Te horomitanga kiore: Superwarfarin Toto, Bromethalin Neurotoxicity, me te Zinc Phosphide Gas¶

Ki te mohio he kohungahunga, he pakeke, he mokai whare ranei kua ngaungau, kua horomia ranei te mate rodenticide ("kiore paihana" me te "mounu kiore") ka pa te mataku, heoi ko te rongoa e hiahiatia ana kei te whakawhirinaki katoa ** ko wai o nga momo matū rereke e wha o te kiore kei roto i te teihana maunu**. Mo nga tekau tau, tata katoa nga paihana kiore o te whare he ** anticoagulant roa-mahi "superwarfarins"** (pērā i te brodifacoum, bromadiolone ranei) e aukati ana i te huaora K i nga mea kato, ka taea te huri ki te waha, ki te uru ranei ** Huaora K1 (phytonadione). Heoi ano, ko nga whakarereketanga ture a te United States Environmental Protection Agency (EPA) me nga mana whakahaere patu patu patu kino kua nekehia nga miriona poraka maunu kaihoko ki te Bromethalin (he neurotoxin mitochondrial kaha e pupuhi ai te roro whakamate me te kaore he rongoa), Cholecalciferol (nui-a-rohe Huaora D3 e mate ana i te mate huka ** me te whakamate mate huka) pire ahuwhenua/kiona kei roto te Zinc Phosphide, Aluminium Phosphide (he kaha te mahi ki te waikawa o te puku me te wai ki te tuku ** hau phosphine ** matemate ki roto i te ara kena).

Na te mea he paraka maunu kaakaariki, puru-matomato, whero, maaka ranei, pire, me nga kete witi mai i nga karaehe matū e wha ** he rite tonu te ahua ki te kanohi tahanga**, ko te whakaaro ki nga kai paihana kiore katoa he "whakaongoi toto" he he ka mate pea. Mena kua horomia, kua pa ranei te tangata ki te patu kiore, waea atu ki to nama whawhati tata (911 i Amerika me Kanata, 112 puta noa i te Kotahitanga o Europi, 999 i te United Kingdom) ma ta maatau tau ohorere whaiaronga, to whare paihana rohe ranei i tenei wa tonu, ka arotake paihana awhina tuatahi, te whakahaere toto nui, a te awhina tuatahi.

Mahia tenei inaianei¶

1. Waea atu ki te Poison Control, ki nga ratonga whawhati tata ranei ka kimihia te tapanga pouaka mounu: Waea 911 (US/Canada), 112 (EU), 999 (UK) ranei mena kua pa te tangata ki te zinc phosphide / aluminum phosphide, kua mate nui ki te horopeta, kua whai tohu ranei (ruaki, mahunga, raruraru, wiri, seiedzu ranei). Mo te reka o te tuhura tamariki ohorere, waea atu ki te Mana Paihana (1-800-222-1222 i te US) i te wa e kimihia ana te pouaka kaata, te teihana maunu kirihou, te nama rehitatanga EPA ranei ki te panui i te rarangi "Kainga Hohe" kei te tapanga o mua.
2. Kati: KAUA e hoatu he wai, he miraka, he wai ranei kia whakakorehia e koe te Zinc Phosphide: Mena he pire hina/pango te maunu, he witi, he paura ranei hei whakamahi mo te kiore, gophers, kiore ranei o te paamu (Zinc Phosphide or Aluminium Phosphide), mena ka hongi te manawa o te tangata, te ruaki ranei, Ka hongi i te waiu, ** KAUA i roto i te wai, KAUA he wai, KAUA i te waiu, KAUA e hoatu he wai i roto i te waiu , KAUA he wai pirau ranei. ruaki. Ka tauhohe te wai me te waikawa o te puku me te zinc phosphide ki te tuku i te ** hau phosphine whakamate (PH3), ka taea te paihana i te turoro me te tangata e manawa ana tata ki te waha, ki te ruaki ranei.
3. Mukuhia te waha me te horoi ringa me te kanohi ki te hopi me te wai: Ma te whakamahi i te kakahu makuku (me te kakahu maroke ranei mena ka whakapaehia te zinc phosphide), tahia nga kongakonga, pire, nga kongakonga waki tae ranei i roto i te waha o te tamaiti ka penapena ki roto i te peeke kirihou hiri hei tohu i te hohipera. Horoia nga ringa me te kanohi o te tangata ki te hopi me te wai.
4. Kaua rawa e whakawhirinaki ki te tae me te ahua o te paraka maunu ki te matapae i te matū: Ko te kaakaariki, te puru, te turquoise, te mawhero, te mawhero ranei nga poraka ware pi me nga pire ka tino tae ki te whakaatu he pesticides kore kai me te tohu i nga para kiore. Ko te poraka matomato o D-Con, Tomcat, ranei Victor kei roto brodifacoum (anticoagulant), bromethalin (neurotoxin), ranei cholecalciferol (Vitamin D3) i runga i te rarangi hua tika me te tau hoko.
5. Kaua e hoatu he taapiri Huaora K i runga i te hoko-kore-kore ranei, ka whakapakeke ranei i te ruaki i te kainga: Kei roto i nga ipu rongoa o te Huaora K te nuinga o te waa ** Huaora K2 (menaquinone)** ranei nga horopeta microgram (100 mcg) he 100 ki te 500 nga wa ngoikore rawa ki te huri i te paihana superwarfarin (e hiahia ana ki te whakahaunga-kaha ** nga horopeta milligram o te Huaora K1 [phytonadione]**), kaore rawa te Huaora K e mahi mo te bromethalin, te cholecalciferol, te zinc phosphide ranei.
6. Kia mohio ki te matapihi tohu whakaroa (24 haora ki te 7 ra): Kaua rawa e whakaaro kei te noho haumaru te tangata, te tamaiti ranei na te mea he tino ahua noa ia i te Ra 1. Ka tango nga superwarfarins 36 ki te 72 haora i mua i te hekenga o nga take kato ka timata te toto; Ko te cholecalciferol e tango 24 ki te 72 haora ki te whakanui i te konupūmā toto; me nga whakaaturanga bromethalin iti-ki-moana ka roa te 1 ki te 4 ra ki te whakaoho i te pupuhi roro me te ataxia.

Rakau whakatau: Te tautuhi me te whakamatautau i nga momo e wha o te patu kiore¶

flowchart TD
    Start["E whakapaetia ana te Rodenticide (Kiore, Kiore, Mole, Gopher Poison ranei) Te horomia"] --> ReadLabel["Tirohia te Tapanga Pouaka Mounu, EPA Reg. Kao, he Tohu Tianako ranei (Kangi / Pire me te Paraka Wae)"]

    ReadLabel --> ClassSplit{"He aha te mea kaha kei runga i te tapanga?"}

    ClassSplit -->|1. Long-Acting Anticoagulant 'Superwarfarin' (Brodifacoum, Bromadiolone, Difenacoum, Difethialone, Chlorophacinone)| SuperWarfarin["Hangaia: Ka aukati i te Huaora K Epoxide Reductase (Factors II, VII, IX, X); Te timatanga kua roa 36-72 haora; Nga Marama Haurua"]
    ClassSplit -->|2. Bromethalin (Most Modern US Consumer Mouse/Rat Blocks)| Bromethalin["Mechanism: Werohia te Roo Mitochondrial Oxidative Phosphorylation -> Intramyelinic Cerebral Edema; KORE ANTIDOTE"]
    ClassSplit -->|3. Cholecalciferol (Vitamin D3 Bait)| VitD3["Hangaia: Nui Huaora D3 Tukekereke -> Te Hiperemia Tino, Te Ngaru o te Tatau, Te Whakatairanga Manawa (Ka timata 24-72h)"]
    ClassSplit -->|4. Zinc Phosphide / Aluminum Phosphide (Rotten Fish/Garlic Odor Pellets) OR Strychnine| Phosphide["Hangaia: Waikawa Pupu + Wai -> Hau Phosphine Whakamate (PH3) -> Cytochrome C Oxidase Blockade, Huri, Pulmonary Edema"]

    SuperWarfarin --> SW_Care["Triage: Te Taste Takitahi i roto i te Tamaiti (< 1 mg) I te nuinga o te wa ka haumaru ki te whai; Kohanga Nui/Kohikohi -> Waro Whakahohe (mehemea <1-2h), Tirohia te Rarangi & 48-72h PT/INR; Whakaorangia Anake INR/Toto Whakanuia me te Huaora-waha/IV Huaora K1 (Phytonadione) mo nga wiki ki te marama + PCC/FFP ki te kaha te toto."]

    Bromethalin --> Brom_Care["Triage: Moata Maha-Inenga Whakahohe Waro + Whole-Bowel Irrigation mo te Ngaro Nui; Aroturuki i roto i te ICU mo te Mahunga o te Mahunga, Wiri, Ataxia, Delirium, Seizures, me te Whakanuia te Intracranial Pressure (Hypertonic Saline / Mannitol)"]

    VitD3 --> VitD_Care["Triage: Waro Whakahohe; Serial Serum Calcium, Ionized Calcium, Phosphorus, and Creatinine i te 24h, 48h, 72h; Mahia te Hypercalcemia me te Agressive IV 0.9% Normal Saline, Calcitonin, IV Bisphosphonates (Pamidronate/Zoledronic Acid), me Corticosteroids"]

    Phosphide --> Phos_Care["Triage: KAUA E HOATU WAI; Rohe Whakahau; Weki hiri; Pehia te waikawa o te puku (PPI + Sodium Bicarbonate); Hinu-Based Gastric Lavage (Coconut/Mineral Oil); ICU Vasopressors, IV Magnesium Sulfate, me te N-Acetylcysteine"]

Ripanga Tautuhinga Matua: E ono nga karaehe matū o Rodenticide¶

Na te mea ko nga ingoa waitohu penei i te d-CON, Tomcat, Victor, Contrac, Havoc, Talon, Kotahi Ngau, Rampage, me Terad3 te whakamahi ano i o raatau tohu tohu puta noa i nga tauira matū maha, kia rite tonu ki te ingoa matū tika i raro i te "Nga Kai Hohe" kei runga i te kete.

Te Ruku Hōhonu o te akomanga 1: Nga Anticoagulants Superwarfarin (Brodifacoum, Bromadiolone, Difenacoum)¶

1. He aha te "Superwarfarins" he 100 nga wa ka kaha ake, ka roa mo nga marama¶

Ko te rongoa paerewa warfarin (Coumadin) he haurua o te plasma mo te 35 ki te 40 haora. I te wa i tipu ai nga kiore i te parenga ira ki te warfarin noa i te tekau tau atu i 1970, ka taapirihia e nga tohunga kemu he mekameka taha phenyl-mowhiti tino nui, tino lipophilic (momona-ngako) ki te ngota ngota coumarin, ka hanga whakatupuranga tuarua 4-hydroxycoumarin "superwarfarins" (**brodifacoum, bromadiolone, difenacoum, difecotumhia, me te difecoumhia) indandiones (chlorophacinone me diphacinone).

• Mechanism of Action: Ko te Huaora K e hiahiatia ana e te ate enzyme gamma-glutamyl carboxylase ki te whakahohe i nga pūmua e wha o te whakaheke toto: Factor II (Prothrombin), Factor VII, Factor IX, me Factor X (me nga Protein C me S). I roto i tenei whakahohenga, ka waikurahia te huaora K hydroquinone kua whakahekehia ki roto i te hohe ** Huaora K 2,3-epoxide**, katahi ka huri ano ki te Huaora K kaha e te enzyme Vitamin K Epoxide Reductase (VKORC1).
• Te Rokiroki ate ate kore e taea te huri: Ka herea nga superwarfarins ki te VKORC1 me te 100-nui ake te hononga i te warfarin rongoa me te aro ki roto i nga toa ngako ate me te haurua o te ora i roto i te tangata o 16 ki te 69 ra (whakaroahia te katoa o te anticoagulation koiora ki te 1 ki te 9+ marama i muri i te horopeta nui kotahi).
• He aha te INR e tino tika ana mo nga haora 24 ki te 36 tuatahi: Karekau e *whakangaromia e te Superwarfarins nga mea whakaheke toto e rere ana i roto i te toto; ka aukati noa i te ate ki te mahi hou. No te mea ko Factor VII te haurua poto rawa atu (6 haora), whai muri ko Factor IX (24 haora), Factor X (36 haora), me Factor II (60 haora), he whakamatautau toto (Prothrombin Time [PT] me te International Normalized Ratio [INR]) ka tuhia ki roto i te ruuma whawhati tata 4, 12 haora i muri i te horomia o te brodi he 12 haora i muri i te horomia o te brodi.INR 1.0). Ka timata te piki o te INR i 24 ki te 36 haora ka eke ki runga i 48 ki te 72 haora, i te wa ka timata te whakaheke toto.

2. Pediatric Single-Taste Triage vs. Intentional Overdose Protocol¶

1. Te Momo Tuhura Pohehe i te Tamariki (< 1 mg o Superwarfarin):
2. He tino waimeha nga maunu superwarfarin o te whare (0.005% brodifacoum, te tikanga 1 karamu o te maunu he 0.05 mg anake o te brodifacoum).
3. He maha nga rangahau a te pokapū paihana e whakaatu ana ko te kohungahunga hauora e waha ana, e horomia ana ranei etahi kongakonga, iti iho ranei i te pire kotahi (iti iho i te 1 mg o te brodifacoum kaha, e rite ana ki te 20 karamu [0.7 hekere] o te 0.005% maunu) ** tata tonu ka kore rawa e puta he coagulopathy koretake noa i te haumanu, karekau e mate te mate o te mate o te haumanu, karekau e mate te mate o te mate o te mate. ka horomia he nui, he maha nga whakaaturanga, he maru ranei. Tukuna tonu te Mana Paihana ki te tatau i te horopeta e pa ana ki te taumaha.
4. He nui, he whakaaro, he tukurua ranei te horomia (Me Aromātai Hohipera):
5. Kaua rawa e hoatu Huaora K1 Prophylactic Empiric I mua i te tirotiro i te INR 48-Hour: Mena ka hoatu e te taote te Huaora K1 i te Ra 1 i muri tonu o te horohanga, ka hunahia e ia te whakamatautau toto INR 48-haora, ka kore e taea te mohio mena kua horomia e te manawanui tetahi horopeta paitini ka pau nga marama o te maimoatanga ina pau te horopeta kotahi o te Huaora K.
6. Engari, i roto i te manawanui asymptomatic, ka tukuna e nga taote te Wao Whakahohe (mehemea i roto i te 1 ki te 2 haora), tuhia he ** turanga PT/INR**, ka whakahoki ano i te PT/INR i nga haora 48 me te 72 haora i muri i te horomanga. Mena kei te noho noa te INR i nga haora 48 me te 72 kaore i hoatu he Huaora K, ka whakakorehia te paihana superwarfarin.
7. Maori INR Whakanuia (> 2.0 to 4.0) ranei Te Toto Hohe:
8. Te whakaheke toto mo te ora (te toto incranial, te toto gastrointestinal, te hematuria, te wiri ranei): Whakanohia tonutia 4-Factor Prothrombin Complex Concentrate (4F-PCC / Kcentra i te 25 ki te 50 Units/kg IV) (mehemea Fresh Frozen Plasma 15kg/C* kaore i te waatea) ki te whakakapi tonu i nga Waahanga II, VII, IX, me X, i te taha o 10 ki te 20 mg o Intravenous Huaora K1 (Phytonadione) kua whakapoipohia kia kaua e neke atu i te 1 mg/minute (ki te karo i nga tauhohenga anaphylactoid onge).
9. Te Tiaki Huaora K1-waha-Waha-roa: Na te mea ka noho te superwarfarin ki roto i te ate mo nga marama i te mea he poto te roanga o te Huaora K1 6 haora, ko nga turoro me te superwarfarin coagulopathy e hiahia ana ** nga horopeta whakahaunga nui o te Huaora A-waha K1 (Phytonadione), te tikanga ** 50 mg ki te 200+6 mg i ia ra, ka wehea tonu ** 50 mg ki te 200+6 mg mo ia ra. marama, e arahina ana e nga rangatū tirotiro INR me nga taumata serum brodifacoum. (He mea nui: Ko te Huaora K1 [phytonadione] anake e mahi ana; Ko te Huaora K3 [menadione] ka kore e whai hua, ka puta he anemia hemolytic).

Te Ruku Hōhonu o te akomanga 2: Bromethalin (Te Munu Neurotoxic Cerebral Edema o Naianei)¶

Na te mea i aukati te US EPA i nga hoko hoko hoko o nga superwarfarins reanga tuarua, ko Bromethalin te whakauru kaha i roto i te nuinga o nga poraka kiore me nga kiore e hokona ana i nga hokomaha me nga toa taputapu puta noa i Amerika Te Tai Tokerau.

• Pehea te Bromethalin ki te Poisoni i te Roo: Ka uru mai i roto i te whekau, ka whakakorikoria te bromethalin (he tino lipophilic diphenylamine) e te ate cytochrome P450 enzymes ki roto desmethylbromethalin, he paitini kaha ake e whakawhiti ana i te arai toto-roro me te ** ka wehe i te mate o te roro me te phosphoryal oxidative oxidative ** Karekau i te pūkoro ATP, te Na+/K+-ATPase ka paheke nga papua i te taha o nga toki nerve, ka waipuke te konutai me te wai ki roto i nga kaupapa myelin e takai ana i nga waahanga ma (te whakakorikori intramyelinic me te edema cerebral edema).
• Whakaaturanga Haumanu:
• Te reka o te tamaiti aitua iti: Na te mea ko te maunu bromethalin kaihoko 0.01% (0.1 mg of bromethalin per gram of bait), ko te reka o te kongakonga ohorere a te tamaiti he uaua ka eke ki te paepae neurotoxic o te tangata, ahakoa me arotakehia e te Mana Paihana nga whakaaturanga katoa.
• He nui te whakaaro, he mokai mokai ranei: He nui te te mahunga o te upoko, te ruaki kore e taea te rongoa, te hyperthermia (kirika), te wiri uaua, te hyperreflexia, te myoclonus, te cerebellar ataxia, te delirium, te mate epilepticus whanui, te pikinga o te pehanga intracranial, te mate o te roro, me te mate.
• Whakahaere i te Hohipera (Kaore he Antidote):
• Ko te Huaora K1 he horihori mo te bromethalin me kaua e whakawhirinaki ki runga.
• Na te mea he nui te te hurihanga enterohepatic (ka peia ki roto i te ate ka kohia mai i te whekau) me te haurua o te ora 6 ra, ka tukuna e nga roopu o te hohipera Multi-Dose Activated Charcoal (MDAC) me/ranei Whole-Bowel Irrigation moata tonu ki te tango i te CU, ka peehia mai i te CU. nga hopukanga (benzodiazepines, propofol, barbiturates ranei), te tirotiro MRI o te edema cerebral mea ma, me te osmotherapy (3% Hypertonic Saline or Mannitol) mo te pehanga intracranial teitei.

Te Ruku Hōhonu o te akomanga 3: Cholecalciferol (Massive Huaora D3 Hypercalcemia)¶

Cholecalciferol rodenticides (0.075% Vitamin D3, e rite ana ki te 30,000 IU o Huaora D3 mo ia karamu o te maunu) ka patu i nga kiore ma te whakapouri i te hypercalcemia (te konupūmā toto teitei o te rangi) me te whakarite i o ratou whatukuhu, ngakau, me te aorta:

• Kua roa te timatanga (24 ki te 72 haora): I muri i te horomanga, ka huri te ate i te cholecalciferol ki 25-hydroxyvitamin D (25-OH-D), e waipuke ana i nga kaiwhakawhiwhi huaora D, e kumea ana te nui o te konupūmā me te ūkuikui i roto i nga whekau me te tango i te konupūmā i roto i ngā kōiwi.
• Nga Tohu Haumanu: Te matewai nui, te nui o te mimi, te nausea nui, te ruaki, te mamae o te puku, te paopao, te toto toto tiketike, te ngenge, te rangirua, te whakapotohia te wa QTc me nga ngaru-J Osborn i runga i te ECG, me te raruraru whakapeka (nephrocalcinosis).
• Kawa Maimoatanga Hohipera:
• Waro Whakahohe Moata (he cholestyramine ranei hei here i te huaora D ngako-wairewa i roto i te kopu) me te raupapa **serum konupūmā katoa, konupūmā katote, ūkuikui, BUN / creatinine, me nga taumata 25-OH-Vitamin D ** i te raupapa, 24, 48, me te 72 haora.
• Kairiri te 0.9% Te Tote Tote Tika (200 to 300 mL/hour) ki te whakahoki mai i te rōrahi i roto i te toto me te whakatairanga i te whakaheke konupūmā mimi (calciuresis), me te taapiri i te furosemide anake i muri i te whakatikahia te whakahekenga o te rōrahi.
• ** Subcutaneous/IM Calcitonin (4 to 8 IU/kg every 6 to 12 hours)** mo te whakaheke tere o te konupūmā i roto i te 4 ki te 6 haora, ka honoa ki te Intravenous Bisphosphonates (Zoledronic Acid). 4 mg IV ko Pamidronate ranei 60 to 90 mg IV) ki te aukati i te resorption wheua osteoclast mo te 48 haora ki te 3 wiki, me te Oral/IV Glucocorticoids (Prednisone or Hydrocortisone) ki te aukati i te 1-alpha-hydroxylase activation me te intestinal calcium absorption.

Ruku Hōhonu o te akomanga 4: Zinc Phosphide me Aluminum Phosphide (Lethal Phosphine Gas)¶

Ka whakamahia i roto i nga maunu witi ahuwhenua, pire gopher/mole (Moletox, ZP Bait), me nga papa fumigant witi (Celphos, Phostoxin), ** Zinc Phosphide (Zn3P2)** me Konumohe Phosphide (AlP) kei roto i nga paihana tino tere whakamate i runga i te whenua:

• Te Tauhohenga matū i roto i te puku: Mārō Zn3P2 tauhohe ki 6 HCl (waikawa pūhaumāota puku) me te wai (H2O) ki te hanga 3 ZnCl2 a 2 PH3 (whakamate ** phosphine hau**).
• He aha te wai i tino rahuitia ai: Ko nga wai, he wai waikawa ranei i horomia e te manawanui, ka whakamahia ranei e te taote kare i mohio mo te horoi i te tote pereti paerewa, ka whakatere i te hauwai me te tuku i te kapua ohorere o te ** phosphine hau (PH3)**.
• Paehere Whakaora Hohipera mo te Zinc/Aluminium Phosphide:
• Tautapu Tiaki Whaiaro (PPE) me te Whakahau: Me atawhai te turoro i roto i te ruuma pehanga kino-kore; hiritia te ruaki me nga mea kei roto i te kopu kia kore ai nga kaimahi e ngongo hau phosphine.
• Te Huka Hukawa Peketere Inamata: Whakahaerehia Kaiwhakahaere Pump Proton Intravenous (Pantoprazole) 80 mg IV) me Oral/IV Sodium Bicarbonate kia piki ake te pH o te kopu ki runga ake 6.0, ka aukati i te waikawa pūhaumāota ki te huri i te toenga zinc phosphide ki te hau phosphine.
• Te Whakakore i te Hinu (KIA KORE I Te Wai-Wai): Mena ka horoi i te kopu i roto i te 1 ki te 2 haora, whakamahia paraffin wai rongoa, hinu kohuke, hinu kokonati ranei (me te waro whakakorikori kua whakatarewahia te hinu, konutai bicarbonate ranei) ki te whakakakahu i nga matūriki zinc phosphide me te aukati i te pa ki te wai i te wa e ngo ana te puku.
• ICU Mitochondrial and Myocardial Tautoko: Infuse ** Intravenous Magnesium Sulfate** (whakapumau i nga kiriuhi myocardial me te whakaiti i te koretake lipid peroxidation), Intravenous N-Acetylcysteine (NAC) (whakakapi i te glutathione ki te whara ate oxidative), High-Dose Insulin Erapuly. Norepinephrine, me ** VA-ECMO moata** mo te myocarditis paitini me te wiri ngakau.

Nga nama ohorere a rohe me nga tikanga umanga¶

Pātai auau¶

He aha te take e kore e taea e te taote te hoatu Huaora K mo ia kai paihana kiore?¶

Ko te Huaora K1 (phytonadione) anake e mahi ana mo te anticoagulant ("superwarfarin") paihana kiore penei i te brodifacoum me te bromadiolone. Na te mea ka hokona e nga toa taonga taonga hou penei i te d-CON, Tomcat, me Victor nga miriona poraka maunu kaakaariki i hangaia me Bromethalin (he neurotoxin pupuhi-roro kaore he rongoa) ko Cholecalciferol ranei (Huaora D3 nui te horopeta e pa ana ki te mate konupūmā), ka hoatu te Huaora K mo aua paihana kaore he mahi, ka hanga he haumaru teka. Ahakoa mo te whakaurunga superwarfarin pono, ka tatari nga taakuta ki te tirotiro i te whakamatautau toto INR 48-haora i mua i te tiimata o te Huaora K ki nga turoro kore tohu kia kore ai e huna mena kua uru te manawanui ki te horopeta paitini.

Me pehea e mohio ai he paraka paihana kiore kaakaariki he tino angiangi toto, Bromethalin, Huaora D3 ranei?¶

KORE koe e mohio ma te titiro ki te tae me te ahua o te poraka. Ka waikanohia e nga Kaihanga nga momo e toru o te rodenticide he kakariki, he puru-matomato, he mawhero, he mawhero ranei ma te whakamahi i nga momo tae kai me te hanga maaka. Ko te huarahi pono ki te tautuhi i te paihana ko te panui i te rarangi "Active Ingredient" me te EPA Registration Number kua taia ki mua o te pouaka kaata, i hirihia ranei ki runga i te teihana maunu kirihou, me te panui i aua kupu tika ki te Poison Control (1-800-222-1222 i te US) ki te rata ruma ohorere ranei.

He aha te mea kino ki te hoatu wai ki te tangata i horomia te mole zinc phosphide, pire kiore ranei?¶

Ka pa ana nga pire zinc phosphide, konumohe phosphide ranei ki te wai me te waikawa puku, ka puta he tauhohenga matū ka huri te paura totoka ki te hau phosphine whakamate i roto i te puku. Ko te tuku wai ka tere ake tenei tauhohenga, ka tukuna he kapua o te hau phosphine e whakangaro ana i te ngakau o te manawanui, nga ngongo, me te ate, ka taea hoki te whakaha, ka ruakina ranei ki nga kaiwhakaora paihana me nga kaimahi ruuma ohorere. Engari, ka whakakorehia e nga hohipera te waikawa o te puku me te aukati i te papu proton me te konutai bicarbonate me te whakamahi i te hinu kokonati, te hinu kohuke ranei, kaua ki te wai mo te whakakore i te kopu.

Ki te horomia e te tangata he paihana kiore superwarfarin penei i te brodifacoum me tana whakamatautau toto ruuma whawhati tata (INR) he rite tonu te 6 haora i muri mai, kei te noho morearea?¶

Kare. Kare a Superwarfarins e whakangaro i nga poroteina whakaheke toto e tere ana i roto i to toto; ka aukati noa i to ate ki te hanga i nga pūmua hou. Na te mea e 24 ki te 48 haora te roa o to tinana ki te whakamahi i te taonga o mua mo te Factor VII me te Factor II, ko te whakamatautau toto i tangohia i te 6, 12 haora i muri i te horomia o te paihana kiore ka 100 paiheneti te ahua noa, ahakoa i muri i te horopeta whakamate. Hei whakakore i te paihana superwarfarin, me whakahoki ano te whakamatautau toto PT/INR i te 48 haora me te 72 haora i muri i te horomanga.

He aha te take ka kai nga turoro i te maunu kiore superwarfarin ki te tango i nga pire Huaora K1 whakahaunga ia ra mo nga marama?¶

Kaore i rite ki te warfarin rongoa (ka mawehe atu i te tinana i roto i nga ra torutoru), ko nga "superwarfarins" tuarua-whakatupuranga penei i te brodifacoum he tino ngako-wairewa me te noho mau ki roto i te ate mo te 2 ki te 9 marama, ka aukati tonu i te whanariki e hangarua ana i te Huaora K. nga horopeta whakahaunga nui (50 mg ki te 200 mg ia ra, wehea ia 6 ki te 8 haora) ia ra mo nga wiki, marama ranei tae noa ki te whakakorenga o te paihana i te ate.

Nga kaiarahi e pa ana¶

• Ko te awhina tuatahi mo te paihana me te whakamatautau paihana
• He kaha te whakahaere toto me te ru hemorrhagic
• Ko te Cyanide, te hauwai sulfide, me te whakauru hau ahumahi hei awhina tuatahi
• Te pesticide Organophosphate, te raau nerve, me te paihana ngarara
• Kapohia te awhina tuatahi me te haumaru

Nga puna me nga aratohu whai mana¶

• American Association of Poison Control Centres (AAPCC): He Aratohu Whakaaetanga I runga i nga Whakaaturanga mo te Whakahaere i waho-o-Hospital o te Rodenticide Rodenticide Ingestions Rodenticide (Clinical Toxicology).
• Te Tiaki Taiao o te United States (EPA): Te Whakaaetanga me te Whakahaerenga o te Paihana Pesticide (Tuhinga 6): Anticoagulant Rodenticides, Bromethalin, Cholecalciferol, me Zinc Phosphide.
• American College of Medical Toxicology (ACMT): Whakahaere Haumanu o Superwarfarin Coagulopathy, Synthetic Cannabinoid Brodifacoum Outbreaks, me nga Rodenticides Kore-Anticoagulant.
• Ratonga Whakamohio Paona Motu (NPIS, United Kingdom): TOXBASE Nga Kawa Haumanu mo te Superwarfarin, Bromethalin, Cholecalciferol, me te Whakapaihana Metal Phosphide.
• Te Whakahaere Hauora o te Ao (WHO): Te Papatono Ao mo te Haumaru Matū (IPCS): Aratohu Hauora me te Haumaru mo Brodifacoum, Bromethalin, me Phosphine / Metal Phosphides.

Ko tenei aratohu mo nga kaupapa korero me te kore e whakakapi i te aromatawai hauora ngaio, te korero mo te Mana Paihana, te tiaki kararehe kararehe/hohipera ranei. Na te mea ka taea e te paihana rodenticide te whakaroa i te whakaheke toto o roto, te edema roro, te tuku hau paitini ranei, ka tino taunaki matou ki te tango i tetahi awhina tuatahi me te akoranga CPR kua whakamanahia i roto i te International Federation of Red Cross and Red Crescent Societies (IFRC), to hapori Rīpeka Whero o te motu, St John Ambulance, tetahi kaiwhakarato rohe whaimana ranei.