Remove the poison from the bloodstream

Measures to remove the poison from the bloodstream (forced diuresis and others) are the competence of hospitals.
A. Forced diuresis. Water stress. Increased output contributes to a significant diversion of urine circulating in the bloodstream of the poison. If the patient is conscious, shown drink plenty of water (alkaline mineral water) 3-5 liters per day. Patients in a coma (or with severe diarrhoea disorders - vomiting) shows subcutaneous or intravenous drip of 0.9% solution of sodium chloride or 5% glucose solution in the amount of 3-5 liters with the addition of 1 g potassium chloride per 1 liter of liquid, intramuscular injection of 1 ml of noworyta. Contraindications: acute cardiovascular and cardiopulmonary failure (pulmonary edema, prolonged collapse), acute renal failure (anuria).
Alkalinity of the blood. Apply, if the poisoning is accompanied by acidosis. Intravenous drip (2-4 hours) enter up to 500 - 800 ml of 4% solution of sodium bicarbonate and repeat the introduction depending on the pH of the urine and a reserve alkalinity of the blood. In the absence of dyspeptic disorders can give sodium bicarbonate inside of 4-5 g every 15 minutes for 1 hour, in the next 2 g every 2 hours. Alkaline reaction urine to keep for several days.
Osmotic diuresis. As an osmotic agent use 30% urea solution (solution № 1) or 10% solution of mannitol. For oschelacivania blood and water load use a solution of electrolytes following composition (solution 2): : sodium chloride 0,9% solution - 1000 ml glucose 40% solution - 80 ml, sodium bicarbonate - 6 g, potassium chloride 2,5,
Treatment urea carried out according to the following scheme. During the first 2-3 hours. injected 1000 - 1500 ml № 2. Then jet intravenously injected 100-150 ml of 30% urea solution (solution № 1), then again in 2-3 hour - solution # 2 in the quantity corresponding to the amount allocated every hour urine (through a permanent catheter!). Valid re-introduction of the solution № 1. When a patient comes in the consciousness introduction urea cease, however, to prevent the deficit of liquid, the introduction of the solution № 2 continued for 4 hours. 300-400 ml in an hour or give the appropriate amount of fluid inside.
When treating the urea solution is necessary to control blood urea; its content in the blood should not exceed 400 mg%. The delay fluid in the body must not exceed 1 l per day. The method is applicable only with normal renal function. Daily diuresis in the treatment of this method is 8 liters per day and more.
Contraindications: low blood pressure, swelling of the lungs, impaired renal function.
B. Substitution of the recipient's blood blood donor. For the operation of substitution blood use 4-5 l single-group respawntime individually matched donor blood or the same number of single-group respawntime corpse blood.
For bloodletting is a large section of superficial vein of the thigh through which Central to 30 cm impose a polyethylene catheter. Simultaneously poured replacement donor blood under low pressure through the catheter in one of the ulnar vein (see Transfusion). It is strictly necessary to measure the recoverable amount and type of the blood, and the rate of substitution. For the prevention tromboobrazovania intravenous 5000 IU heparin. When using donor blood containing sodium citrate, intramuscularly 10% solution glukonata calcium 10 ml per 1 l of transfused blood.
Century Hemodialysis and peritoneal dialysis. These methods use in the first hours after the poisoning barbiturates, salicylates, bromide, methyl alcohol, etc. with the purpose of their rapid elimination from the body.
Hemodialysis and peritoneal dialysis (see) can be applied for treatment of uraemia poisoning nephrotoxic poisons (mercuric chloride, antifreeze, tetrachloride carbon, dichloroethane, copper sulphate, Lysol, acetic essence etc).
Contraindications to hemodialysis - acute cardiovascular insufficiency (collapse) and the possibility of bleeding in the conditions of use of heparin. Contraindications to the peritoneal dialysis, a local inflammatory lesions in the abdominal cavity.