Problem nr. 3
A patient, male aged 42 years, working for 17 years at the
Chemical industry for substances in production of perfumery.
During work a gas leak occurred caused by an dishermetization
process after characteristics it could be benzene vapor.
3 hours after being under this harmful conditions at the worker
appeared next accuses: general weakness, fatigue, cyanosis of lips and
hands. Along with worsening condition: appeared vertigo, palpitations,
breathlessness, chest pain, nausea, sleep disorders, bleeding gums,
nosebleeds.
Clinical and laboratory findings: The condition is of moderateimpaired. Skin and mucous membranes became eggplant colormeasures.
Trembling fingers of outstretched hands, red dermographism,
sweating palms.
FR - 16 in min. Vesicular breathing, rales were not.
Pulse 92 beats per minute, regular. Percutory heart limits are
normal limits. Rhythmic heart sounds, attenuated. Blood pressure
110/70 mm Hg. Abdomen soft, painless. Liver in the right costal
hypohondral area.
Blood count, erythrocyte 3.7 • 1012 / l, WBC 3.2 • 109 / L,
platelets 100 • 109 / L, macrocytosis and hyperchrome.
Urine analyse: the presence of phenols in urine: free phenol: 114
mg/24 hours;
Formulate and explain the diagnosis:
Chronic benzene poisoning, moderate severity (astenoneurotic syndrome
and hemorrhagic).
Principles of treatment:
- Interrupt entry of toxic body
- oxygen
- gastric lavage
-assisted ventilation
sulfur-containing drugs: Cystine, Metronina, Hiposulfit
Prevention - protective clothing (overalls work, protective
measures, glasses) properly use and maintain, spraying morning or
evening, the wind direction, protection training and explaining.