LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD

STUDENT NOTES ON MEDICAL FIRST AID

2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

2.3.1 TOXIC HAZARDS OF CHEMICALS, INCLUDING POISON

Ships carry a number of substances in addition to cargo that are potentially toxic. For instance,
medicines are not generally poisonous but can became so if taken other than as prescribed . then
there are substances like cleaners , degreasers, and disinfectants that can give rice to toxic hazards
through misuse . For instance, emptying a bucket of bleaching solution in to a lavatory bowl
containing a proprietary caustic cleaner may result in the release of poisonous in a confined space.
Notes on specific toxic substances are given at the end of this chapter.

Toxic substances can affect the body in various ways:

 through the lungs by inhalation of toxic gases and fumes;
 through the mouth and digestive system , if swallowed :
 through eye contact
 through skin contact

Breathing in is the most common route of poisoning in the shipping industry and the toxic substance
may consist of vapor, gas, mist, spray, dust or fumes . Swallowing of a poison occurs less frequently
and is usually the result of an accident . Absorption through the skin and by inhalation may have a
delayed effect. The substances that cause harm do so by burning, or causing local damage to the skin
, eyes, or other tissue or by general poisoning after absorption. Allergic reactions are also possible.
The effects may by sudden and dramatic, or gradual and cumulative. The damage may by temporary
or permanent . Suspect every chemical to be dangerous until know otherwise. Whatever the cause of
the poisoning , treatment must be prompt. Complications of poisoning can be avoided by rapid
emergency treatment.

Diagnosis of poisoning
General principles

The diagnosis of poisoning may be simplified if one or more of the factors point to the probable cause
:

 The circumstances of the incident . e g.. , a leak age of chemicals :

 The nature of the illness, and its relationship in time to recent exposure to chemicals ;
 The epidemiological aspects , . e g. , if more then one person is involved and all develop a
similar illness .

It must be realized however that :

 the effects of some poisons resemble those of natural illness, e,,g,, vomiting and diarrhea or
collapse, :
 because a ship is carrying a cargo of chemicals it does not follow that the cargo is responsible
for the illness( this is , in fact , unlikely unless there is evidence of a leakage)
 different individuals may be exposed to the poison at different times, or to a different extent
during a single episode , and they may as a result become ill at different times or to differing
degrees:
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

 individuals react differently to poisons as cording to their health, their constitution, and the
extent of their exposure to the poison.

The extent of their exposure to the poison in a typical case of poisoning, there stages of illness
may be distinguished, namely latent , active, and late.

The latent stage

This is the interval between the moment of entry of a poison in to the and the appearance of the first
aid symptoms (feelings ) or signs . these usually occur rapidly after exposure, but in some cases there
may be a delay of several hours before they develop.

The active stage

This is the stage at which the signs and symptoms of the poisoning are apparent . often there are a
great many different chemicals that could produce have to be treated in a general way.

The general symptoms of poisoning include:

 headache
 nausea and vomiting
 drowsiness
 changes in mental behavior
 unconsciousness
 convulsions
 pain

Signs of severe poisoning are :

 a rapid and weak pulse
 grey or blue colour of the skin
 severe difficulty in breathing
 a prolonged period of unconsciousness
The late stage.

The signs and symptoms usually resolve after a fen hours in the majority of incidenty of incidents,
perticularely if the degree of exposure is small. If a greater amount of chemical has been absorbed, or
the period of exposure prolonged, of the chemical is very toxic, symptoms may persist for some hours
or even days. The patient’s condition may deteriorate as a result of complications, the most common
of which are: suffocation, bronchitis, pneumonia, pulmonary oedema, heart failure, failure.

For details regarding various toxins, the signs and symptoms of poisoning by them, and the appropriate
first aid and follow-up treatment , refer to Medical first aid guide for use in accidents involving
dangerous goods ‘ The Chemicalats Supplement to the present guide.
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

Inhaled poisons
Many chemicals produce fumes that can irritate the lungs and cause symptoms as cough and burning
sensation in the chest

Gases such as carbon dioxide and carbon monoxide may also be poisonous , particularly in a
confined space , because they replace oxygen in the air and blood.
The main symptoms are :
 Difficulty in breathing
 headache , dizziness
 Unconsciousness in some cases.

Always remember that some poisonous gases, such as carbon dioxide, carbon monoxide, and
some refrigerant gases, have no smell to warn you of their presence for rescue from an enclosed
space)
Remember that the presence of certain gases, E.g.: hydrogen , may make it necessary to take
precautions against fire and explosion .

Treatment
 Remove the casualty at once in to the fresh air Loosen tight clothing and ensure a airway
 Start artificial respiration by the mouth – to- mouth method if breathing is a absent .
 Start heart compression by the heart has stopped. In cases of carbon monoxide and toxic gas
poisoning , give oxygen) as soon as the spontaneous respiration has been restored.
 Keep the patient at rest in bed fro at least 24 hours or until he has fully recovered.
 Complications may occur after this type of poisoning . They are : severe difficulty in breathing,
with frothy sputum ( pulmonary oedema 1) and pneumonia and bronchitis.

Do not give morphine to a casualty who has been gassed.

Swallowed poisons

Most of these exert their dangerous effects on the stomach and intestines causing retching,vomiting
(sometimes the vomit is blood stained), abdominal pain, colic, and later diarrhoea . Examples of such
poisons are arseniclead, poisonous fungi, berries, and contaminated or decomposed food (see Food-
borne diseases. Particularly severe symptoms are caused by corrosives, strong acid, alkalis, or
disinfectants, disinfectants, Which burn the lips and mouth cause intense pain .
Other poisons produce general toxic effects without irritation of the gastrointestinal tract. After
ingestion, the onset will be gradual , following their absorption in to the gradual, following their a
bsorption ,in to the blood stream and their effect on the nervous system. Which may cause
unconsciousness and death . Examples are the various types of sedative tablets or medicines for pain
relief, when taken in excessive amounts. Alcohol taken to excess may likewise act as an acute poison.

Treatment
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

Identify the nature of the poison, if possible . If the victim is cooperate . If he is unconscious , there
may be a bottle or container nearby which will provide the answer. Do not however, waste time
over identification . prompt treatment is more important.
Do not make the casualty vomit.

If the casualty is conscious, give one sachet of activated charcoal in 500 ml ( half a litre ) of water
If the casualty is unconscious, put him in the unconscious position and

 Give artificial respiration if breathing has stopped

 Give heard compression if the heat has stopped:
 DO NOT give anything by mouth :
 Seek RADIO MEDICAL ADVICE if the casualty remains unconscious.

In cases of hydrogen cyanide(prussic acid ) poisoning Where breathing and pulse are prest .
break an ampoule of amyl amyl nitrite1 in to a cloth and hold it under the patient ‘s nose so that
he inhales the vapour.
All patients should be kept warm in bed until they have recovered .
Skin contact

Toxic subustanct, can affect the skin in tow ways:

 By direct contact , cases, burns of the skin
 By absorption the rough the intact skin, producing general symptoms such as drowsiness
.weakness, and in rare cases unconsciousness.

Treatment
 The contaminated clothing and shoes should be removed immediately.
 Wash off the chemical with copious amounts of lukewarm water for at least 10 minute .
Continue For a further 10 minutes. If there is any evidence of chemicals still on the skin.
 If a burn has occurred .
 If burns are severe and extensive, obtain RADIO MEDICAL ADVICE.
Eye contact

Many substances , notably chemical liquids , and the fumes of certain chemicals will produce redness
and irritation if the eyes are accidentally splashed by , or exposed to , them . Treatment should be
immediate
Wash the substance out of the aye with copious amounts of fresh water as quickly as possible,
keeping the eyelids wide open .This must be done thoroughly for 10 minutes. If there is any doubt
whether the chemical has been completely removed, repeat washing for a further 10, minutes. If
severe pain is experienced, physical restraint of the patint may be necessary in order to be certain of
effective treatment. Read page 76- 79 abut identifying and treating damage to the eye . For pain ,
give two paracetamol tablets by mouth every four hours until the pain subsides. If there is very severe
pain refer to
Get RADIO MEDICAL ADVICE
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

Special considerations

If you are dealing with a suicide attempt , it is tour duty to do everything your can to save the
victims’

Important: the patient should not be left without an attendant.

Your should save any remains of poison that you may find in a glass, cup, botte, or package. Also
collect any vomited matter in a bowl and seal it in a bottle . These items may be helpful for identifying
the toxic substance and deciding on further treatment after the patient has been seen by a docter or
taken ashore.

Specific toxic substances

(For treatment , see under Inhaled poisons , Swallowed poisons, , etc. above )

Drugs
Many drugs can be taken accidentally or in anattempt at suicide. The most common are sedatives(
sleeping tablets ) and tranquillizers. These include the barbiturates and such drags as diazepam .
The usually case a gredual onset of unconsciousness, which may be prolonged. The breathing may
slow down and become shallow. In severe cases it may stop . In barbiturate poisoning
unconsciousness may be present for several days, but the majority of patients recover.
Simple pain – killers such as acetylsalicylic acid and paracetamol may also be taken in overdose.
Acetylsalicylic acid causes vomiting , ringing in the ears , and deep rapid breathing . In a severe
overdose , this drug can cause bleeding in the gut and the patient may vomit up bright red blood .
paracetamol dose not usually cause any immediate symptoms except occasional vomiting . It can ,
however, cause liver damage 2 or 3 days after being swallowed if more Than 20- 30, tablets are
takan . Neither of these drugs causes unconsciousness.
Disinfectants

Many types of disinfectant such as carbolic acid, cresol, and bleaching solutions are toxic .
Carbolic acid (phenol) and cresols cause a severe rash on contact with the skin in dilute solutions.
Strong concentrated solutions will produce painless white burns of the mouth will occur, and there
may be severe vomiting, followed by collapse and unconsciousness. Convulsions may
Bleaches ( e: g: , lavatory cleaners, etc) are usually solutions of sodium hypochlorte in water. They
cause irritation of the skin and are poisonous if swallowed. The patient may complain of burning in the
mouth and stomach and feel generally unwell.

On contact with acids, these substances retase fumes that are irritating to the lungs, causing a cough a
feeling of breathlessness, and burning in the throat. However, the fumes are not severely toxic, and
the symptoms usually subside rapidly.

Solvents, petroleum products, and fuel oils.

 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

These substances usually cause symptoms after the vapours have been accidentally inhaled. The
symptoms are drowsiness, dizziness, nausea , and occasionally vomiting. If severe exposure occurs, the
patient may become unconscious. If the substances are swallowed, they usually produce the same
symptoms, but the nausea and vomiting are worse .

Cyanide
Hydrogen cyanide ( prussic acid )gas is and the gas are extremely poisonous, and symptoms and signs
may develop very rapidly . They are slightly corrosive, if swallowed, and cause a burning feeling in the
mouth and in the abdomen . However, the main danger is general poisoning There will be shortness of
breath, anxiety, and rapid loss of consciousness. Convulsions can occur. Death may result within a
few minutes.

Carbon dioxide (Carbon Carbonic acid gas )

Suffocation by this odourless gas may occur when its concentration in the air is so high that it
replaces a substantial part of the oxygen. This may happen while crew- members are dealing with a
fire in a hold. Ferments, and it may be generated by refrigerated cargoes of certain foods ;it is also
used as a refrigerant. The gas is heavier than air and collects in the lower parts of holds and
compartments. ,A person exposed to it giddiness, difficulty in breathing, and headache .Later he may
fall down and lose consciouness.

Carbon monoxide
This odourless infalmmable gas occurs in hold fires, as the product of an explosion, in the waste gases
of petrol-and oil-driven engines, and when refrigerated meat cargoes decompose . It is lighter than air
and highly poisnous, even in very low concentrations.
A person suffering from the effects of this gas feels giddy , often with muscular weakness ; he
may become unconscious quickly . In severe cases , the lipe may be bright red, and the skin of the face
and body pink in colour.
Oxygen inhalation is a treatment of choice in this type of poisoning, and it should be given as
soon as possible

Refrigerant gases
Inhalation of ammonia vapour will cause intense irritation , ranging from a catching of the breath
with smarting and watering of the eyes (in the case of low concentrations) to intense irritstion and
corrosion of the whole air passages, gasping for breath, collapse, and death (When concentrations are
high )
Carbon dioxide is also present in refrigerants. If a person become faint or loses consciousness in a
refrigerating plant where there is no evidence of escaping ammonia, he is probably suffering from
the effects of carbon dioxide.
Methyl chloride is colourless gas , smelling like ether . It may cause drowsiness , mental confusion,
coma , nausea, vomiting , convulsions , and death. It is also dangerous in low concentrations because
of its explosive nature. On no account should any naked light be exposed in the presence of the
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

vapour: electric motors should be stopped to avoid the risk of sparking . A heavy- duty electric torch,
switched on before approaching the leak , is the only safe light to use
Freon is an odourless gas , which is generally harmless, except when present in a concentration high
enough to deprive a of sufficient oxygen. The signs of oxygen deficiency are faintness, staggering
gait, collapse, and unconsciousness .

Poisonous gases from refrigerated cargoes

Certain refigegerat cargoes, including fruit, vegetables, and cheese, generate carbon dioxide during
normal storage . With any failure of a refrigerating plant, food cargoes (especially meat ) may
generate poisonous and inflammable gases. This can be particularly dangerous if the cargo space is
flooded. Carbon monoxide, ammonia , hydrogen sulfide, and hydrogen may be generated in addition
to carbon dioxide. In any great concentration these gases are extremely poisonous and some are
explosive. Full precaution must be taken in addition to those against suffocation and poisoning

Other gases

Trichlorethene------ usually called trilene or “trike” ---- is a volatile anaesthatic gas which causes
drowsiness, mental confusion , nausea vomiting , and coma . It can also result in death It is usud
medically in obstetrics and dentistry because it acts quickly . In the impure form it is used as a dry-
cleaning agent. Some people are addicted to “sniffing” it

Prevention of poisoning
( See also : Ventilation, Control of disease vectors, page 290 )

Remember: prevention is better than cure

Knowledge of the basic safety precautions and strict adherence to them by people working with
dangerous goods, and also knowledge of the conventional labeling of these goods , play an important
part in the prevention of poisoning .

For the handling of some dangerous goods, protective clothing (e: g: , rubber or plastic gloves , aprons
, boots ) and breathing apparatus ( compressed air system, smoke helmet ) may be required and
should be provided. They should be kept on board ship and be available at the workplace , regularly
inspected, and cleaned or replaced. A dequate washing and shower facvilities for the workmen should
be provided nearby.

In the event of a leakage or spillage involving dangerous gas or fumes , the use of a gas detector ed to
be free. Gas masks will not provide complete protection , but may be used to aid escape. The place
where a leakage has occurred should be immediately treated with an appropriate neutralizing
substance and then covered with sand, which should afterwards be removed in a special container to a
safe place .
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

Holds and closed spaces in which toxic ours and gases could accumulate should be thoroughly
ventilated, and a gas detector (not an explosimeter) used, before people are allowed to enter and also
during cargo- handing operation . places used for the storage of dangerous goods should be
decontaminated, if necessary, after use and / or before reuse.

Dangerous goods should not be carried or stored in proximity to other materials ( particularly
foodstuffs) that , as a result of contact with the dangerous goods , could cause illness or accidents (
poisoning )

Special measures relating to the prevention of poisoning in particular cases are in the sections
pertaining to each individual group of substances in the IMO publication mentioned at the beginning
of this chapter
2.3.4 USE OF OXYGEN RESUSCITATOR:

PREPARATION FOR USE

1. Check that the oxygen supply cylinder is clean and marked ‘Medical Oxygen’.
Line up the cylinder valve to locate on the indexed stirrup pins. This is an
International Standard to ensure only an oxygen cylinder can be used. Tighten
the stirrup screw to secure the valve into position. Secure the cylinder with the
Velcro strap.

2. Open the cylinder valve slowly at least one full turn anti-clockwise. An oxygen
key wheel, secured by a chain is attached to the stirrup screw

3. Observe the pressure gauge & note the contents. If less than 1/2 full ensure a 2nd
oxygen cylinder or an external supply cylinder is available

INSTRUCTION GUIDELINES
Caution: The OXI-life® oxygen resuscitator is only recommended for use by those specially
trained in the use of oxygen equipment.

UNCONSCIOUS PATIENTS
1. Clear the airway
2. IF THE VICTIM IS NOT BREATHING place the facemask in position ensuring
the narrow part of the facemask is between the eyes. Keeping the head pulled
back firmly, depress the button on the MTV-100 Manually Triggered Ventilator.
If the facemask is correctly applied the patient’s chest and abdomen will rise
gently. Release the button when an adequate tidal volume has been delivered

3. If there is an obstruction to free flow the MTV-100 will automatically stall.

 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

Release the button, reposition the

patient’s head and try again

4. WHEN THE PATIENT

COMMENCES TO BREATHE
the oxygen flow is
automatically triggered on
inspiration. It is not necessary to
adjust the flows for
adults and children
In breathing patients an oxygen
therapy mask can be used:

1. Connect the green oxygen therapy tube to the therapy mask and the therapy outlet
(at the right side of the case). Turn the OXYGEN THERAPY knob ON (one turn
anti-clockwise): 8L/min oxygen will flow automatically

2. Alternatively connect the therapy mask to the flow outlet* at the rear left side of
the KDK Autovalve™ and dial the required flowrate.
*NOTE: This outlet is particularly useful to connect to a self-inflating bag resuscitator with a
reservoir bag. 8L/min is recommended: to conserve oxygen press the OXYGEN FLUSH to
rapidly refill the reservoir bag only as necessary.

OXI-vac™ VENTURI SUCTION SYSTEM

Includes a polycarbonate 250mL reservoir bottle with a marking at 200mL, secured in an aluminium
bottle base screwed into the base. The narrow neck reduces the likelihood of spillage when removing a
used bottle. A spare suction bottle with blue cap is included for rapid changeover.

Operation of the OXI-vac™

Suction System:
1. Attach one end of the silicone
suction tubing to the outlet of the
OXI-vac™ system and the other
end to a Y-suction catheter.

2. Push the control knob to the

ON position. Occluding the
opening near the base of the
suction catheter controls suction.

3. The suction control must be turned OFF IMMEDIATELY after use to avoid wastage of oxygen
WARNING: The OXI-vac™ operates on a venturi principal: a vacuum is created by a high oxygen
flow through a narrow jet. The oxygen cylinder can be rapidly depleted if the suction control is left
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

on inadvertently.

4. After use, remove the

suction tubing, lift the OXI-
vac™ from the bottle base,
unscrew the bottle, fit the blue
cap (from the spare bottle) and
discard. Then screw the clean
bottle onto the OXIvac ™ and
replace the assembly in the
bottle base.

PRECAUTIONS:

1. Turn the oxygen cylinder valve on slowly. Naked flames must not be used in the vicinity of the
apparatus. Do not put oil or grease on any oxygen connections
2. This equipment should only be used after a training program on resuscitation has been
Completed
3. Clean the equipment after each use. Use a cloth moistened with chlorhexidene ('Hibitaine') in
alcohol to wipe over the components
4. Turn the oxygen supply cylinder OFF after use. Ensure a spare full oxygen cylinder is
available and situated adjacent to the machine

PRECAUTIONS:
1. Turn the oxygen cylinder valve on slowly.
2. Naked flames must not be used in the vicinity of the apparatus.
3. Do not put oil or grease on any oxygen connections
4. This equipment should only be used after a training program on resuscitation has been
completed
5. Clean the equipment after each use. Use a cloth moistened with chlorhexidene ('Hibitaine')
in alcohol to wipe over the components
6. Turn the oxygen supply cylinder OFF after use.
7. Ensure a spare full oxygen cylinder is available and situated adjacent to the machine

CLEAN AND DISINFECT THE MTV-100/Manually Triggered Ventilator AFTER EVERY

USE.
Warning
The MTV-100/Manually Triggered Ventilator is designed to be used on adults and
children, and should not be used on infants. This equipment should be used only by
properly trained personnel. The unit should not be used in oxygen deficient atmosphere
or near open flame. Do not smoke while using this unit.

Resuscitation
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

1. Install a standard medical mask on the MTV-100/Manually Triggered Ventilator and connect
the hose to an oxygen supply capable of delivering 100 LPM @ 40-60 psig. These steps should
be accomplished prior to the actual need for resuscitation.
2. Turn the oxygen supply valve on slowly.

Warning
When turning on the oxygen supply, be sure the MTV-100/Manually Triggered Ventilator
outlet is not blocked.

3. Verify that there are no obstructions in the patient’s throat or mouth(vomitus, foreign
bodies, broken dentures, etc.).
4. With one hand placed under the patient’s chin, tilt the head back (to open the patient’s air passages)
and place the mask over the nose and mouth. Hold the mask in place with the thumb, index finger, and
middle finger, while using the rest of the fingers under the chin to hold the patient’s head back.
5. Using the other hand to assist in holding the MTV-1 00/ManuallyTriggered Ventilator and mask
in place, depress the manual control button and hold it down until the patient’s chest rises. Then
release the button and allow the patient to exhale. Repeat this cycle 10 times per minute for an
adult, and 20 times per minute for a child. If the patient begins to breath spontaneously, maintain
the mask seal and the flow of oxygen, but do not depress the manual control button. The patient
will receive 100% oxygen as a result of his inspiratory effort.

Warning
Depressing the Manual Control Button when the patient is breathing spontaneously may
make it impossible for the patient to exhale.
Heart Lung Resuscitation
The MTV-1 00/Manually Triggered Ventilator may be used for Heart Lung Resuscitation when a
combination of lung resuscitation and external cardiac compression is required to restore the
heart beat and breathing of patient.

Maintenance
Cleaning

Warning
All cleaning procedures must be performed in a hydrocarbon residue free area because of the danger of
spontaneous combustion when the residues are exposed to gaseous oxygen.

CLEAN & DISINFECT THE MTV-100/MANUALLY TRIGGERED VENTILATOR AFTER

EVERY USE.

1. Remove the outlet adapter and the exhalation valve assembly from the MTV-100/Manually
Triggered Ventilator.
2. Clean all foreign matter from the outlet adapter and the exhalation valve assembly with a mild
soap solution, being careful not to get any liquid inside the MTV-100/Manually Triggered
 LANKA ACADEMY OF TECHNOLOGICAL SUDIES (PRIVATE) LTD
STUDENT NOTES ON MEDICAL FIRST AID
2.3 TOXICOLOGICAL HAZARDS ON BOARD, INCLUDING USE OF THE MEDICAL FIRST
AID GUIDE FOR USE IN ACCIDENTS INVOLVING DANGEROUS GOODS (MFAG) OR ITS
NATIONAL EQUIVALENT.

Ventilator subassembly.Rinse the parts thoroughly in clean water.

3. Rinse outlet end of the MTV-100/Manually Triggered Ventilator body assembly thoroughly in
clear water.
4. Carefully examine the parts of the MTV-100/Manually Triggered Ventilator. Replace any
cracked or damaged parts.
5. Disinfect the MTV-100/Manually Triggered Ventilator body assembly and components by cold
disenfecting.

Cold Disinfecting
1. Immerse the outlet adapter and the exhalation valve assembly from the MTV-1 00/Manually
Triggered Ventilator in a CIDEX solution according to the disinfectent manufacturer’s instructions.
2. The MTV-100/Manually Triggered Ventilator body assembly can be flushed with water and
CIDEX only from or through the outlet end of the valve. After flushing, rinse thoroughly with sterile
water.

Caution
Do not submerse the MTV-100/Manually Triggered Ventilator body in liquid.
3. Remove the outlet adapter and the exhalation valve assembly from the CIDEX solution and
rinse thoroughly with sterile water. Rinse repeatedly to be sure that all the CIDEX solution is
removed from the parts.
4. Connect the MTV-100/Manually Triggered Ventilator body assembly to an oxygen supply. Turn
on the oxygen supply and depress the manual control button several times to blow out any liquid
that may have entered.
5. Check the exhalation valve assembly to be sure the flapper valve is not twisted and the
locating bosses are properly positioned.

Warning
If the flapper valve is twisted or the locating bosses are not properly positioned, the MTV-1
00/Manually Triggered Ventilator will not function properly. Make sure that the flapper valve lies
flat against the seat.
6. Reassemble the parts and test the unit with a Test Kit, P/N109. Follow the instructions
included with the Test Kit.