Trimethyl Phosphite

CAS RN:121-45-9

Treatment Overview

0.4.2 ORAL EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE TOXICITY
    • 1) Treatment consists of predominantly symptomatic and supportive care. For patients with ingestion, dilution with 4- to 8 ounces of fluid may decrease symptoms. Neutralization is not recommended.
  • B) MANAGEMENT OF SEVERE TOXICITY
    • 1) Although irritants by definition should not produce tissue damage, it is almost impossible to assure that a particular substance under a particular set of circumstances could not act as a corrosive instead of an irritant. Patients with severe symptoms after ingestion of an irritant should be evaluated with upper GI endoscopy for possible corrosive injury with mucous membrane damage.
  • C) DECONTAMINATION
    • 1) PREHOSPITAL: The patient should be removed from the exposure; remove contaminated clothing and wash exposed skin; irrigate exposed eyes. Emesis is NOT indicated due to the irritant nature of these agents. Activated charcoal is NOT recommended.
    • 2) HOSPITAL: Dermal or eye exposures should be irrigated as above. For patients with ingestion, dilution with 4 to 8 ounces of fluid may decrease symptoms. Emesis is NOT indicated due to the irritant nature of these agents. Charcoal is NOT recommended.
  • D) AIRWAY MANAGEMENT
    • 1) Rarely, patients with signs and symptoms of respiratory failure and severe hypoxia may required intubation for acute lung injury.
  • E) ANTIDOTE
    • 1) None
  • F) ENHANCED ELIMINATION PROCEDURE
    • 1) There is no role for hemodialysis in irritant exposure.
  • G) PATIENT DISPOSITION
    • 1) HOME CRITERIA: Patients with inadvertent small exposures who have no more than mild symptoms can be observed home.
    • 2) OBSERVATION CRITERIA: Patients with deliberate exposures or moderate to severe symptoms should be referred to a healthcare facility for evaluation and treatment. They should be observed in the ED until asymptomatic.
    • 3) ADMISSION CRITERIA: Patients with persistent symptoms, upper GI burns, persistent bronchospasm or hypoxia should be admitted.
    • 4) CONSULT CRITERIA: Contact your local poison center or a medical toxicologist for any patient with severe toxicity or in whom the diagnosis is unclear.
  • H) PITFALLS
    • 1) Failure to monitor patients who are at risk for delayed-onset pulmonary edema and acute lung injury. Failure to recognize corrosive rather than irritant exposure.
  • I) DIFFERENTIAL DIAGNOSIS
    • 1) Occupational or environmental asthma, heart failure, allergic reactions, caustic exposure.
0.4.3 INHALATION EXPOSURE
  • A) Patients should be removed from exposure into fresh air and monitored for respiratory distress. Oxygen should be administered as needed for hypoxia. Treat bronchospasm with inhaled beta-2 agonist and steroids. Patients with acute lung injury may require intubation for hypoxia; these patients should be managed with lung-protective ventilation techniques.
0.4.4 EYE EXPOSURE
  • A) Irrigate eyes with copious amounts of water or saline; the pH of the ocular cul de sac can be evaluated and the eyes should be irrigated until symptoms improve and this pH is neutral.
0.4.5 DERMAL EXPOSURE
  • A) OVERVIEW
    • 1) Skin should be thoroughly irrigated. Contact dermatitis may arise after repeated exposure to irritants.
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Find more information on this substance at: Hazardous Substances Data Bank , TOXMAP , TOXNET , PubMed