Features of determining the severity of the condition of victims exposed to the chemical factor of fire

Abstract

BACKGROUND: To determine the severity of the condition of the victims exposed to the chemical factor of the fire, they are guided by the content of carboxyhemoglobin in the blood. Inhalation exposure of combustion products of polymeric materials with pulmonotoxic effect leads to disruption of the structure and function of the respiratory system, which plays an important role in aggravating the condition of the victims and predicting the outcome.

AIM: To identify the features of determining the severity of the condition of victims exposed to the chemical factor of fire, depending on the calculated initial concentration of carboxyhemoglobin in the blood and the presence of interstitial changes in lung tissues.

METHODS: When conducting a retrospective analysis of the medical histories of victims exposed to the chemical factor of fire, the initial concentration of carboxyhemoglobin in the blood was calculated, X-rays of the chest cavity organs performed on the first day after admission were analyzed.

RESULTS: Depending on the calculated initial concentration of carboxyhemoglobin in the blood, patients with severe (59 [55; 60]%), moderate (42 [36; 43]%) and mild (18 [15; 24]%) severity. The duration of hospitalization of patients did not depend on a certain degree of severity. It was found that the duration of hospitalization (5 [4; 8] days) of patients with interstitial changes in the lungs detected on radiographs (47 ± 7% of victims) was higher (p = 0.03) compared (3 [2; 5] days) with patients in whom interstitial changes were not detected (53 ± 7% of victims). A moderate correlation (r = 0.31, p < 0.05) was determined between the duration of hospitalization of patients and the presence of interstitial changes on the part of the respiratory system.

CONCLUSION: The presence of interstitial changes in lung tissues identified during radiography should be considered as an unfavorable prognostic sign and taken into account when organizing medical care for victims exposed to the chemical factor of fire.

Keywords

combustion products / carbon monoxide / severity of condition / carboxyhemoglobin / radiography / lung lesions

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