Management of OPC and Carbamate Poisoning in Intensive Care Unit of Enam Medical College & Hospital, Savar, Dhaka
Journal Title: Journal of Enam Meical College - Year 2018, Vol 8, Issue 3
Abstract
Background: Bangladesh is an agriculture-dependent country. Organophosphorus insecticides are widely used for the better outcome of cultivation. It is used for suicidal purpose due to its easy availability all over the country. Worldwide, acute pesticide poisoning is causing major health problems with high mortality in developing countries. Objective: The objective of our study was to establish that early management of acute poisoning with organophosphorus and carbamate in ICU along with ventilatory support in severe respiratory distress reduces the mortality rate. Materials and Methods: This study was conducted in the Department of Anesthesiology & ICU in Enam Medical College & Hospital, Savar, Dhaka from January 2013 to December 2015. Total 84 patients with acute poisoning cases were selected. The diagnosis was confrmed by the history of ingestion of insecticides, observing clinical signs and symptoms and presence of foul smelling of poisonous agent. Management included supportive care, intubation, artifcial ventilation in selective cases, administration of antidotes as loading and maintenance dose for atropinization with atropine and pralidoxime, antibiotics, anti-ulcerant, anticonvulsant, inotropic support (in severe hypotension) along with other symptomatic treatment. After stabilization, decontamination was started with removal of contaminated clothes, thorough wash with soap and water, irrigation of eyes with water and normal saline. Gastric lavage was given within 2 to 3 hours of ingestion of poison. Results: Acute poisoning was observed more in male (60.71%) than in female (39.29%) and in age group of 21–40 years (60.71%). Suicidal attempt was present in 97.61% cases and causes of suicidal poisoning were familial disharmony (76.19%), fnancial loss (14.28%) and failure in examination (9.52%). Organophosphate group poison ingestion was in 77.38% cases and carbamate group poison in 21.43% and both agents in 1.19% cases. Ventilatory support was given in 48.80% cases and 78.05% patients were successfully extubated from mechanical ventilator. Mean duration of ventilatory support was 2–14 days. Out of 84 patients, 75 (89.28%) survived and 9 (10.72%) patients expired. Fifty two (61.91%) patients were discharged within 4–6 days, 16 (19.04%) within 2–3 days, and 7 (8.33%) patients were discharged within 7–14 days. Conclusion: Early ICU admission and appropriate management of patients after ingestion of poisonous agent results in reduced morbidity and mortality
Authors and Affiliations
Easnem Khanum, Md Ashraful Islam, Mohammad Salim, SM Rafiqul Islam, Md Rezaul Haque PK
Keywords
Related Articles
- EP ID EP36312
- DOI https://doi.org/10.3329/jemc.v8i3.38364
- Views 302
- Downloads 0
Chronic Calcific Pancreatitis in a 9-Year-Old Boy
Chronic pancreatitis is defined as continuing inflammatory disease of pancreas, characterised by irreversible morphological changes leading to pancreatic insufficiency. Chronic pancreatic insufficiency without pancreat...
Effect of Oxytocin Injection into Umbilical Vein for Management of Retained Placenta
Background: Retained placenta is one of the causes of post-partum hemorrhage in Bangladesh as it is worldwide. If a retained placenta is left untreated, there is a high risk of maternal morbidity and mortality and it h...
Isolation and Identification of Pathogenic Gram-Positive Bacteria from Egg Shell of Hen and to See Their Antimicrobial Susceptibility Pattern
Background: Food-borne disease is a major public health problem affecting developed as well as developing countries. Inaccurately treated eggs can be one of its causes. So we designed this study to observe the possibil...
Clopidogrel Resistance: Current Issues
Antiplatelet agents are mainly used in the prevention and management of atherothrombotic complications. Dual antiplatelet therapy, combining aspirin and clopidogrel, is the standard care for patients having acute coron...
Hepatitis E Virus — A Potential Threat to Pregnancy
Hepatitis E virus has become the most frequent and leading cause of acute hepatitis in developing countries.1 The disease was first recognized in the Indian subcontinent in 1950s following contamination of drinking w...