Handbook of preventive medicine.

  • Great Britain. Air Ministry.
Date:
1959
Catalogue details

Licence: Public Domain Mark

Credit: Handbook of preventive medicine. Source: Wellcome Collection.

    436/556 (page 372)
    233. Nitrous fumes may, after a latent period of variable duration following exposure, cause respiratory distress, accompanied by a general constitutiona] upset. Acute bronchitis, pulmonary oedema and broncho- pneumonia may result. Alternatively pneumonia may occur later, well after the initial irritative symptoms have subsided. 234. Personal Protection. Everything possible must be done to exclude nitrous fumes from the atmosphere by engineering measures. When it is known that men will be exposed to nitrous fumes, or when there is risk of accidental exposure, the following should be provided:— (a) Impermeable protective clothing that will give complete skin coverage. - (b) Goggles or face shields. (c) Respirators. These must be of the self-contained breathing apparatus design or of the gas-mask type with special canisters. (The latter protect for a short time only.) (d) Washing facilities and if practicable showers near the place of work. A large open container holding a saturated solution of sodium bicarbonate should be placed adjacent to handling areas for decontamination of contaminated skin. 235. First Aid. (a) Skin contamination should be at once copiously flushed with water or sodium bicarbonate solution, whichever can be reached first. Contaminated clothing should be removed as soon as possible and placed in a vessel containing sodium bicarbonate solution. After first-aid treatment the patient should be sent to sick quarters. (b) Eyes. Copious irrigation of the eyes with water should be started immediately and the medical officer should be sent for. Irrigation should continue for at least 30 minutes or until the medical officer arrives and directs otherwise. (c) Personnel should be instructed in the dangers of nitrous fumes and in the first aid of acid contamination. They should be warned of the latent period between exposure and the onset of respiratory symptoms and of the possible onset of the latter without knowledge of exposure. If they suspect that they are suffering from nitrous fume poisoning, they must report sick at once. 236. Medical Treatment. (a) Respiratory Damage. Patients should be observed for at least 24 hours and expectant treatment for pulmonary oedema started. Antibiotics in anticipation of pneumonia may be indicated. If after 24 hours there are no signs of pulmonary involvement, the patient may be discharged to duty, but should be kept under observation for two further weeks in case of the late development of pneumonia. (b) Skin Burns. The treatment is the same as for thermal burns. (c) Eye Injuries. The emphasis is on immediate and adequate first aid. Thereafter the patient should be referred as soon as possible to an ophthalmologist. 237. Medical Supervision. Those with respiratory or heart disease, or a history of either, should be excluded from nitrous fume exposure. Periodical medical examinations are not indicated, but close supervision of safety precautions and their observance by personnel is essential.