Screening: 12 lead ECG, BSL, Paracetamol level.Monitor fluid resuscitation and general supportive measure for any organ failure.Chronic mercury toxicity – leads to multi-system disorders, predominantly neurological (tremor, neurasthenia, erethism, emotional lability, insomnia, delirium, mixed sensorimotor neuropathy, ataxia and anosmia), gastrointestinal (metallic taste, burning pain in the mouth, loose teeth, gingivostomatitis and hypersalivation), renal dysfunction (proximal tubular atrophy with mercuric deposits within the renal interstitium and macrophages) and acrodynia.Any number of neurological dysfunctions can occur covering sensory loss, motor loss, cerebellar signs and psychological dysfunction. Delayed neurotoxicity develops over weeks or months after initial exposure and usually permanent. Acute exposure to organic mercury – GI symptoms, respiratory distress, tremor, dermatitis, renal tubular dysfunction and ECG (ST segment) changes.Massive fluid loss leading to hypotension, shock and acute tubular necrosis follows. Grey discolouration of the mucous membranes. Severe local oropharyngeal pain, metallic taste, nausea, vomiting and diarrhoea.
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