GBZ 14-2015Diagnosis of occupational acute ammonia poisoning (English PDF)

Foreword

According to the "People's Republic of China Occupational Disease Prevention Law" to develop this standard.

This standard is drafted in accordance with the rules given in GB/T 1.1-2009.

Chapter 6 of this standard is recommended and the remainder is mandatory.

This standard instead of GBZ 14-2002 "occupational acute ammonia poisoning diagnostic criteria".

Compared with GBZ 14-2002, the main modifications are as follows.

- change laryngeal edema to throat obstruction at diagnostic grade;

- in the diagnosis of moderate poisoning increased interstitial pulmonary edema and necrosis of the bronchial mucosa off two indicators;

--- adjust the contents of the treatment principle.

This standard is responsible for drafting units. Dahua Group Co., Ltd. Hospital.

This standard participates in the drafting unit. China Center for Disease Control and Prevention Occupational Health and Poisoning Control, Shanghai Chemical Industry Occupational Disease Prevention and Control Institute.

1 Scope

This standard specifies the principles of diagnosis and treatment of occupational acute ammonia poisoning.

This standard applies to the diagnosis and treatment of occupational acute ammonia poisoning.

2 Normative reference documents

The following documents are indispensable for the application of this document. For dated references, only the dated edition applies to this article Pieces. For undated references, the latest edition (including all modifications) applies to this document.

GB/T 16180 Labor capacity - Identification of workers' injury and occupational disease GBZ 51 Occupational chemical skin burns diagnostic criteria GBZ 54 Occupational chemical eye burns diagnostic criteria GBZ 73 Occupational acute chemicals - Criteria for the diagnosis of toxic respiratory diseases

3 Diagnostic principles

According to a short period of time inhalation of higher concentrations of ammonia occupational history, with acute respiratory system damage-based clinical manifestations and chest X-ray as the main basis for the study, combined with blood gas analysis and on-site occupational health survey results, a comprehensive analysis, excluding other causes caused by Like the disease, before diagnosis.

4 Contact reaction

According to a short period of inhalation of ammonia professional history, eye and upper respiratory tract irritation symptoms, such as cough, tears, runny nose, throat, etc., the lungs without yang Sexual signs, chest X-ray examination no abnormal findings, 48h symptoms significantly reduced or disappeared.

5 Diagnostic grading

6 Principles of handling

7 Correctly use the instructions in this standard

See Appendix A.

Appendix A

(Informative)

Correctly use the instructions in this standard A.1 ammonia poisoning to trachea, bronchial damage as a prominent performance, and the disease is easy to repeat, so the diagnosis, classification should be comprehensive analysis, comprehensive consideration. artery Blood gas analysis to determine the disease, guiding treatment has important reference significance, should be detected as soon as possible.

A.2 prevention and treatment of pulmonary edema is the focus of acute ammonia poisoning treatment, and should not be a lot of rapid rehydration, so as not to induce, increase pulmonary edema;

Strong corrosive easy to cause pneumothorax, mediastinal emphysema, such as the use of mechanical ventilation positive pressure oxygen should be careful and the pressure should not be too high.

A.3 prevention and treatment of airway obstruction. trachea, bronchial burns necrosis of the mucous membrane easy to poison in the 3d ~ 7d or so off, such as the discovery of airway obstruction Like, should try to use laryngoscopy or bronchoscopy as soon as possible to remove the blockage, if necessary, do tracheotomy.

A.4 correct understanding, early diagnosis of ammonia poisoning caused by ARDS is to save the lives of patients, reduce the risk of complications; ARDS diagnostic criteria, Treatment principle (see GBZ 73).

A.5 ammonia-containing compounds are mostly alkaline liquid, strong ammonia corrosion, ammonia poisoning is often accompanied by eye and skin burns, it should be immediately washed thoroughly Eyes and skin, and asked the specialist to give the appropriate treatment.

A.6 three recesses refers to the inspiratory sternal fossa, supraclavicular fossa, intercostal space obvious depression, is due to the upper airway obstruction caused by breathing Difficult to smoke.