First Aid for Elemental Mercury Poisoning

First Aid for Elemental Mercury Poisoning

Article
Ear, Nose, & Throat (ENT)
Brain & Nerve
+7
Contributed byKrish Tangella MD, MBAMay 27, 2018

What is Elemental Mercury Poisoning?

  • Mercury (Hg) is a heavy silver-grey liquid metal that exists in elemental, organic, and inorganic forms. Elemental mercury may be used in dental fillings and is found in batteries and thermometers
  • Elemental Mercury Poisoning is the accidental or intentional intake of compounds containing the mercury in its elemental form (i.e., when used as an element)
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Elemental Mercury Poisoning may be also referred to as Elemental Mercury Toxicity.

What are the Causes of Elemental Mercury Poisoning?

  • Elemental Mercury Poisoning is caused by the ingestion/swallowing of elemental mercury. Exposure may also occur following inhalation of tiny droplets of mercury into the lungs
  • This intake could be accidental, or in some cases intentional, to bring self-harm
  • All forms of mercury are considered to be highly-toxic and exposure to mercury compounds are known to present severe symptoms and complications
  • Elemental mercury is also found in certain medical equipment, glass bulb thermometers, and electrical lights (fluorescent bulbs) and accessories

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Elemental Mercury Poisoning?

The signs and symptoms of Elemental Mercury Poisoning can vary from one individual to another. It may be mild in some and severe in others. Several systems of the body may be affected. The poisoning may occur due to swallowing or inhalation of mercury. Children are severely affected from mercury poisoning than adults, especially if the element is inhaled.

The signs and symptoms of Elemental Mercury Poisoning may include:

  • Fever and chills
  • Headache
  • Nausea and vomiting
  • Diarrhea (blood in stool may be noted)
  • Cough, sore throat, and chest pain
  • Abdominal pain
  • Visual disturbances
  • Swallowing difficulties
  • Skin and eye exposure may result in dermatitis (inflammation of the skin) and itching of eyes respectively
  • Breathing difficulties from inhaling tiny mercury droplets that may include coughing and respiratory distress

Long-term inhalation (over a period) may lead to chronic symptoms, severe lung damage, and even present neurological symptoms. Chronic symptoms may include the following:

  • Taste of metal in the mouth
  • Severe coughing and breathing difficulties
  • Mouth ulcers and bleeding gums
  • Vomiting

In most cases, ingesting or swallowing small quantities of mercury in its elemental (pure or metallic) form may not cause severe symptoms. The ingested mercury may be excreted from the stomach and gastrointestinal tract without being absorbed by the body, since it is a dense and slippery liquid metal.

How is First Aid administered for Elemental Mercury Poisoning?

First Aid tips for Elemental Mercury Poisoning:

  • Call 911 or your local emergency help number immediately, for emergency assistance
  • Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
  • Carefully remove the individual from the exposure area; move them to region of fresh air immediately
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • Take individual to emergency room (ER) for further treatment
  • Always try to take the compound bottle/container to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

  • Monitoring of vital signs
  • Medically manage symptoms and provide breathing support, if necessary
  • Administer activated charcoal to avoid absorbance of the substance in the body
  • Administer suitable medication to counter the effects of the toxin
  • Administer fluids by an intravenous drip line
  • Undertake kidney dialysis, if necessary
  • In case of inhalation of elemental mercury presenting symptoms, the following treatment measures may be undertaken:
    • Administer suitable medication to remove the toxic element from the body
    • Use of suction to remove mercury from lungs
    • Provide breathing support via humidified oxygen/air
    • In case the individual is unable to breathe, then breathing tubes may be placed into the lungs

Who should administer First Aid for Elemental Mercury Poisoning?

First aid for Elemental Mercury Poisoning is administered by healthcare professionals.

  • The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Elemental Mercury Poisoning?

  • The prognosis of Elemental Mercury Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
  • Severity of the poisoning and timely medical assistance are the key prognostic indicators. If early treatment is provided and suitable medication and support provided, the prognosis may be improved
  • Inhalation of large amounts of elemental mercury can lead to permanent injury to the lungs and central nervous system. In such cases, deaths have been reported

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Elemental Mercury Poisoning be Prevented?

Elemental Mercury Poisoning can be prevented by:

  • Suitably disposing any material or equipment that contains mercury and its compounds/salts
  • Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
  • Keep all poisons correctly labeled and in suitable storage locations
  • Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

  • Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
  • Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
  • It would be helpful if the following information is readily available:
    • Type, amount and time of consumption of the substance
    • Age and weight of the individual
    • And, the overall health status of the individual
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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