular toxicity and increase its excretion from the body. 18 This study showed all of the poisoning cases to be accidental rather than suicidal and were encountered after exposure to phosphine from insecticides most commonly bug sprays and tablets which were used a night prior without the knowledge of hazardous contents of the insecticide.…”

“…[5][6][7] The objective of this study was to investigate various presentations of phosphine poisoning to ED in a lowincome setting in Karachi, Pakistan. Through this study we tried to connect the dots on the extent, common presentations and reasons of exposure to phosphine poisoning.…”