This is an automatically translated article.
The article was professionally consulted by Specialist Doctor I Do Van Manh - Emergency Medicine Doctor - Emergency Resuscitation Department - Vinmec Ha Long International General Hospital.Puffer fish, although known to be a poisonous fish, is still consumed and served in dishes such as sushi or sashimi. This is also the cause of severe cases of puffer fish poisoning due to tetrodotoxin and can lead to death.
1. Why does eating puffer fish get poisoned?
The main cause of puffer fish poisoning is tetrodotoxin in puffer fish, concentrated in fish eggs, intestines and testicles, one of the very toxic substances found in nature. Tetrodotoxin is a non-protein, water-soluble poison that is not destroyed by heat (cooked or dried) but is inactive in strongly acidic or alkaline environments.
Tetrodotoxin is rapidly absorbed from the gastrointestinal tract after 5-15 minutes and peaks after 20 minutes, significantly excreted in the urine. This toxin greatly affects the nervous system, inhibits sodium channels, especially in skeletal muscle, leading to hindering the generation of electrical potential and impulse conduction with the main consequences being muscle paralysis and respiratory failure.
Nguyên nhân gây ngộ độc cá nóc chính là do độc chất tetrodotoxin ở trong cá nóc, tập trung ở trứng, ruột và tinh hoàn cá
2. Symptoms of pufferfish poisoning
Manifestations of puffer fish poisoning usually occur 10-45 minutes after eating poisonous puffer fish, including dried or dried fish. Initially, the patient will experience numbness of the mouth, tongue, 2 lips, increased salivation, nausea and vomiting, accompanied by symptoms such as:
Fatigue, dizziness, dizziness; Hard to say; Numbness in fingers, hands and feet; Loss of reflexes; Severe hypotension; In 4-6 hours symptoms can worsen and lead to paralysis, loss of consciousness, eventually respiratory failure and death. To classify the toxic effects of tetrodotoxin can be divided into 4 levels of neurological and cardiovascular effects as follows:
Grade 1: Only numbness, perioral paresthesia, may or may not have gastrointestinal symptoms such as: nausea, increased salivation, diarrhea; Grade 2: Numbness in tongue spreading to face, extremities and other areas, motor paralysis and ataxia, slurred speech, headache and sweating but normal reflexes Grade 3: Patient has convulsions, flaccid paralysis whole body, respiratory failure, speechless, pupils maximally dilated, loss of light reflex, may remain awake Grade 4: Patient is critical, severe respiratory failure, arrhythmia, coma.
Biểu hiện ngộ độc cá nóc thường xảy ra sau 10-45 phút sau khi ăn cá nóc còn độc tố
3. How to handle puffer fish poisoning?
Principles of treatment of puffer fish poisoning include:
Limiting the body's good absorption of poison Treat symptomatically Active intervention if there are life-threatening manifestations such as generalized paralysis, severe respiratory failure To For local treatment, if the patient has symptoms of poisoning after eating puffer fish for about 3 hours, he may try to vomit, cough, and spit, so the patient should be placed on the side of the head low to prevent choking. Can give the patient to drink activated charcoal while awake, dose of 30g mixed with 250ml of clean water. For children from 1-12 years old, use 25g of activated charcoal with 100-200ml of clean water. For children under 1 year old, use 1g of activated carbon/1kg of body weight mixed with 50ml of clean water. Should be taken within 1 hour after eating puffer fish for the best effect.
For patients who are comatose or have a loss of consciousness, have difficulty breathing or have weak breathing, stop breathing, it is necessary to perform artificial respiration, give rescue breaths and take them to a medical facility for emergency resuscitation treatment. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.
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