Lithium peroxide

· CALL 911. Then call emergency response telephone number on shipping paper. If shipping paper not available or no answer, refer to appropriate telephone number listed on the inside back cover.

· Keep combustibles (wood, paper, oil, etc.) away from spilled material.

Excerpt from ERG Guide 143 [Oxidizers (Unstable)]:

General First Aid:

If material on fire or involved in fire: Use suitable dry powder. Cool all affected containers with flooding quantities of water. Do not use water on material itself. Use water in flooding quantities as fog. Keep run-off water out of sewers and water sources.

SRP: The most favorable course of action is to use an alternative chemical product with less inherent propensity for occupational exposure or environmental contamination. Recycle any unused portion of the material for its approved use or return it to the manufacturer or supplier. Ultimate disposal of the chemical must consider: the material's impact on air quality; potential migration in soil or water; effects on animal, aquatic, and plant life; and conformance with environmental and public health regulations.

If material not on fire and not involved in fire: Keep sparks, flames, and other sources of ignition away. Keep material out of water sources and sewers. Do not use water. Keep material dry.

Personnel protection: Avoid breathing vapors or dusts. Avoid bodily contact with the material. ... Do not handle broken packages unless wearing appropriate personal protective equipment. If contact with the material anticipated, wear appropriate chemical protective clothing. Wash away any material which may have contacted the body with copious amounts of water or soap and water. Avoid breathing dusts, and fumes from burning material. ...

SRP: The scientific literature for the use of contact lenses in industry is conflicting. The benefit or detrimental effects of wearing contact lenses depend not only upon the substance, but also on factors including the form of the substance, characteristics and duration of the exposure, the uses of other eye protection equipment, and the hygiene of the lenses. However, there may be individual substances whose irritating or corrosive properties are such that the wearing of contact lenses would be harmful to the eye. In those specific cases, contact lenses should not be worn. In any event, the usual eye protection equipment should be worn even when contact lenses are in place.

Excerpt from ERG Guide 143 [Oxidizers (Unstable)]:

Immediate precautionary measure

Excerpt from ERG Guide 143 [Oxidizers (Unstable)]:

Personnel protection: ... Wear appropriate chemical protective gloves, boots and goggles. ... Wear positive pressure self-contained breathing apparatus when fighting fires involving this material.

/SIGNS AND SYMPTOMS/ In contact with eyes these substances produce inflammation. /Peroxides/

/SIGNS AND SYMPTOMS/ Acute intoxication can occur in the initial phase in a course of therapy, but also at any point of time during long-lasting treatment or after an acute overdose. At plasma levels between 1.5 and 2.5 mmol/L, signs of toxicity include anorexia, dry mouth, nausea, vomiting, diarrhea, tremor of the hands, faintness of musculature, thirst, leucocytosis, and concentration and memory disturbances (especially with older people). These phenomena are often seen in the initial phase of a course of treatment and usually disappear when treatment continues, except with the tremor of the hands. In elderly people, reversible delirious conditions can occur with confusion, restlessness, and ataxia. At plasma levels above 2.5 mmol/L, serious toxic symptoms occur; fasciculations, muscle contractions, hyperreflexia and hypertonia, drowsiness, confusion, sometimes epileptiform insults, hypotension, coma, collapse. Independent of the plasma level, changes can occur in the ECG and in the EEC, with symptoms such as polyuria and polydipsia, seldom nephrogenic diabetes insipidus, ulcers of the leg, enhancement of acne and psoriasis, transient hyperglycemia, pruritus, and a metal taste. In about 5% of the cases, a (usually reversible) hypothyroidia develops. /Li+/

/SIGNS AND SYMPTOMS/ A ... selective action of Li+ is to inhibit inositol monophosphatase and thus interfere with the phosphatidylinositol pathway ... This effect can lead to decr in cerebral inositol concn, which can be detected with magnetic resonance spectroscopy in human brain tissue. However, the physiological consequences of this effect remain uncertain, including interference with neurotransmission mechanisms that are mediated by the phosphatidylinositol pathway ... /Li+/

/SIGNS AND SYMPTOMS/ The prolonged use of Li+ causes a benign and reversible depression of the T wave of the ECG, an effect not related to depletion of Na+ or K+. /Li+/

Basic treatment: Establish a patent airway (oropharyngeal or nasopharyngeal airway, if needed). Suction if necessary. Watch for signs of respiratory insufficiency and assist ventilations if necessary. Administer oxygen by nonrebreather mask at 10 to 15 L/min. Monitor for pulmonary edema and treat if necessary ... . Monitor for shock and treat if necessary ... . Anticipate seizures and treat if necessary ... . For eye contamination, flush eyes immediately with water. Irrigate each eye continuously with 0.9% saline (NS) during treatment ... . Do not use emetics. For ingestion, rinse mouth and administer 5 mL/kg up to 200 mL of water for dilution if the patient can swallow, has a strong gag reflex, and does not drool ... . Cover skin burns with dry sterile dressings after decontamination ... . /Lithium and related compounds/

Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious, has severe pulmonary edema, or is in severe respiratory distress. Positive-pressure ventilation techniques with a bag-valve-mask device may be beneficial. Consider drug therapy for pulmonary edema ... . Monitor cardiac rhythm and treat arrhythmias if necessary ... . Start IV administration of D5W /SRP: "To keep open", minimal flow rate/. Use 0.9% saline (NS) or lactated Ringer's (LR) if signs of hypovolemia are present. For hypotension with signs of hypovolemia, administer fluid cautiously. Consider vasopressors if patient is hypotensive with a normal fluid volume. Watch for signs of fluid overload ... . Treat seizures with diazepam or lorazepam ... . Use proparacaine hydrochloride to assist eye irrigation ... . /Lithium and related compounds/