Liquid Nicotine Vape Juice, Nicotine Pouch, da Patch Poisoning a Yara da Manya¶

Nicotine mai tsafta shine ɗayan neurotoxins na botanical mafi sauri da aka sani da toxicology na asibiti, yana aiki kai tsaye akan masu karɓar nicotinic acetylcholine a cikin kwakwalwa, tsarin juyayi mai zaman kansa, glandan adrenal, da skeletal tsoka neuromuscular junctions. Yayin da taba sigari na al'ada ya haifar da ƙima na kula da guba na yara shekaru da yawa, haɓakar fashewar ** tattara ruwa mai nicotine e-liquids (" ruwan 'ya'yan itace" da 5% / 50 mg / ml nicotine gishiri mai cika kwalabe)**, * alewa-flavored na baki nicotine pouches *** (kamar ** ZYN, Rangi, Rogue, da Veelo). 15+ MG a kowace jaka), ** nicotine danko da lozenges **, da ** transdermal nicotine facin ** (wanda ya ƙunshi har zuwa 21 MG zuwa 114 MG na jimlar nicotine tafki a kowane faci) ya canza guba na nicotine na gida zuwa gaggawar gaggawa na likita. Saboda kwalabe na e-liquid da buhunan nicotine suna wari kamar 'ya'yan itace, Mint, vanilla, ko bubble danko kuma ana barin su akai-akai akan teburin kofi, wuraren daddare, ko na'urorin kwantar da tarzoma na mota, yara masu sha'awar sha'awar za su iya haɗiye ko zubar da kashi mai yiwuwa a cikin daƙiƙa.

Idan yaro ko babba ya shanye ruwan nicotine vape juice, tauna ko hadiye buhunan nicotine ko danko, shafa facin nicotine da yawa, ko zubewar e-ruwa a jikin fata, kira lambar gaggawa ta gida (911 a Amurka da Kanada, 112 a fadin Tarayyar Turai, 999 a cikin United Kingdom). lambobin gaggawa directory nan da nan, kuma bita guba na taimakon farko, kamun taimakon farko, kuma yara da jarirai CPR. Abin da ke sa guba na nicotine ya zama mayaudari na musamman shine ** saurin biphasic toxidrome : farkon Matsalar hawan jini na 1 hyper-cholinergic tashin hankali (Amai mai fashewa, yawan zufa, zubar da jini, hawan jini, saurin bugun zuciya, tashin hankali, tsokanar tsoka, da ** gama-gari a cikin mintuna 10 zuwa 3) depolarizing toshewa da rugujewa (mai haɗari jinkirin bugun zuciya, matsanancin hauhawar jini, coma, da ** gurɓataccen gurɓatawar diaphragm da tsokoki na numfashi**).

Yi wannan yanzu¶

1. Kira 911/112/999 ko Guba Control nan da nan: Kira ma'aikatan kiwon lafiya na gaggawa nan da nan idan yaro ya hadiye KOWANE adadin nicotine na ruwa (ruwan vape), hadiye ko tauna fiye da jakar nicotine guda ɗaya mara ƙarfi, ko kuma idan kowane yaro ko babba ya kamu da amai, kodadde fata, ruɗani, bushewa ko bushewa. wahalar numfashi. Don ƙananan bayyanar da asymptomatic, kira Control Guba (1-800-222-1222 a cikin Amurka) nan da nan.
2. A share baki sannan a duba jikin gaba daya domin samun boyayyen jakar nicotine ko faci: Nan da nan sai ki duba cikin bakin yaro ko mara lafiya, musamman a sanya tsakanin lebe na sama ko na kasa da kuma danko, sannan a yi amfani da yatsa a nannade cikin mayafi don cire duk wani jakar nicotine (ZYN, Velo, On), ** taunar cingam, ko tozen. Idan majiyyaci ya rude ko bai amsa ba, sai a tube rigar su sannan a duba baya, kirji, kafadu, hannaye, da cinyoyinsa don ** transdermal nicotine facin* (wanda galibi masu launin fata ne ko launin fata da saukin kuskure).
3. A wanke ruwan nicotine da ya zubo (ruwan vape) ko kuma a datse manne daga fata tare da sabulu mai dumi da RUWA: Nicotine mai tushe da gishiri suna shiga cikin sauri ta hanyar da ba ta da kyaun fatar mutum kai tsaye zuwa cikin jini. Idan ruwan e-liquid ya zubo a hannun yaro, fuskarsa, wuyansa, ko rigarsa, a cire duk wata gurbatacciyar rigar nan take sannan a wanke fata sosai da ** ruwan dumi da sabulu mai laushi na tsawon mintuna 10 zuwa 15**. KADA a yi amfani da ruwan zafi (zafi yana faɗaɗa magudanar jini kuma yana hanzarta shigar nicotine a cikin jini) da KADA a yi amfani da abubuwan tsabtace hannu na barasa (wanda ke rushe shingen fata kuma yana ƙara sha).
4. Kada a taɓa haifar da amai ko ba da ruwa don sha: Nicotine yana motsa cibiyar amai ta kwakwalwa (** area postrema*) kai tsaye a cikin mintuna kaɗan da shan shi, KUMA yana iya haifar da kamawar gaba ɗaya ko rasa hayyacinsa cikin mintuna 10 zuwa 20**. Haɗa amai ko zuba ruwa/madara a baki yana haifar da babban haɗarin mugun buri na huhu idan mai haƙuri ya kama kwatsam ko ya rame.
5. ** Sanya mai amai ko mai bacci a gefensu (Matsayin Farfadowa) sannan kuma a kalli numfashin su da kyau**: Saboda Guba na Nicotine na 2 yana gurguntar da ** diaphragm da tsokoki na numfashi na intercostal** (mai kama da succinylcholine na paralytic miyagun ƙwayoyi), mara lafiyar da ya daina girgiza ko da alama yana "kwantar da hankalin" amai. Idan sun kasa amsawa kuma suka daina numfashi kullum, fara nan da nan CPR tare da numfashin ceto (30:2 ga manya ko yara masu ceto guda ɗaya; 15:2 don masu ceto biyu na yara CPR).
6. *Kawo madaidaicin kwalban vape, na'urar vape da za'a iya zubar da ita, ko jakar jaka zuwa dakin gaggawa : Karanta lakabin ** maida hankali na nicotine (mg/mL ko %, tuna cewa 5% nicotine daidai 50 mg/mL) da * ƙarfin milligram ɗin jaka (3 mg, 6 mg, 8 mg, 12 mg, or 15+ mg).

Bishiyar yanke shawara: e-ruwa mai nicotine, jaka, faci, da nau'in guba na taba¶

flowchart TD
    Start["Suspected Nicotine Exposure (E-Liquid Vape Juice, Oral Pouches [ZYN/Velo], Gum, Patch, or Tobacco)"] --> ClearSource["1. Shafa Baki Don Jakunkuna/danko/Taba\n2. Duba Fatar Fati don Boyayyen Faci\n3. Cire Tufafi & Wanke Ruwan E-Liquid daga Skin tare da sabulu mai dumi & Ruwa (Babu Ruwan Zafi)"]

    ClearSource --> RouteSource{"Gano Nau'in Samfur da Matsayin Alama"}

    RouteSource -->|Liquid Nicotine (Vape Juice / Refill Bottle / Broken Pod) Ingested OR Any Symptomatic Patient| Urgent911["KIRA 911/112/999 NAN TAKE:\nFarawa cikin Sauri (minti 10 zuwa 30) na Amai, Kamuwa, da Nakasawar Nufi"]

    RouteSource -->|Oral Nicotine Pouch (ZYN/Velo/On), Gum, or Cigarette Butt in Asymptomatic Child| DoseCheck{"Shin Yaro Ya Ci Abinci> 1 Pouch/Gum KO> Cigare 1 Gabaɗaya KO> 0.2 mg/kg?"}
    DoseCheck -->|Yes or Uncertain Count| UrgentED["Ƙimar Sashen Gaggawa & Duban Sa'o'i 4-zuwa-6 (Har zuwa 12-24h idan An haɗiye Mummunan Faci)"]
    DoseCheck -->|Minor Brief Taste (< 1/2 Cigarette Butt or Brief Pouch Mouthing) + Zero Symptoms| PoisonCall["Kira Ikon Guba (1-800-222-1222 a cikin Amurka) don Jagorar Kulawar Gida na Awa 4"]

    Urgent911 --> BiphasicTrack["Asibitin ICU Kulawa don Biphasic Nicotine Tooxidrome"]
    UrgentED --> BiphasicTrack

    BiphasicTrack --> Phase1["PHASE 1 (Farkon: Minti 15 zuwa Sa'o'i 1-2) - Ƙunƙarar Maganin Maganin Nicotinic:\nNausea, Amai Amai, Kodadde Diaphoresis, Salivation/Bronchorrhea, Hawan Jini, Tachycardia, Tashin hankali, Girgizawa, Fasciculations, Gaba ɗaya Seizures"]

    Phase1 --> Phase2["PHASE 2 (Late: 30 Min to 4+ Hours) - Rage Mai karɓa & Rarraba Ƙunƙarar Neuromuscular:\nMai tsanani Bradycardia, Hypotension/ Shock, Lethargy/Coma, Flaccid Muscle Weakness, Diaphragmatic Paralysis & Apnea"]

    Phase2 --> HospitalRescue["Ceto Asibitin da Aka Nufi:\n1. Seizures: IV Benzodiazepines (Lorazepam/Midazolam)\n2. Sirrin Muscarinic/Bradycardia: IV Atropine (0.5-1 MG Adult / 0.02 mg/kg Child)\n3. Nakasawar Numfashi: Farkon Jigilar Endotracheal + Inshorar Injiniya (KA GUJI Succinylcholine)\n4. GI Decontamination: Gawayi Da Aka Kunna (na Aljihu / Allunan / Faci) + Ruwan Hanji gabaɗaya idan Patch ya haɗiye"]

Pathophysiology: Fahimtar Biphasic Nicotine Tooxidrome¶

Me yasa mutumin da sinadarin nicotine ya shafa yana farawa da ** hawan jini, bugun zuciya, tashin hankali, tashin hankali da tashin hankali**, sannan kwatsam ya yi karo da mintuna 30 zuwa 90 tare da ** hawan jini mai hatsarin gaske, jinkirin bugun zuciya, coma, da cikakkiyar gurbacewar tsokar numfashinsu**?

1. Inda masu karɓa na Nicotinic Acetylcholine (nAChRs) Rayuwa a Jikin Dan Adam¶

Nicotine mimic ne na tsarin tsarin neurotransmitter ** acetylcholine (ACh)** kuma yana ɗaure zaɓaɓɓu zuwa tashoshi mai karɓar nicotinic acetylcholine ligand-gated.nAChRs*** a wurare guda huɗu masu mahimmanci na jiki: 1. Tsarin Jijiya na Tsakiya (Brain da Braintem): Ciki har da chemoreceptor trigger zone (yankin postrema) a cikin medulla (wanda ke haifar da fashewar amai da wuri), cortex (wanda ke haifar da tashin hankali, girgiza, da kamawa gabaɗaya), da cibiyar numfashi. 2. Ganglia mai tausayi da kuma Adrenal Medulla ***: Ƙarfafa jijiyoyi masu juyayi na postganglionic da glandon adrenal don zubar da yawan karuwar ** epinephrine da norepinephrine ** a cikin jini (wanda ke haifar da vasoconstriction na farko, ** pallor fata, hauhawar jini, da tachycardia). 3. **Parasympathetic Autonomic Ganglia ***: Hanyoyi masu ban sha'awa na vagal da cholinergic waɗanda ke haifar da ** yalwar salivation (drooling), lacrimation, bronchorrhea (rufin huhun ruwa), gumi (diaphoresis), ciwon ciki, amai, da gudawa *. 4. ** Ƙwararrun tsokar Neuromuscular JunctionsNMJ, Motar Ƙarshen-Plates): Madaidaicin masu karɓar nicotinic guda ɗaya akan filayen tsoka na skeletal da kuma ** diaphragm ** wanda ke haifar da ƙwayar tsoka lokacin da kake numfashi ko motsi.

2. Me yasa Hankali na Farko na Farko Ya Juye Zuwa Mataki na 2 Paralysis (Depolarizing Blockade)¶

Lokacin da al'ada acetylcholine *** yana ɗaure zuwa mai karɓar nicotinic a mahadar neuromuscular, yana buɗe tashar sodium/calcium don ɗan ƙaramin millisecond don haifar da ƙanƙarar tsoka sannan kuma * nan take enzyme acetylcholinesterase ta lalata shi.

Sabanin haka, ** nicotine ba za a iya rushe shi ta hanyar acetylcholinesterase : - Mataki na 1 (Agonist Hyper-Stimulation: Minti 10 zuwa 1 zuwa 2 Hours): Nicotine yana kullewa akan masu karɓar nicotinic kuma yana tilasta tashoshin ion su buɗe gabaɗaya, suna harbi jijiyoyi da tsokoki ba tare da ɓata lokaci ba. Majinyacin yana fuskantar amai, kodadde gumi mai sanyi, bushewa, hawan jini, tachycardia, tsokar tsoka (rippling twitches), da kamawar tonic-clonic gabaɗaya. - Sashe na 2 (Digewar Depolarization da Mai karɓa: Minti 30 zuwa 4+ Hours): Saboda masu karɓar nicotinic suna ci gaba da ɗaure su ta nicotine kuma membrane tantanin halitta ya ci gaba da lalacewa, tashoshin sodium mai ƙarfin lantarki da ke kusa da farantin ƙarshen motar ba za su iya sake saitawa ba, kuma ba za su iya sake kunnawa ba. ** rashin fahimta, rufaffiyar rufaffiyar daidaituwa ** ( depolarizing toshewar neuromuscular , kama da yawan wuce gona da iri na paralytic ** succinylcholine). - A lokaci guda, ganglia mai cin gashin kansa ya zama toshewa kuma abin tuƙi na tsakiya ya gaza. Hawan jini yana raguwa (hawan hawan jini da girgiza), bugun zuciya yana faduwa cikin ** tsananin bradycardia ko AV block, hankali ya dushe cikin coma, kuma ** diaphragm da tsokoki na intercostal sun zama gaba daya, suna haifar da mutuwa ta hanyar ** asphyxiation (apnea)* sai dai idan an sanya majiyyaci akan injin iska.

Kwatanta Kayayyakin Nicotine Na Zamani: Me yasa Juice Vape Liquid da Jakunkuna Sun Fi Haɗari Fiye da Tushen Sigari¶

Shekaru da yawa, likitocin gaggawa sun lura cewa yara da suka ci gaba dayan sigari ko sigari ba safai suke mutuwa ba. Me yasa e-liquids na zamani da ** jakunkunan nicotine** ke haifar da guba mai tsanani?

Fatar (Dermal) da Ka'idojin Gyaran Ido¶

Saboda un-ionized (freebase) nicotine duka ruwa ne- kuma mai narkewa, ** Nicotine mai daɗaɗɗen ruwa yana wucewa da sauri ta cikin ƙananan ƙwayar cuta na fata kai tsaye zuwa cikin dermal capillaries **, gaba ɗaya yana ƙetare hanta mai kariyar 70% na farko na metabolism:

1. ** Cire Tufafin Nan da nan da Sabulun Dumi-da-Ruwa**:
2. Saka safofin hannu na nitrile ko latex kafin a taɓa mutum ko yaron da aka jiƙa a cikin ruwan e-liquid don kada ku yi wa kanku guba ta yatsunku.
3. Cire duk riguna, wando, safa, ko diapers nan da nan.
4. A wanke fatar da ta same ta a hankali da kyau da ** sabulu mai laushi ko sabulun hannu da ruwan dumi na tsawon mintuna 10 zuwa 15**.
5. ** Me ya sa ba za ku taɓa amfani da ruwan zafi, Vinegar, ko Sanitizer na Hannun Barasa ba**:
6. Babu Ruwan Zafi: Ruwan zafi yana haifar da cutaneous vasodilation (fadiwar jini na fata), wanda ke saurin saurin adadin nicotine yana shiga cikin tsarin.
7. Babu Barasa/Maganin Magani*: Shafa barasa ko sanitizer na hannaye yana cire lipids na fata kuma yana haɓaka shigar transdermal.
8. Babu Maganin Acid: Kar a bata lokaci wajen kokarin kawar da nicotine a fata tare da vinegar ko ruwan lemun tsami; sabulu mai laushi da ruwan dumi mai dumi a jiki suna cire propylene glycol/glycerin mai ɗaukar hoto nan da nan.
9. ** Cire Facin Nicotine Mai Fassara ***:
10. Cire duk facin nan da nan, ninke su biyu tare da dunƙule gefuna tare (don haka babu yaro ko dabbar dabbar da zai iya taɓa su), sannan a wanke wurin fata da ** ruwa mai laushi da sabulu mai laushi ** don cire ragowar nicotine depot gel a saman fata. (Lura: Ko da bayan cire facin, "ma'ajiyar fata" na nicotine da aka rigaya shiga cikin epidermis zai ci gaba da shiga cikin jini har tsawon awanni 2 zuwa 6*).
11. Fsashe Ido (Ido):
12. E-ruwa da aka fantsama cikin ido yana haifar da ƙonawa mai tsanani, jajayen haɗe-haɗe, lahani na epithelial na corneal, da ** shayar da nicotine na tsarin a cikin duct nasolacrimal. Bayar da ido a kai a kai da ruwan famfo mai dumi ko 0.9% na al'ada na yau da kullun na 15 zuwa mintuna 20 kuma a nemi tantancewar gaggawa.

Gaggawa na Asibiti da Ka'idojin Jiyya na ICU¶

Babu wani takamaiman maganin hana mai karɓa na kai tsaye ** wanda ke juyar da cututtukan nicotinic na tsakiya da neuromuscular lokaci guda; Rayuwa ya dogara da ** m, ƙayyadaddun gudanarwa na ICU na musamman ***:

1. Kariya ta Jirgin Sama da Na'ura mai ɗaukar hoto (Tsarin Ceto #1)¶

Saboda mutuwa a cikin mummunan guba na nicotine kusan koyaushe yana faruwa daga ** Mataki na 2 gazawar numfashi ** (haɗuwa da damuwa na numfashi na tsakiya, ɓoyayyen ɓoyayyen ɓoyayyiyar ƙwayar cuta, da ** depolarizing neuromuscular paralysis na diaphragm ): - Cikin Ciwon Farko na Endotracheal: Likitocin gaggawa suna shigar da iska da injina ta kowane majiyyaci da ke nuna alamun gajiyar tsokar numfashi, sharar numfashi, hypoxia, coma, ko maimaita halin farfadiya. - ** HUKUNCIN MAGANAR RSI: Guji Succinylcholine: Lokacin yin Intubation Mai Sauri (RSI) akan majiyyaci mai guba na nicotine, ** guje wa yin amfani da succinylcholine mai gurɓataccen gurɓataccen ƙwayar cuta, wanda ke aiki ta daidai daidaitaccen nicotinic receptor depolarization inji kuma yana iya haifar da haɓakar haɓakar haɓakar neurokal Yi amfani da gasa ** mara hana ɓarna neuromuscular blocker (kamar Rocuronium)* maimakon. - ** Sake jujjuyawar Paralysis na Numfashi ***: Idan dai an tallafa wa majiyyaci akan injin iska tare da kariya ta iska 100% da oxygenation, hanta (CYP2A6 metabolism cikin cotinine) da koda suna share nicotine akan ** 4 zuwa 24 hours ***, da ** 100 bisa dari na diaphragm da karfin tsoka sun dawo gaba daya.

2. Sarrafa Mataki na 1 Seizures da Tashin hankali¶

• Anticonvulsants na Farko: Benzodiazepines na Jiki: Mai Gudanarwa ** Lorazepam (0.1 mg/kg IV, har zuwa 4 mg***, Midazolam (0.1 to 0.2 mg/kg IV or IM, ko Diazepam nan da nan don kamuwa da nicotine gabaɗaya ko tashin hankali.
• Layi na Biyu na Refractory Seizures: Idan matsayi na epilepticus ya ci gaba duk da benzodiazepines, haɓaka nan da nan zuwa ** Phenobarbital , ** Propofol, ko ** Levetiracetam** ( guje wa phenytoin, wanda ba shi da tasiri ga kamun da aka haifar da guba).

3. Sarrafa Biphasic Autonomic Rashin zaman lafiya (Atropine for Muscarinic Overload vs. Vasopressors for Phase 2 Shock)¶

1. ** Atropine na Jiki don Alamun Muscarin mai tsanani (Bronchorrhea, Salivation, da Phase 2 Bradycardia)**:
2. Saboda nicotine yana motsa ganglia parasympathetic ganglia don sakin wuce haddi acetylcholine akan ** muscarinic receptors** a cikin huhu, salivary gland, da sinoatrial/atrioventricular nodes, marasa lafiya na iya nutsewa cikin sirrin huhunsu na ruwa (bronchorrhea) ko kuma su ci gaba da toshewar zuciya da bugun zuciya.
3. Gudanarwa ** Atropine na Jiki (0.5 mg to 2 mg IV a cikin manya; 0.02 mg/kg IV a cikin yara, m 0.1 mg***, ana maimaita kowane minti 5 zuwa 10 har sai ɓoyayyen ɓoyayyen ƙwayar cuta ya bushe kuma alamar bradycardia ta warware.
4. ** Sarrafa Hawan Jini na Mataki na 1 vs. Mataki na Biyu
5. Kada a Taba Magance Farkon Hawan Jini na Farko ko Tachycardia tare da Dogayen Ayyukan Beta-Blockers: Saboda hauhawar jini na Phase 1 yana wucewa kuma akai-akai yana jujjuyawa cikin hanzari zuwa Sashe na 2 hypotension, bradycardia, da gigice cikin mintuna 30 zuwa 60, yana ba da beta-blockers na dogon lokaci ko zai haifar da beta-blockerase. rugujewar zuciya da ba za a iya murmurewa ba lokacin da Mataki na 2 ya fado. Yi maganin tashin hankali / hauhawar jini a hankali tare da ** IV benzodiazepines ** (ko infusions na gajeriyar gajeriyar aiki kawai idan rikicin hauhawar jini ya faru).
6. Sashe na 2 Hypotension da Shock: Gudanarwa ** isotonic crystalloid boluses na cikin jini (20 mL/kg 0.9% Normal Saline** kuma fara jiko na vasopressor kai tsaye (Norepinephrine ko Epinephrine) idan ganglionic blockade yana haifar da ci gaba na vasoplegic/cardiogenic hypotension.

4. Dokokin Kashe Gastrointestinal ta Nau'in Samfur¶

• Nicotine Liquid (Vape Juice): Saboda ruwan nicotine yana shiga cikin mintuna kuma yana haifar da amai da sauri cikin mintuna 10 zuwa 20*************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Idan an hadiye babban adadin ruwa mai kisa a cikin mintuna 30, burin nasogastric da gawayi mai kunnawa (1 g/kg) ana gudanar da su ** bayan endotracheal intubation ** yana tabbatar da hanyar iska.
• ** Jakunkuna na Nicotine da aka hadiye, Gum, Lozenges, ko Faci mai Fassara**:
• Saboda jakunkuna, matrices na danko, da facin transdermal suna sakin nicotine akai-akai sama da sa'o'i masu yawa a cikin ciki da hanji, ** Kashi-daya ko Gawayi Mai-Kasa (Multi-Dose Activated Charcoal).1 g/kg up to 50 g*** An nuna idan majiyyaci ya farka kuma yana kare hanyar iska (ko intubated).
• ** Ruwan Hanji Gabaɗaya (WBI): Idan yaro ko babba ya haɗiye ** facin nicotine mara kyau ** ko kuma ** adadi mai yawa na jakunkuna / gut ɗin nicotine **, likitocin gaggawa suna ba da ruwa mai cike da hanji tare da Polyethylene Glycol Electrolyte Solution (PEG-ssolving out the pouches of nicotine gastrointestinal fili.

5. Tsawon Lokacin Kulawa na Asibiti Kafin Sashin Lafiya¶

• ** Liquid Nicotine (E-Liquid) ko Chewed Gum/Pouches**: Saboda ruwa da nicotine na mucosal suna sha da sauri, idan majiyyaci ya rage ** 100 bisa dari asymptomatic (babu amai, al'ada bugun zuciya, hawan jini na yau da kullun, faɗakarwa ta al'ada) na 4 zuwa 6 hours ** bayan fallasa, an kawar da mummunar guba.
• ** Akwatunan Nicotine da aka haɗiye, Dukan Cigarettes / Cigars, ko Patches Transdermal ***: Saboda ci gaba-sakin matrices da faci na iya barin nicotine a cikin ƙananan sashin GI na sa'o'i da yawa, marasa lafiya waɗanda ke haɗiye facin ko manyan jaka suna buƙatar ** 12 zuwa 24 hours na kulawar asibiti.

Lambobin gaggawa na yanki da ka'idojin hukumar¶

Tambayoyin da ake yawan yi¶

Me yasa hadiye ruwan vape ruwa ko jakar nicotine ZYN ya fi haɗari ga yaro fiye da cin gindin sigari?¶

Lokacin da yaro ya ci busasshiyar cigare ko sigari, pH na busassun ganyen taba yana adana mafi yawan nicotine a cikin nau'in ionized wanda ke sha a hankali a cikin ciki, yayin da ɗanɗano mai ɗaci da haushin ciki ke haifar da amai da wuri wanda ke fitar da taba kafin kashi mai mutuwa ya shiga cikin jini. Sabanin haka, ruwan vape ruwa (musamman gishiri nicotine 5%, wanda ya ƙunshi 50 MG na nicotine mai tsafta a kowace millilita) an riga an narkar da kashi 100 cikin ruwa, kuma fararen jakunkuna na nicotine (kamar ZYN, Velo, ko On) suna ɗauke da gishirin buffering na alkaline musamman wanda aka ƙera don tilasta nicotine cikin sauri ta cikin rufin baki da gumis. Dukansu suna da ɗanɗano kamar 'ya'yan itace ko Mint maimakon taba mai ɗaci, ƙyale yaro ya sha maganin kamewa ko shanyewar numfashi a cikin mintuna 10 zuwa 20.

Menene ma'anar "mai guba na biphasic" a cikin guba na nicotine?¶

Biphasic yana nufin guba yana faruwa a matakai biyu sabani. A lokacin Phase 1 (minti 10 zuwa 60 na farko), nicotine yana haɓaka masu karɓar nicotinic a cikin kwakwalwa, glanden adrenal, da tsokoki, yana haifar da amai mai fashewa, kodadde sanyi gumi, faɗuwa mai nauyi, hawan jini, saurin bugun zuciya, murɗawar tsoka, da kamawa gabaɗaya. A lokacin lokaci na 2 (minti 30 zuwa 4 hours bayan haka), masu karɓan da suka wuce gona da iri suna kullewa kuma suna hana su (depolarizing blockade), suna haifar da mahimman alamun mara lafiya don jujjuya su zuwa akasin shugabanci: haɗari mai saurin jinkirin bugun zuciya, faɗuwar cutar hawan jini, coma, da cikakkiyar gurɓataccen gurɓataccen ƙwayar diaphragm da tsokoki na numfashi.

Me ya sa dole ne a wanke nicotine mai ruwa da aka zubo daga fata da sabulu mai dumi da ruwa maimakon ruwan zafi?¶

Nicotine ruwa mai tsafta yana sha kai tsaye ta cikin lafiyayyan fatar mutum mara karye zuwa cikin jini kamar facin nicotine na likita. Idan ka wanke fata da ruwan zafi, zafi yana faɗaɗa (fadi) ƙananan tasoshin jini a cikin fata, wanda ke aiki kamar buɗe babbar hanya zuwa cikin jini kuma yana saurin haɓaka guba na nicotine. Koyaushe cire duk wani suturar da aka jika da e-ruwa ta amfani da safar hannu kuma a wanke fata a hankali da sabulu mai laushi da ruwan dumi ko ruwan sanyi na tsawon mintuna 10 zuwa 15.

Shin wani facin nicotine da aka yi amfani da shi da aka jefa a cikin shara zai iya zama guba ga yaro ko dabba?¶

Ee. Facin nicotine transdermal yana buƙatar babban matakin maida hankali don tura nicotine a hankali ta cikin fatar ɗan adam sama da awanni 24. Saboda wannan zane, wani facin da aka yiwa lakabin "21 MG a cikin sa'o'i 24" a zahiri ya ƙunshi har zuwa 50 MG zuwa 114 MG na jimlar nicotine a cikin tafki, kuma lokacin da babba ya bare shi bayan sa'o'i 24, fiye da 50% zuwa 70% na nicotine har yanzu yana barin a cikin facin. Idan yaro ko kare ya ciro facin da aka yi amfani da shi daga cikin sharar ya manne shi a kan fatarsa ​​ko ya tauna ya hadiye shi, zai iya haifar da gubar nicotine mai hatsarin gaske. Koyaushe ninke facin da aka yi amfani da su manne-gefe-tare kuma a jefar da su a cikin wani akwati da aka rufe ba zai isa ba.

Menene Ciwon Taba Koren kuma yaya ake bi da shi?¶

Ciwon Taba Koren Taba (GTS) cuta ce mai saurin kamuwa da nicotine wacce ke addabar ma'aikatan gona waɗanda ke girbi jikakken ganyen tabar da ba a warkewa ba, musamman da sanyin safiya lokacin da ganyen ya rufe da raɓa ko bayan ruwan sama. Ruwa a cikin ganye yana narkar da nicotine na halitta daga saman shuka, wanda sai ya jika ta rigar rigar ma'aikaci da wando kuma yana sha kai tsaye ta fatar jikinsu (yana ba da kwatankwacin sigari 30 zuwa 50+ na nicotine). Ma'aikata suna fama da tashin hankali mai tsanani, amai mai ɗorewa, kodadde sanyi gumi, tashin hankali, ciwon kai, da jujjuyawar hawan jini da bugun zuciya. Taimakon gaggawa na gaggawa ya ƙunshi barin filin, cire duk rigar rigar, wanke jiki duka da sabulu da ruwa mai dumi, hutawa a wuri mai sanyi tare da ruwa na baki ko na jini, da neman magani idan amai, bradycardia, ko numfashi ya faru.

Jagora masu alaƙa¶

• Guba taimakon farko da sarrafa guba
• Organophosphate maganin kashe kwari, wakili na jijiya, da guba na kwari
• Kame taimakon farko da aminci
• Likitan yara da jarirai CPR da kushewar ceto
• Ciwon zuciya na zuciya (CPR) da jagorar AED

Tushen da jagorar hukuma¶

• Ƙungiyar Cibiyoyin Kula da Guba ta Amirka (AAPCC) & Cibiyoyin Kula da Cututtuka da Cututtuka (CDC): Nicotine Liquid, E-Cigarette, da Na Bakin Nicotine Pouch Kulawa da Jagororin Jagorori.
• Kwalejin Ilimin Ilimin Yara na Amurka (AAP): Rahoton asibiti da Bayanin Manufa: E-cigaret, Matsalolin Nicotine Liquid, da Rigakafin Guba na Nicotine na Yara.
• Sabis na Bayanin Guba na Ƙasa (NPIS, United Kingdom): TOXBASE Gudanar da Clinical Gudanar da Guba na Nicotine (E-Liquids, Jakunkunan Nicotine na Baka, da Faci).
• Hukumar Lafiya ta Duniya (WHO): Ƙaddamar da Kyautar Taba Sigari da Tsaron Sinadarai: Mugun Gubar Nicotine da Koren Ciwon Taba Guidance.
• Cibiyar Tsaro da Lafiya ta Ƙasa ta Ƙasa (NIOSH / CDC): Maganin Wurin Aiki: Hana Ciwon Taba Koren (Dermal Nicotine Guba) a Ma'aikatan Taba.

*Wannan jagorar don dalilai ne na bayanai kuma baya maye gurbin ƙwararrun ƙwararrun likita, shawarwarin Kula da guba, ko kulawar gaggawa na asibiti. Saboda tsananin guba na nicotine na iya haifar da kama kwatsam da gurɓataccen tsokoki na numfashi a cikin yara da manya, muna ba da shawarar ɗaukar ƙwararrun ƙwararrun manya da taimakon gaggawa na yara da kuma hanyar CPR ta Ƙungiyar Red Cross da Red Crescent Societies (IFRC), ƙungiyar Red Cross ta ƙasa, St John Ambulance, ko mai ba da sabis na gida da aka yarda.