Course Toxic Exposures

Most earthquake fatalities are due to physical injuries, but the medical staff must be alert to signs and symptoms of secondary toxin exposures. Aftershocks should be expected with earthquakes and can lead to further damage and injuries. The majority of deaths from volcanoes are secondary to ash fall, which causes immediate suffocation. The ash mixes with mucous, forming plugs in larger airways. Survivors may complain of cough, wheeze, eye irritation, blisters on the skin, and muscle weakness. Volcanic eruptions also release large amounts of gas that contain carbon monoxide, sulfur dioxide, methane, hydrogen sulfide, and hydrogen fluoride. These gases can be very irritating to the airways and can result in pulmonary edema or act as primary asphyxiants.