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I-Dry Ice Asphyxiation, i-Liquid Nitrogen Frostbite, kanye ne-Cryogenic Burns

Izinombolo zezimo eziphuthumayo ziyehluka ngezwe. Leli khasi lisebenzisa u-911, inombolo yase-United States naseCanada. Amanye amazwe amaningi asebenzisa u-112, 999, noma enye inombolo. Thola inombolo yezwe lakini.

Izinto ze-Cryogenic namagesi a-liquefied, ikakhulukazi I-Dry Ice (i-solid carbon dioxide, \(\text{CO}_2\), ku-\(-78.5^\circ\text{C} / -109.3^\circ\text{F}\)), I-Liquid Nitrogen (\(\text{LN}_2\)\()**, **I-Liquid Helium (\)-269^\circ\text{C} / -452^\circ\text{F}\()**, **I-Liquid Oxygen (\)\text{LOX}$ at \(-183^\circ\text{C} /\)quid297\F}) But Propane (\(-42^\circ\text{C} / -44^\circ\text{F}\)), kanye ne-compressed difluoroethane "canned air" dusters noma amasilinda e-nitrous oxide, awasavalelwe kulabhorethri yezimboni. Izigidi zemindeni zihlangabezana neqhwa elomile kanye ne-nitrogen ewuketshezi ngaphakathi kwamabhokisi e-oda enyama eqandisiwe kanye nempahla yokudla, ukulethwa kuka-ice-cream, imishini yenkungu ye-Halloween, ama-dessert okupheka "we-dragon's breath" nama-cocktails anentuthu, izinsiza zokususa insumpa yesikhumba, nezifutho zokuhlanza ugesi.

Lezi zinto zidala izimo eziphuthumayo ezine ezihlukile ezibeka impilo engcupheni ezidinga usizo lokuqala olusheshayo, olukhethekile:

  1. I-Confined-Space Asphyxiation kanye ne-Hypercapnic Narcosis: Uma iqhwa elomile lishona ngaphakathi kwemoto yomgibeli evaliwe, iveni yokulethwa, isiqandisi esingangena endlini, noma igumbi lokulala elincane, noma lapho i-nitrogen ewuketshezi ibilisa kukheshi noma ngaphansi, igesi ekhulayo isusa umoya-mpilo ophefumulayo kuyilapho isikhutha sifaka ushevu ngokuqondile egazini.
  2. I-Instantaneous Cryogenic Contact Frostbite: Ukuthinta iqhwa elomile elinesikhumba esingenalutho, noma ukuthola i-nitrogen ewuketshezi noma i-propane ewuketshezi evaleleke ngaphakathi kwegilavu ​​noma ebhuthini, kuqandisa izicubu zomuntu ziqine ngemizuzwana, kuqhume ulwelwesi lwamaseli ngamakristalu eqhwa angaphakathi kwamangqamuzana.
  3. Ukubhobozwa Kwamathumbu Kusuka Ku-Nitrogen Ewuketshezi Olugwinywe Noma Iqhwa Elomile: Ukugwinya i-nitrogen ewuketshezi engahwamuki ku-cocktail entsha noma i-cereal puff, noma ukufaka ucezu lweqhwa elomile emlonyeni, kubangela ukuqhuma okuphindwe izikhathi ezingu-700 kuya ku-800 ukunwetshwa kwevolumu ngaphakathi kwembobo yomphimbo oqhuma ngokuqondile esiswini noma esiswini esishisayo. (i-barotrauma perforation).
  4. Ukuqhuma Kwebhomu Le-Cryogenic-Isitsha Esivaliwe: Ukufaka iqhwa elomile elisele noma i-nitrogen ewuketshezi ngaphakathi kwebhodlela lesoda yepulasitiki eboshwe ngokuqinile, isitsha sengilazi, noma isipholile esivalwe nge-latch kwakha izingcindezi ezingaphezu kuka-700 kuya ku-1,100 PSI*, okuqhunyiswa ngamandla ebhomu elihlukanayo.

Lo mhlahlandlela uhlinzeka ngezinyathelo ngezinyathelo zokuhlenga, ukufudumala, kanye nezinqubo zokuhlola esibhedlela ezihambisana ne-United States National Institute for Occupational Safety and Health (NIOSH / CDC), i-Occupational Safety and Health Administration (OSHA), i-Compressed Gas Association (CGA), i-Wilderness Medical Society (WMS), kanye ne-UK Health and Safety Executive (HSE).

Yenza lokhu manje

Uma uphendula esimweni esiphuthumayo esibandakanya iqhwa elomile, i-nitrogen engamanzi, noma igesi eliwuketshezi elicindezelwe:

  1. UNGALOKOTHI ungene egumbini elingangenisi umoya, indawo epholile ehamba ngezinyawo, noma imoto evaliwe lapho othile ewele khona eduze kweqhwa elomile noma i-nitrogen ewuketshezi: Uzophuma ushone eduze kwabo phakathi kwamasekhondi angu-20 kuya kwangu-60 ngaphandle kwe-Self-Contained Breathing Apparatus (SCBA). Okokuqala, vula uvule yonke iminyango yemoto, iminyango yegaraji, noma amafasitela angaphandle ukusuka ngaphandle ukuze unqamule isikhala, shayela u-911/112/999 ngeyethu izinombolo eziphuthumayo lwemibhalo, futhi udonsele isisulu kuphela emoyeni omusha wangaphandle uma ungenza kanjalo ngaphandle kokuphefumula umoya ovalekile.
  2. Khipha noma yisiphi isikhumba esiqandisiwe ukuze some iqhwa noma insimbi eqandayo usebenzisa amanzi ayisivivi (UNGALOKOTHI uyiklebhule yomile): Uma iminwe engenalutho, izindebe, noma ulimi luba yiqhwa ngokushesha lube yiqhwa elomile, ipayipi le-nitrogen eliwuketshezi, noma isiqukathi sensimbi, thela amanzi ayisivivi (\(37^\circ\text{C}\text{9{3{3}} kuya ku-}} 98.6^\circ\text{F}\text{ to }102.2^\circ\text{F}\)) phezu kwendawo yokuxhumana ukuze uncibilikise ibhondi yeqhwa kancane. Ukudonsa isikhumba esomile endaweni ye-cryogenic kudabula yonke i-epidermis ne-dermis eminwe.
  3. Khipha izindandatho, amawashi, nezingubo noma amabhuzu afakwe i-cryogen ngokushesha: Uma i-nitrogen ewuketshezi noma i-propane ewuketshezi isakazeka ngaphakathi kwegilavu ​​yomsebenzi exegayo, isokisi, noma ibhuthi, uketshezi luvaleleka esikhumbeni bese lulahlekelwa umcamelo walo ovikelayo we-Leidenfrost. Donsa igilavu ​​noma uyivule kungakapheli isekhondi elingu-1 (usebenzisa izindlawu noma amathawula omile ukuze uvikele izandla zakho) bese uslayida ukhiphe zonke izindandatho zeminwe ngaphambi kokuthi kuqale ukuvuvukala.
  4. I-cryogenic frostbite efudumala ngokushesha ku-\(37^\circ\text{C}\text{ ukuya }39^\circ\text{C}\) (\(98.6^\circ\text{F}\text{ kuya }102.2^\circ\text{F}\)) okugeza amanzi afudumele imizuzu engu-30 ukuya ku-15
  5. Hlola izinga lokushisa lamanzi nge-thermometer noma ngendololwane yakho engalimele kuqala. Ungalokothi usebenzise amanzi ashisayo angaphezu kuka-\(40^\circ\text{C}\text{ ukuya }42^\circ\text{C}\) (\(104^\circ\text{F}\text{ ukuya }ku-108^\circ\text sebenzisa{F}\), isitsha sokushisisa, ukomisa umshini wokushisisa, noma ukomisa umshini wokushisa ukushisa imililo), epheka izicubu ezindikindiki, eziqandisiwe.
  6. UNGALOKOTHI ukuhlikihle noma ukubhucunga ukusha kwe-cryogenic: Amaseli esikhumba esiqandisiwe agcwele amakristalu eqhwa abukhali acijile; ukuhlikihla indawo kugaya lawo makristalu ngolwelwesi lwamangqamuzana nemithambo yegazi, kucekele phansi izicubu ebezingasindiswa.
  7. Uma othile egwinye i-nitrogen ewuketshezi noma iqhwa elomile (kwi-cocktail, inkomishi yenkungu, noma i-dessert), shayela ku-911 / 112 / 999 ngokushesha futhi UNGAPHOQI ukuhlanza noma unikeze iziphuzo ezine-carbonated: Hlalisa lowo muntu aqonde noma ancike kancane phambili ukuze igesi enwebekayo igobhoze iphume emlonyeni, futhi umhambise ngokushesha ukuze ahlinzwe* CT scan kanye ne-esophatric i-barotrauma perforation kanye ne-pneumoperitoneum*.
  8. Uma ibhodlela elivaliwe noma isipholile esineqhwa elomile siqhuma noma sihayiza, phuma endlini ngokushesha: UNGADLULI futhi uzame ukukhulula ikepisi. Ukudlidliza nokubamba okufudumele kwesandla sakho kuzoqhumisa isiqukathi esisebusweni bakho, kubangele imivimbo ephuphuthekisa i-cornea kanye nokunqunywa kweminwe okudabukisayo. Sula indawo, vala isicabha ngemuva kwakho, futhi usivumele siphume noma sigqabuke ngemuva kwekhava eqinile.

Kungani Ukushayela Ngeqhwa Elomile Emotweni Evaliwe Kungabangela Ukuphefumula Okubulalayo Ngemizuzu eyi-15

Ikhilogremu eyodwa (amakhilogremu angu-2.2) yeqhwa eliqinile lingena ngaphansi ku-541 amalitha (19.1 cubic ft) wegesi ehlanzekile ye-carbon dioxide (\(\text{CO}_2\)). Ngokungafani ne-nitrogen ewuketshezi (okuyi-asphyxiant elula emane ihlambulule umoya-mpilo), i-carbon dioxide ingushevu osebenzayo we-systemic (hypercapnic intoxicant). Lapho i-\(\text{CO}_2\) ingaphakathi kwendlu yemoto evaliwe ene-air conditioner ebekwe kokuthi "Recirculate" ikhuphuka isuka kwevamile. 0.04% (400 ppm) kuze kube 3% to 5% (30,000 to 50,000 ppm), abagibeli baphathwa ikhanda elishaya ngamandla, isiyezi, ukuhefuzela ngokushesha, nokushaya kwenhliziyo okugijima; kanye \(\text{CO}_2\) ifinyelela 7% to 10% (70,000 to 100,000 ppm), kubangela **i-acidosis enzima yokuphefumula, ukuquleka, ukuquleka phakathi nemizuzu engu-1 kuya kwemi-2, nokufa **, ngisho noma kusekhona amaphesenti angu-19 umoya-mpilo osele emotweni. Ngaso sonke isikhathi hambisa iqhwa elomile esiqwini sangaphandle/ebhuthini noma kumbhede weloli, noma okungenani amafasitela amabili ehliswe phansi ngamasentimitha angu-5 (2 amayintshi) futhi isilawuli sezulu simiswe ukuze sithi Umoya Omusha Wangaphandle (UNGAZE Ujikeleze).

Ishadi lokugeleza lokuchayeka kwesimo esiphuthumayo kanye ne-asphyxiation triage triage

flowchart TD
    Start["I-Dry Ice (CO2), I-Nitrogen Ewuketshezi (LN2), noma Isimo Esiphuthumayo Esicindezelwe se-Cryogen"] --> SceneSafety["UKUPHEPHA KWESIGCAWU KUQALA: Ingabe isisulu singaphakathi emotweni evaliwe,<br/>indawo epholile yokuhamba ngezinyawo, ingaphansi, ilifti, noma igumbi elincane?"]

    SceneSafety -->|Yes: Confined-Space Collapse| VentRescue["UNGANGENA NGAPHANDLE KWE-SCBA / VENTILATION<br/>1. Vula yonke iminyango/amawindi kusukela ngaphandle ukuze unqamule umoya<br/>2. Shayela ku-911 / 112 / 999 (Bika I-Confined Space Cryogen Asphyxiation)<br/>3. Uma usemoyeni omusha: Hlola ukushaya kwenhliziyo/ukuphefumula -> Qala i-CPR + 100% I-Oxygen uma i-apneic"]

    SceneSafety -->|No: Conscious Patient in Safe Air| InjuryType{"Uhlobo luni lokulimala kwe-cryogenic olwenzekile?"}

    InjuryType -->|Ingestion of Liquid Nitrogen Cocktail / Dessert<br/>OR Swallowed Piece of Dry Ice| GiPerf["ESIPHUTHUMAYO SOKUSEBENZA KWE-GASTRIC BAROTRAUMA (CALL 911)<br/>1. Gcina isiguli sihlezi siqondile ukuze igesi ikwazi ukuphuma (ibhince) ngaphandle<br/>2. Akukho ngomlomo (NPO); UNGALINGE ubangele ukuhlanza<br/>3. Isibhedlela Esiphuthumayo I-CT + Ukuncipha Kokuhlinzwa Kwe-Pneumoperitoneum<br/>+ I-Endoscope ye-Esophageal/Gastric Cryo-Necrosis"]

    InjuryType -->|Dermal Contact / Splash Burn on Hands, Feet, or Face<br/>(Dry Ice, Liquid Nitrogen, Propane, or 'Canned Air' Duster Spray)| SkinBurn["I-CRYOGENIC FROSTBITE PROTOCOL<br/>1. Uma isikhumba sinamathele eqhweni/insimbi: Khulula ngamanzi afudumele (37-39°C)<br/>2. Hlubula amagilavu ​​amanzi/ahlanganiswe ndawonye, ​​amasokisi, amabhuzu, namaringi ngokushesha<br/>3. Gxila ku-37°C ukuya ku-39°C (98.6°F ukuya ku-102.2°F) azungeza amanzi imizuzu engu-15-30<br/>4. UNGALOKOTHI usihlikihle isikhumba; shiya amabhamuza ehlanzekile; nikeza i-Ibuprofen (anti-thromboxane)"]

    InjuryType -->|Cryogenic Splash into the Eye<br/>(Liquid Nitrogen, Refrigerant Freon/R-134a, or Propane)| EyeBurn["I-OCULAR CRYOGENIC BURN PROTOCOLI<br/>1. Nisela iso ngobumnene (37°C / 98.6°F) usawoti oyinyumba oyinyumba noma amanzi imizuzu engu-15<br/>2. Uma amajwabu amehlo evalekile eqandisiwe, afudumale nge-saline compressed esivivi aze avuleke<br/>3. UNGAZE ucikice iso; mboza ngokukhululeka ngesivikelo samehlo futhi uye ku-Emergency Ophthalmology"]

I-Physics kanye ne-Pathophysiology ye-Cryogenic Gases kanye ne-Liquids

Ukuqonda indlela ama-cryogen aziphatha ngayo kuchaza ukuthi kungani elithi Dry Ice (\(\text{CO}_2\)) kanye ne-Liquid Nitrogen (\(\text{LN}_2\)) libulala abantu ngezindlela ezihluke ngokuphelele zegesi, nokuthi kungani ukuchaphaza kafushane kwe-nitrogen ewuketshezi esandleni esingenalutho kuvame kungenangozi kuyilapho ukuchaphaza ngaphakathi kwegilavu kubangela ukunqanyulwa komunwe.

1. Izilinganiso Zokunwetshwa Kwegesi Nokuminyana: I-Carbon Dioxide (\(\text{CO}_2\)) vs. Nitrogen (\(\text{N}_2\))

I-Physical & Toxicological Property I-Solid Dry Ice (I-Carbon Dioxide / \(\text{CO}_2\)) I-Liquid Nitrogen (\(\text{LN}_2\)) I-Liquid Oxygen (\(\text{LOX}\)) Isiqandisi Esicindezelwe / "I-Canned Air" Duster (1,1-Difluoroethane / Propane / \(\text{N}_2\text{O}\))
Abilayo / I-Sublimation Temperature \(-78.5^\circ\text{C}\) (\(-109.3^\circ\text{F}\)) (i-sublimates ngokuqondile isuka kokuqinile iye kugesi ngo-1 atm) \(-195.8^\circ\text{C}\) (\(-320.4^\circ\text{F}\)) (amathumba asuka oketshezini aye kugesi) \(-183.0^\circ\text{C}\) (\(-297.3^\circ\text{F}\)) (uketshezi oluluhlaza okwesibhakabhaka oluphaphathekile lwe-cryogenic) \(-25^\circ\text{C}\text{ to }-88^\circ\text{C}\) (\(-13^\circ\text{F}\text{ to }-127^\circ\text{F}\)) phezu kokuwohloka okusheshayo kwe-adiabatic
I-Expansion Ratio (I-Solid/Liquid to Gas at \(20^\circ\text{C}\)) 1 : 845 ngevolumu (1 kg iqhwa elomile eliqinile = 541 Amalitha we-\(\text{CO}_2\) emsulwa) 1 : 694 ngevolumu (1 Liter kwe-\(\text{LN}_2\) ibilisa ku- 694 Litre wegesi emsulwa engu-\(\text{N}_2\)) 1 : 860 ngevolumu (1 Liter kwe-\(\text{LOX}\) = 860 Amalitha we-\(\text{O}_2\) emsulwa) 1 : 250 kuya ku-1 : 400 lapho ifuthwe ihlanekezelwe njengejethi eliphehla uketshezi
I-Vapor Density vs. Air (\(\text{Air} = 1.00\)) \(1.53\) (53% AYISINDA kunomoya): Osinki abaya phansi, izinyawo zemoto, amagumbi angaphansi, nemisele, abaminyanisa izingane, izilwane ezifuywayo, nezisulu eziwile kuqala. \(0.97\) uma kufudumele, kodwa \(1.5\umbhalo{ukuya kokuthi }4.0\times\) OKUZINI kunomoya lapho kubanda (\(-196^\circ\text{C}\)): Okubandayo \(\text{N}_2\) inkungu inganga phansi ngaphambi kokuxubana nalo lonke igumbi. \(1.14\) (Isinda kunomoya): Amachibi asezindaweni eziphansi futhi agcwale imicu yezingubo. \(1.5\umbhalo{ ukuya ku-}2.3\) (Usinda kunomoya): Amachibi asezindaweni eziphansi nangaphakathi kwamaphaphu lapho ehogeliwe.
Indlela Yokuphefumula Nezimpawu Zesexwayiso I-Active Hypercapnic Poisoning + Acidosis: Izimbangela ukulamba komoya okukhulu (dyspnea), ukwethuka, ikhanda elishaya ngamandla, ukujuluka, kanye ne-tachypnea 3% to 5%, bese koma nokudlikiza at 7% to 10% (ngisho noma i-\(\text{O}_2\) isengu-\(> 18\%\)). I-Hypoxic Asphyxiation Ethule (ZERO Warning): Ngoba ukuphefumula komuntu kubangelwa \(\text{CO}_2\) ephezulu, hhayi low \(\text{O}_2\), ukuphefumula okumsulwa \(\text{N}_2\) kubangela ZERO shortness of breath or choking sensation. Isisulu sizizwa sijwayelekile ngokuphelele, sithatha1 kuya ku-2 ukuphefumula, bese siquleka ngemizuzwana engu-8 kuya kwengu-15. Ingozi Yomlilo Nokuqhuma Okudlulele: Ayinciphisi, kodwa izingubo noma itiyela elifafazwa ngo-\(\text{LOX}\) iba isiqhumane esiphezulu esizwela umthelela esiqhuma sisuka esinyathelweni sokuqalisa noma inhlansi emile. I-Sudden Sniffing Death Syndrome (I-Myocardial Sensitization): I-Difluoroethane ne-butane zenza inhliziyo izwakale ku-adrenaline, okubangela i-Ventricular Fibrillation Ukuboshwa kwenhliziyo okusheshayo eduze kwesithwathwa esinzima somlomo/esandleni.
Imikhawulo Yokuchayeka ye-OSHA / NIOSH TWA (8-amahora): 5,000 ppm (0.5%).
STEL (15-min): 30,000 ppm (3.0%).
IDLH (Iyingozi Ngokushesha Empilweni/Empilweni): 40,000 ppm (4.0%).		 I-Oxygen-Deficint Atmosphere: Umoya ojwayelekile 20.9% O2.
Ingozi ye-OSHA: < 19.5% O2.
Ikhoma Nokufa Ngokushesha: < 6% to 10% O2.		 Ingozi Yokuqhuma Enomoya-mpilo: Noma yimuphi umkhathi > 23.5% O2. I-Acute Frostbite + Cardiac Arrhythmia lapho uhogelwa ngamabomu ("uthuli" / "iziswebhu") noma isifutho sesikhumba esihlanekezelwe.

2. I-Leidenfrost Effect Trap: Kungani Amagilavu Nezingubo Zenza I-Nitrogen Ewuketshezi Ishise Kakhulu Kakhulu

Lapho ithonsi elincane le-Liquid Nitrogen (\(-196^\circ\text{C} / -320^\circ\text{F}\)) lisakazeka esikhumbeni esifudumele, esingenalutho, esomile futhi lihlehle ngokushesha:

  • Ngoba umehluko wezinga lokushisa phakathi kwesikhumba somuntu esifudumele (\(33^\circ\text{C}\)) kanye ne-nitrogen eyi-liquid (\(-196^\circ\text{C}\)) idlula \(229^\circ\text{C}\) (\(412^\circ\text{F}\)), indawo engaphandle yethonsi ekhanyisa i-nitrogen ngokushesha e-Level* Umphumela**). Kumasekhondi angu-0.5 kuya kwangu-1.5*, lelo gas ungqimba oluncane lugwedla ithonsi eliwuketshezi lisuka esikhumbeni esingenalutho ngaphandle kokuqandisa inyama.
  • Lapho i-Leidenfrost Shield Yehluleka (Ukuqanda Okugcwele Okugcwele Ngokushesha):
  • Ngaphakathi kwamagilavu, amasokisi, iShoes, noma imikhono kakotini: Uma i-nitrogen ewuketshezi isakazeka phansi kwi-cuff evulekile yegilavu ye-cryogenic, noma icwiliswe ehembeni likakotini, ijini ledenim, noma amateku, indwangu **iyacwenga futhi ibambe u-$-196^\circ\text{C}*3 imizuzwana emi-5 ukuya esikhumbeni. I-Leidenfrost gas cushion iyawa ngokushesha, futhi isikhumba, imisipha, imithambo yegazi, kanye nethambo kubanda kuqine njengengilazi ngemizuzwana.
  • I-Solid Dry Ice Contact: Ngenxa yokuthi iqhwa elomile liyibhulokhi eliqinile ku-\(-78.5^\circ\text{C}\) elibanjwe ngokuqinile esikhumbeni ngokucindezela komunwe (noma kukhothwa ngolimi olumanzi), umswakama esikhumbeni ubanda ngokushesha ube yibhondi yeglue eqinile, ehambisa amakhaza amakhulu ngqo ku-dermis ejulile ngaphandle kwe-cushion yegesi evikelayo.
  • Izifutho Ze-Aerosol Ecindezelwe (Iziduli Zomoya Ezithi "Inverted "Canned Air", Liquid Propane, noma I-Nitrous Oxide Charger): Uma i-electronics duster can (1,1-difluoroethane) ibanjwa ibheke phansi futhi ifuthwe esikhumbeni, noma uma *nitrous oxide ($\text{N}_2") enkuluibanjweithangi{N}")**whipOxid{N}_2\")*whipOde* ibambe phakathi kwamathanga angaphakathi omsebenzisi njengoba ikhiphigesi ngokushesha, ijethi yesivinini esiphezulu noma udonga lwethangi lensimbi eliqandayo likhumula noma iyiphi ungqimba lomhwamuko bese libangela ukushiswa kwesithwathwa okujulile, okungenabuhlungu, okugcwele okugcwele kwe-third-and-four degree phakathi kwamasekhondi angu-3 kuya kwangu-10.

I-Deep Dive 1: Isinyathelo Ngesinyathelo Usizo Lokuqala Lokusha kwe-Cryogenic Frostbite (Isikhumba, Izandla, Namehlo)

Ukuthi ukusha kwe-cryogenic kwavela ekuphatheni iqhwa elomile ngaphandle kwezindlawu, ukuchitheka kwe-nitrogen ewuketshezi, ukushintshana kwethangi le-propane, noma isifutho segesi esicindezelwe, ukulimala kwezicubu kulandela i-cascade yezigaba ezimbili: Isigaba 1 (Direct Extracellular and Intracellular Ice Crystal Formation) ngesikhathi sokuqhwa, kanye Isigaba 2 (Reperfusion Endothelistage \(\text{PGF}_{2\alpha}\), kanye ne-Thromboxane \(\text{A}_2\) I-Microvascular Clotting) ngesikhathi sokuncibilika.

1. I-Immediate Field Rewarming Protocol (The \(37^\circ\text{C}\text{ to }39^\circ\text{C}\) Umthetho Wokugeza Amanzi)

  1. Khulula noma yisiphi isikhumba esinamathelayo esinamanzi ayisivivi: Uma isikhumba sibambeke eqhweni noma ensimbi ebandayo, thela amanzi ampompi ayisivivi ($37^\circ\text{C}\text{ kuya }39^\circ\text{C} / 98.6^\circ\text{F}\text{ ukuya }ku-}102.2.2 ukuze uyikhiphele yona{102.2} yodwa.
  2. Lungiselela ukugeza kwamanzi afudumele azungezayo at ncamashi \(37^\circ\text{C}\text{ to }39^\circ\text{C}\) (\(98.6^\circ\text{F}\text{ to }102.2^\circ\text{F}\)):
  3. Sebenzisa ithemometha uma ikhona, noma hlola amanzi ngesihlakala sakho sangaphakathi esingalimele noma ngendololwane; kufanele kuzwakale ukugeza kamnandi kokugeza kwengane, kungashisi.
  4. Gxilisa iminwe eqandisiwe, isandla, noma unyawo emanzini okugeza (noma sebenzisa ukuminyanisa kwamanzi afudumele avuselelwe ngokuqhubekayo ekushiseni kobuso)imizuzu eyi-15 ukuya kwengama-30 kuze kube yilapho izicubu eziphaphathekayo, eziqinile, ezimhlophe-oku-waxy noma eziluhlaza okwesibhakabhaka ziphenduka obomvu obomvana futhi uzizwe uthambile futhi uthambile ichopho.
  5. Njengoba amanzi ephola esuka esithweni esiqandisiwe, engeza amanzi afudumele amancane eceleni komcengezi (ususa isandla isikhashana ngenkathi uxukuza emanzini afudumele ukuze amanzi ashisayo angalokothi athelele esikhumbeni esilimele).
  6. Lungiselela isiguli "Ubuhlungu Obuvuselelayo Obubuhlungu" futhi unikeze ngomlomo i-Ibuprofen:
  7. Nakuba kuqinile kuqandisiwe, ukushiswa kwe-cryogenic kuba ndikindiki ngokuphelele futhi akubuhlungu (yingakho abantu abaphethe isilinda se-nitrous oxide eqandayo phakathi kwamathanga abo noma abafutha i-difluoroethane engalweni yabo abaqapheli ukuthi bashiswa yizinga lesithathu).
  8. Njengoba ukugeleza kwegazi kubuya ngesikhathi sokuncibilika kwamanzi afudumele, indawo izoqala ukuqhuqha futhi ishise kakhulu.
  9. Uma isiguli siphapheme, sikwazi ukugwinya, futhi singenakho ukungezwani komzimba, isifo sezinso, noma umlando wezilonda zesisu, imihlahlandlela yeWilderness Medical Society (WMS) incoma ukunikeza i-Ibuprofen yomlomo (12 mg/kg/day ihlukaniswe kabili ngosuku, ngokuvamile 400 mg to 600 mg okomuntu omdala) kune-acetaminophen noma i-aspirin kuphela, ngoba ibuprofen ikhetha ngokukhetha arachidonic acid / thromboxane \(\text{A}_2\) kanye ne-prostaglandin \(\text{PGF}_{2\alpha}\) cascade ebangela ukuthi imithambo yegazi ekhuphukile ihlule futhi ibulale isikhumba.
  10. Indlela yokuphatha amabhamuza e-Cryogenic (Sula vs. I-Hemorrhagic / Ukugcwala Ngegazi):
  11. Phakathi** namahora angu-1 kuye kwangama-24** ngemva kokuncibilika kokusha kwe-cryogenic, amabhamuza amakhulu (ama-bulla) azokhuphuka esikhumbeni:
    • Amabhamuza Amanzi Acwebile Noma Aphuzi Ukwelula Kuze Kufike Iminwe: Bonisa ukulimala okungaphezulu noma okujulile kokuqina okuncane lapho i-subdermal plexus yemithambo isaphila. **UNGAWAQHUBEKI noma unqamule amabhamuza aphelele ensimini **; gcoba ijeli yenhlaba ehlanzekile (esebenza njenge-ejenti yendawo ye-anti-thromboxane) uma ikhona, beka i-gauze eyomile eyinyumba phakathi komunwe ngamunye noma uzwane ukuze zingakwazi ukunamathelana, futhi usonge ngokukhululeka ngendwangu eyinyumba enkulu, engavimbi.
    • Amabhamuza Okunsomi Okumnyama noma Agcwele Igazi (Hemorrhagic) (noma isikhumba esimpunga/esimnyama esiqinile, esingashwabanisi esihlala sibandayo ngemva kokuncibilika): Bonisa ukulimala okujulile kokuqina okugcwele ku-reticular dermis kanye ne-subcutaneous vascular plexus. UNGALOKOTHI ubhoboze noma uchithe amabhamuza egazi akopha, njengoba ukuwavula kuholela ekuwohlokeni kwezicubu ezijulile kanye nokutheleleka kwesibili.

2. Kungani Ukuhlolwa Kwesibhedlela Phakathi Kwamahora angama-24 Kungasindisa Iminwe Eqandisiwe (Iloprost & tPA)

Konke ukusha okujulile kwe-cryogenic okuhlanganisa iminwe, izinzwane, izandla, ubuso, noma izitho zangasese, nanoma yikuphi ukusha okuba nsomi ngokumnyama, impunga, noma kube namabhamuza agcwele igazi, kufanele kuhlolwe isikhungo sokusha sasesibhedlela phakathi namahora angu-12 kuya kwangu-24 ngemva kokuncibilika. Izikhungo zokusha zesimanje zisebenzisa i-Iloprost ephuthumayo i-intravenous Iloprost (i-prostacyclin vasodilator) noma i-catheter-directed / intravenous Tissue Plasminogen Activator (tPA) thrombolysis phakathi kwamahora okuqala angama-24 okufudumala kabusha ukuze kuncibilike amahlule egazi amancane angaphakathi emithanjeni yedijithali, ukusika umunwe* ngamaphesenti angu-5* ngaphezu kwamaphesenti angu-6

I-Deep Dive 2: I-Nitrogen Ewuketshezi Egwinyile (Uphudingi we-"Dragon's Breath" nama-Cocktails Abhemayo) kanye Nokungenisa Iqhwa Elilomile

Kule minyaka eyishumi edlule, amabha, ama-fairs, nezindawo zokudlela eziyingozi zinikeze ama-cocktails agcwele i-nitrogen ewuketshezi ebhemayo noma isiqephu seqhwa elomile, kanye nezinhlamvu zezinhlamvu ze-"Dragon's Breath" ezicwiliswe ku-\(-196^\circ\text{C}\) liquid nitrogen ukuze ikhasimende likwazi ukufuthela umhwamuko omhlophe kanye nentuthu emlonyeni ngenkathi lihlafuna.

1. Kungani Ukugwinya I-nitrogen Ewuketshezi Kuqhuma Imbobo Ngodonga Lwesisu

Lapho umthengisi ethela i-nitrogen ewuketshezi esiphuzweni noma enikeza okusanhlamvu okufakwe uketshezi-nitrogen, ukuphepha kuncike ngokuphelele kumaphesenti angu-100 e-nitrogen ewuketshezi abilayo NGAPHAMBI kokuba ikhasimende libeke inkomishi noma ukhezo ezindebeni zalo (umusi ngokwawo uwumhwamuko wamanzi abandayo ongenabungozi ophuma emoyeni wegumbi). Uma ngisho amamililitha angu-2 kuya ku-5 (uhhafu wethisipuni) we-nitrogen ewuketshezi engahwamuki isala ihlanganiswe phansi engilazini noma icwiliswe ngaphakathi kwebhola lokusanhlamvu elinembobo futhi igwinywe:

  1. I-Instant Cryogenic Necrosis of the Mouth and Esophagus: Uketshezi lwe-\(-196^\circ\text{C}\) lumisa ulwelwesi lwamafinyila olimini, pharynx, nommizo lapho uthintana.
  2. I-Explosive 1 : 694 Ukunwetshwa Kwevolumu Esiswini Esifudumele: Isikhathi lapho 5 milliliters we-nitrogen ewuketshezi ishaya ijusi ye-gastric efudumele (\(37^\circ\text{C} / 98.6^\circ\text{F}\)) ngaphakathi kwesisu esivaliwe, ibaneka ngokunamandla ibe yi-nitrogen engamalitha angu-3.5 2 imizuzwana* (kanye ne-a 15 mL ukugwinya isipuni kunwebeka kube 10.4 Amalitha kagesi).
  3. I-Gastric Barotrauma Perforation kanye Ne-Tension Pneumoperitoneum: Ngenxa yokuthi i-esophageal sphincter ne-pyloric sphincter ayikwazi ukukhipha amalitha angu-3.5 kuya kwangu-10 egesi engxenyeni yomzuzwana, amabhaluni esisu adlule ukucindezela kwawo kokuqhuma futhi klzzwxh:0123 (**massiveneumoperitoneum), ukucindezela i-vena cava engaphansi namaphaphu (**abdonal compartment syndrome / tension pneumoperitoneum), futhi kudinga **i-laparotomy yokuhlinzwa ephuthumayo (ngokuvamile i-gastrectomy eyingxye noma ephelele)** ukuze kusindiswe impilo yesisulu.

2. Usizo Lokuqala Olusheshayo Lokungenisa I-Cryogenic

  • Shayela ku-911 / 112 / 999 ngokushesha futhi usho ngokucacile: "Isiguli sigwinye i-nitrogen ewuketshezi (noma iqhwa elomile) futhi sinobuhlungu obukhulu besisu kanye nokuvuvukala, okusolakala ukuthi sibhobokile esiswini."
  • Misa isiguli sihlezi siqondile noma sincike phambili: Lokhu kusiza noma iyiphi igesi ekhulayo esele esiswini iphumele phezulu ngomminzo ngokuphuma (i-belching) kunokuba iphoqe igesi eyengeziwe idabule odongeni lwesisu iye esiswini.
  • UNGANIKEZI LUTHO ngomlomo (NPO): Unga unganiki amanzi afudumele ukuze uphuze (uma i-nitrogen ewuketshezi isisesiswini, ukwengeza amanzi afudumele kusheshisa ukunwetshwa kwegesi futhi kugeze uketshezi luphume ngodonga lwesisu olunezimbobo lungene ku-peritoneum), futhi akulokothi kubangele ukuhlanza.
  • Uma ucezu lweqhwa elomile eliqinile lunamathele emlonyeni (olimini noma esihlathini) futhi lungakagwinywa*: Thela amanzi ayisivivi emlonyeni bese ucela umuntu ancike phambili ukuze awakhafulele kokubili amanzi kanye neqephu leqhwa elomile elikhululiwe liphumele phansi ngokushesha ukuze angaligwinyi.

I-Deep Dive 3: I-Ocular Cryogenic Splashes kanye ne-Compressed Gas Inhalant Cardiotoxicity

1. I-Nitrojeni Ewuketshezi, Isiqandisi (R-134a / R-410A), noma I-Propane Ichaphazeka Esweni

Ngenkathi ukuchaphaza okufushane kwe-nitrogen ewuketshezi emsulwa ku-cornea kuvame ukuphumela ngokungenabungozi efilimini yezinyembezi ngomphumela we-Leidenfrost, isifutho esinengcindezi ephezulu sezimoto noma sesiqandisi se-HVAC (Freon / R-134a / R-410A), i-propane ewuketshezi, noma i-nitrogen efafazwe ende ye-nitrogen ewuketshezi. i-epithelium, i-stroma, namajwabu amehlo:

  • Uma amajwabujwabu amehlo avalekile: Ungalokothi uphoqelele noma uvule amajwabu amehlo afriziwe ngeminwe eyomile, okungase kuvule umkhawulo wejwabu leso elithambile noma kudabuke i-corneal epithelium. Kunalokho, beka iphedi ye-gauze eyinyumba ecwiliswe kusawoti ovamile oyinyumba oyizivivinyo noma amanzi kampompi (\(37^\circ\text{C} / 98.6^\circ\text{F}\)) ngobumnene phezu kweso elivaliwe noma uthele uketshezi oluthambile lukasawoti oluvundile emivimbolweni kuze kube yilapho iqhwa lincibilika kahle nezinkophe.
  • Nisela imizuzu engu-15 uma uwoyela wesiqandisi noma izithasiselo zamakhemikhali bezikhona: Iziqandisi zezimoto nezokupholisa umoya ziqukethe i-polyalkylene glycol (PAG) ecindezelweyo noma amafutha e-ester kanye nama-hydrocarbon ayi-fluorinated. Uma selincibilikile, geza iso elivuliwe ngokuqhubekayo ngamanzi anosawoti ayisivivi oyinyumba noma amanzi kampompiimizuzu engu-15, vala amehlo womabili ngokukhululeka ngesivikelo sokuzivikela (ukunciphisa ukunyakaza kwamehlo ngokuvumelana), bese uya ngokushesha kudokotela wamehlo ophuthumayo.

2. "I-Sudden Sniffing Death Syndrome" evela ku-Compressed Gas Dusters kanye nama-Cryogenic Aerosols

Lapho intsha noma abantu abadala behogela umoya ocindezelwe 1,1-difluoroethane ("umoya okheniwe" iziduli zekhibhodi zekhompyutha), butane, propane, noma nitrous oxide (\(\text{N}_2\text{O}\)) ngokuqondile kusuka kubhobho noma ibhaluni:

  • I-Cryogenic Airway Obstruction (Laryngospasm and Glottic Edema): Ukufafaza i-computer duster ehlanekezelwe noma ithangi le-nitrous oxide emlonyeni ngqo kumisa i-uvula, ulwanga oluthambile, nezintambo zezwi ku-$ -50^\circ\text{C}\text{ kuya ku-}-88^\circ\text{8{8{5}\(\ci\rc\text{8{5}\) }-126^\circ\text{F}$), okubangela ngokushesha ukuvuvukala kwe-oropharyngeal kanye nokuvinjelwa okuphelele kwendlela yokuphefumula ephezulu phakathi kwemizuzu eyi-15 kuya kwengama-45 okudinga ukuhlotshaniswa kwe-endotracheal okuphuthumayo ngaphambi kokuba umzila womoya uvaleke.
  • Ukuzwela kwe-Myocardial ku-Epinephrine (I-Sudden Ventricular Fibrillation): Ama-halogenated hydrocarbons afana ne-difluoroethane eqwashisa i-myocardium yenhliziyo ku-adrenaline endogenous (catecholamines). Uma umuntu ethukile, egijima, noma ezabalaza ngemva nje kokuhogela igesi, ukuqhuma okuvamile kwezibangeli ze-adrenaline ukuboshwa kwenhliziyo okusheshayo kwe-Ventricular Fibrillation ("Ukuhogela Okuzumayo"). Abatakuli kumele baqale i-CPR yekhwalithi ephezulu ngokushesha futhi basebenzise i-Automated External Defibrillator (AED) ngenkathi bexwayisa abezimo eziphuthumayo ukuthi ukuboshwa kuqalwe ukuzwela kwe-myocardial inhalant (esibhedlela, odokotela bagwema ama-epinephrine boluses ajwayelekile ngesikhathi sokuvuselela futhi banikeze i-intravenous beta-blocker* njenge-betamimolo* i-beta-blocker* i-refractory ventricular fibrillation).

I-Deep Dive 3: Ukuphathwa Okuphephile, Ezokuthutha, kanye Nohlu Lokuhlola Lokulahla Lweqhwa Elomile kanye Ne-Nitrojeni Ewuketshezi

  • Ungalokothi Uthuthe Iqhwa Elomile noma Ama-Nitrogen Dewars Ngaphakathi Kwekhabhinethi Evaliwe Yabagibeli: Hlala ubeka izinto ezipholile eqhweni ezomile noma iziqukathi ze-nitrogen eziwuketshezi esiqwini/ebhuthini ehlukile, umbhede weloli ovulekile, noma iveni yezimpahla ehlukaniswe ngobuningi obuvaliwe. Uma une-SUV, i-hatchback, noma i-sedan lapho isiqu sihlanganyela umoya nendlu yabagibeli, geqa phansi okungenani amafasitela amabili ngo-5 cm (2 amayintshi) bese usetha ifeni yokulawula isimo sezulu kudeshibhodi ukuthi ithi Imodi Entsha Yangaphandle Yomoya (UNGAZE Ujikeleze) kuyo yonke idrayivu.
  • Ungalokothi Ugcine Iqhwa Elomile Ebhodleleni Elivaleke Kakhulu, Kujazi, noma Isipholile Esingenamoya: Gcina iqhwa elomile kuphela kokuthi izimbobo zokupholisa ezinwetshiwe ze-polystyrene (Styrofoam) ezivalekile noma ezifakwe umoya ezivumela igesi engaphansi engu-\(\text{CO}_2\) ukubaleka ngokukhululeka. Ungalokothi ujike isivalo ebhodleleni lepulasitiki noma isitsha sengilazi esineqhwa elomile ("ibhomu leqhwa elomile" liwubugebengu ezindaweni eziningi futhi libangela ukulimala okulimazayo kokuqhuma).
  • Ungalokothi Ugcine Iqhwa Elomile Ngaphakathi Kwesiqandisi Sekhaya Esingangenisi Noma Isibandisi Sokungena Ngaphansi Kwendlu: Efrijini lasendlini,\(-78.5^\circ\text{C}\) iqhwa elomile likhohlisa i-thermostat ukuthi ivale i-compressor yesiqandisi. Endaweni epholile yezentengiselwano noma egumbini elingaphansi elingenawo umoya ohlanzekile, iqhwa elomile elithulisa iqhwa lakha buthule 5% ukuya ku-10% \(\text{CO}_2\) ifu le-asphyxiation phansi ubusuku bonke.
  • Ungayilahla Kanjani Iqhwa Elomile Elisele Ngokuphepha (Ungalokothi Ulilahle Phansi Kusinki noma Indle Yendlu yangasese):
  • UNGALOKOTHI ulahle iqhwa elomile elisele kusinki wasekhishini, indawo yokulahla udoti, noma endishini yasendlini yangasese: Okuqinile okungu-\(-78.5^\circ\text{C}\) kumisa amanzi ngaphakathi kwe-PVC noma okuqinile kwe-iron P-trap ngenkathi inweba ukuphuka kwegesi futhi iqhumisa amapayipi amanzi.
  • Indlela Yokulahla Okuphephile: Beka iqhwa elomile elisele ngaphakathi kwebhokisi lalo elivulekile le-Styrofoam ngaphandle endaweni enomoya omuhle, enomthunzi ngokuphelele lapho izingane nezilwane ezifuywayo zingafinyeleli khona, futhi ulivumele lithobeke ngokwemvelo emoyeni ongaphandle ngaphezu kwamahora angu-24.
  • Gqoka Amagilavu ​​​​e-Cryogenic e-Loose-Cuff (Aphushelwe Ngaphandle Noma Ngaphansi Kwemikhono ukuze Uketshezi Lungakwazi Ukufanelwa Ngaphakathi) Nokuvikelwa Kwamehlo: Ungalokothi uthinte iqhwa elomile noma impahla ye-nitrogen ewuketshezi enesikhumba esingenalutho noma amagilavu ​​aqinile amanzi. Gqoka izicathulo ezivalekile, amabhulukwe amade avala amabhuzu akho (ungalokothi ushuke imilenze yebhulukwe ngaphakathi amabhuzu lapho i-nitrogen ewuketshezi echithekile izosebenza iqonde phansi eqakaleni), kanye namagilavu ​​avaleleke angagqame angapheshulwa ngokunyakaziswa kwengalo okukodwa uma uketshezi luchaphazeka ngaphakathi.

Imibuzo evame ukubuzwa

Ngithole ibhokisi lezinyama zenyama eziqandisiwe zilethwe eposini eligcwele iqhwa elomile, futhi ngathinta iqhwa elomile ngeminwe yami engenalutho imizuzwana embalwa. Manje iminwe yami isimhlophe, indikindiki futhi iyaluma. Kumele ngenzeni?

Unokushiswa yiqhwa elingaphandle kwe-cryogenic kusuka ku--78.5 degrees Celsius (-109.3 degrees Fahrenheit) eqhweni elomile. Gcoba ngokushesha iminwe yakho endishini yamanzi afudumele ahlolelwe ukuthi abe phakathi kuka-37 no-39 degrees Celsius (98.6 kuya ku-102.2 degrees Fahrenheit, afudumele kamnandi njengamanzi okugeza engane, angashisi) imizuzu engu-15 kuya kwengu-20 kuze kube yilapho amabala amhlophe e-waxy aphenduka pink futhi athambe futhi. UNGAYIhlikihli noma uhlikihle iminwe yakho, njengoba ukuhlikihla kugaya amakristalu eqhwa amancane kumaseli esikhumba sakho. Uma amabhamuza akheka ngemva kwalokho, zishiye zingaphelele, zimboze ngokukhululeka ngebhandeshi elomile elihlanzekile, futhi uthathe umthamo ongaphezu kwe-counter we-ibuprofen uma ukwazi ukuthatha ama-NSAID ngokuphepha. Funa ukuhlolwa kwezokwelapha uma isikhumba sihlala simpunga, sinsomi, noma sindikindiki ngemva kokufudumala.

Kungani abantu bequleka bengenasixwayiso sokuvuza kwenitrogen ewuketshezi, kuyilapho iqhwa elomile libangela ukuhefuzela nokwethuka ngaphambi kokuquleka?

Isikhungo sokuphefumula sobuchopho bakho asilinganisi ukuthi ungakanani umoya-mpilo osegazini lakho ukuze uvuse isifiso sokuphefumula; esikhundleni salokho, ikala ukukhuphuka kwamazinga e-carbon dioxide (CO2) kanye ne-pH yegazi ehlayo. Lapho iqhwa elomile lincipha emotweni noma ekamelweni elivaliwe, uhogela ukugxila okuphezulu kwe-CO2, okuthinta ngokushesha igazi lakho i-CO2 futhi kubangele ukulamba komoya okunamandla, okwesabekayo, ukuphefumula okusheshayo, kanye nekhanda elibuhlungu ngaphambi kokuba uphume ku-7% kuya ku-10% CO2. Ngokuphambene, lapho i-nitrogen ewuketshezi ibilisa ekamelweni elivaliwe futhi iphushela izinga le-oxygen phansi ngaphansi kuka-6% kuya ku-10%, uyaqhubeka nokukhipha i-CO2 yakho ngokujwayelekile ngawo wonke umoya. Ngenxa yokuthi igazi lakho i-CO2 ayivuki, ubuchopho bakho abuzizwa ukuphelelwa umoya kanye nesexwayiso esiyiqanda: uzizwa uphile saka kuze kube yilapho umoya-mpilo wobuchopho bakho wehla ngaphansi komkhawulo wokwazi futhi umnyama kumasekhondi angu-8 kuya kwangu-15.

Kungani "ukusha kwethangi le-nitrous oxide" noma "ukusha kwe-air duster ethinini" emathangeni angaphakathi noma ezandleni kujule kangangokuthi ngokuvamile kudinga ukuxhunyelelwa kwesikhumba?

Lapho isilinda esikhulu esicindezelwe se-nitrous oxide noma i-difluoroethane "yomoya okheniwe" ehlanekezelwe iphuma ngokushesha, ukunwetshwa kwegesi ye-adiabatic kwehlisa udonga lwethangi lensimbi noma indiza yokufutha uketshezi ibe phakathi kuka -40 no -88 degrees Celsius (-40 kuya ku -126 degrees Fahrenheit). Ngenxa yokuthi amakhaza aqanda izinzwa esikhumbeni ngemizuzwana nje, futhi ngenxa yokuthi i-nitrous oxide noma i-difluoroethane inhalation kanyekanye kwehlisa ukuqonda kobuhlungu, umuntu obambe isilinda esibanda phakathi kwamathanga akhe angaphakathi noma afutha uketshezi esikhumbeni sakhe akabuzwa ubuhlungu kuyilapho i-dermis ejulile namafutha angaphansi kwesikhumba kubanda kuqine emizuzwini embalwa. Lokhu kulimala kuwukuqina okugcwele kweqiniso (izinga lesithathu nelesine) isithwathwa esishisayo okufanele sihlolwe esikhungweni sokusha esibhedlela ukuze kuhlinzekwe ukunakekelwa kwenxeba nokuxhunyelelwa.

Lo mhlahlandlela ngowezinjongo zokwaziswa futhi awuthathi indawo yokunakekelwa kwezokwelapha okuqeqeshiwe noma ukuqeqeshwa kokuphepha emsebenzini. Ngenxa yokuthi ukuvuza kwegesi ye-cryogenic ezindaweni ezivalekile kungabangela ukuboshwa kwenhliziyo okungazelelwe, sincoma ngokuqinile ukuthatha inkambo yosizo lokuqala egunyaziwe, i-CPR, nesifundo sokuphatha umoya-mpilo nge-International Federation of Red Cross and Red Crescent Societies (IFRC), umphakathi wakho kazwelonke we-Red Cross, i-St John Ambulance, noma umhlinzeki wokuqeqeshwa wendawo oqinisekisiwe.

Imithombo ihloliwe

  • I-National Institute for Occupational Safety and Health (NIOSH, United States) & Centers for Disease Control and Prevention (CDC): NIOSH Pocket Guide to Chemical Hazards: Carbon Dioxide (Dry Ice) and Liquid Nitrogen / Oxygen-Deficient Atmospheres.
  • I-Compressed Gas Association (CGA): Safety Bulletin SB-2: Oxygen-Deficient Atmospheres kanye P-12: Ukuphathwa Okuphephile Kwe-Cryogenic Liquids.
  • I-Wilderness Medical Society (WMS): Iziqondiso Zokusebenza Zomtholampilo Zokuvimbela Nokwelashwa Kwe-Frostbite (Ukufudumeza Kabusha Kokugeza Kwamanzi Afudumele, Ibuprofen, Iloprost, kanye Ne-Thrombolytic Protocols).
  • Ukulawulwa Kokuphepha Nezempilo Emsebenzini (OSHA, United States): Ishidi Leqiniso le-OSHA: Ukuphatha Ngokuphephile Iqhwa Elomile (I-Solid Carbon Dioxide) ne-Liquid Nitrogen.
  • I-Health and Safety Executive (HSE, United Kingdom): Ukusetshenziswa Okuphephile Kwe-Liquid Nitrogen kanye namagesi e-Cryogenic ku-Hospitality, Catering, and Laboratories.

Iziqondiso ezihlobene