Acute exposure

Inhalation

The victim should be removed from exposure and all contaminated clothing removed. The respiratory function should be assessed. Monitor liver function. Further treatment is symptomatic and supportive.

Dermal

Contaminated clothing should be removed and the skin thoroughly irrigated with water or saline. Further treatment is symptomatic and supportive.

The eyes should be thoroughly irrigated with water or saline for 15 minutes and then stained with fluorescein. Referral to an ophthalmologist is recommended if there is any uptake of fluorescein. Despite apparent worsening of effects in rabbit eyes when washed with water following DMF exposure, the magnitude of the response is not great enough to contraindicate irrigation. Copious irrigation can prevent serious lasting injury to the eye (Kennedy and Sherman, 1986).

Ingestion

Gastric decontamination should be considered following ingestion of DMF. It is not known whether activated charcoal would be of any benefit. The white blood cell count and LFTs should be monitored. A ratio of AST to ALT of less than one will distinguish toxic liver disease from alcoholic hepatitis (Redlich et al., 1988; Fleming et al., 1990). Treatment is symptomatic and supportive. Antidotal therapy may be considered (see below).

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