Arsine Poisoning Follow-up

Updated: Apr 22, 2015
  • Author: Kermit D Huebner, MD, FACEP; Chief Editor: Robert G Darling, MD, FACEP  more...
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Follow-up

Further Outpatient Care

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  • Monitor the patient for signs of chronic arsenic toxicity.
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Further Inpatient Care

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  • All patients who have suspected arsine exposure should be carefully observed for 24 hours.
  • Monitor renal function; initiate hemodialysis as necessary for acute renal failure.
  • Monitor hemoglobin levels; perform transfusions to maintain oxygen-carrying capacity of the blood.
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Inpatient & Outpatient Medications

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  • Chelating agents (eg, BAL) may be used to treat chronic arsenic toxicity. [15]
    • Chronic arsenic toxicity from arsine exposure is treated no differently than exposure from other sources.
    • See Toxicity, Arsenic for more information.
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Deterrence/Prevention

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  • Train workers in high-risk industries to avoid toxic arsine exposures.
  • Screen workers in the same environment as those persons already exposed to acute arsine poison.
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Complications

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  • Renal failure
  • Death
    • Overwhelming exposures cause rapid death from massive hemolysis.
    • In those who survive acute exposures, most deaths occur from renal failure.
  • Chronic arsenic toxicity: Patients who survive acute arsine exposure may develop chronic arsenic toxicity, including anemia and peripheral neuropathy.
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Prognosis

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  • Patients who reach medical attention should survive with modern, supportive medical care.
  • Historically, patients who developed renal failure had 100% mortality. More recent (but still dated) studies report a mortality rate from arsine poisoning of approximately 25%.
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Patient Education

For excellent patient education resources, visit eMedicineHealth's First Aid and Injuries Center. Also, see eMedicineHealth's patient education articles Chemical Warfare and Personal Protective Equipment.

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