Saady J J, Blanke R V, Poklis A
Department of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0597.
J Anal Toxicol. 1989 Sep-Oct;13(5):310-2. doi: 10.1093/jat/13.5.310.
A three-year-old child died after ingestion of a mouthful of an estimated 44% sodium arsenite solution. Litigation was initiated based on the quality of emergency treatment at a rural hospital. An issue raised in litigation was whether the child could have survived if he had received an additional dose of BAL (dimercaprol). BAL had been sent for from a neighboring city and arrived approximately 2.0 h after admission. The first 50-mg dose of BAL could have combined with a maximum of 30 mg arsenic; a second dose could have brought the total of chelated arsenic to 60 mg. To determine the total body burden of arsenic in the child, multiple tissues were analyzed. The total body burden was estimated at 113 mg, with 100 mg of this total attributable to the ingested solution. The actual body burden after two doses of BAL therefore would have been at least 40 mg, a fatal level.
一名三岁儿童因误服一口估计含44%亚砷酸钠的溶液而死亡。基于一家乡村医院的急救质量引发了诉讼。诉讼中提出的一个问题是，如果该儿童额外接受一剂二巯丙醇（BAL），是否有可能存活。BAL是从邻近城市送来的，入院后约2.0小时到达。首剂50毫克的BAL最多可与30毫克砷结合；第二剂可使螯合砷总量达到60毫克。为确定该儿童体内砷的总负荷，对多个组织进行了分析。估计体内总负荷为113毫克，其中100毫克可归因于所摄入的溶液。因此，两剂BAL后实际的体内负荷至少为40毫克，这是一个致命水平。
