ACUTE ORGANOPHOSPHORUS POISONING- AN EXPERIENCE

Abstract

Objective: To determine various modes of acute poisoning due to pesticides with respect to gender, age, time period, mechanical ventilation, hospital stay and outcome.
Design: Prospective observational study. Place and Duration of Study: Department of medicine, Combined Military Hospital Pano Aqil Sindh, from April 2003 to November 2004. Patients and Methods: All indoor patients poisoned by pesticides, of either sex, age more than 12 years were included in the study. Data collected on proforma, contained categories of age, gender, mode of poisoning, time duration, clinical presentation, mechanical ventilation, hospital stay and final outcome.  Results: Out of 24 poisoned patients, 18 were males (75%) and 6 were females (25%). Mean age was 23 years (range 13 years to 47 years). About 79% of the victims were in the age range of 16-25 years. Suicidal, occupational and accidental incidences were 70.83%, 20.83% and 8.33% respectively. Only 10 patients (42%) needed mechanical ventilation due to acute respiratory failure and other 14 patients (58%) managed conservatively. Mean hospital stay was 4.5 days (range 01 to 15 days). A total of 3 deaths with death rate of 12.5% were observed and all the deaths were among the suicidal victims. Conclusion: Pesticides are the major chemical agents which pose a health threat, particularly to young people, depressed females and farm workers, in rural set up. Since respiratory failure is the major reason for mortality, its early recognition, prompt endotracheal intubation and mechanical ventilation are life saving measures in severe organophosphorus (OP) poisoning.