Organophosphate poisoning by dr. joshua cherukuri
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OP Poisoning routes, pathophysiology, diagnosis, sludge syndrome, effects on different systems, symptoms and severity, goals of treatment, decontamination and treatment
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This document discusses the management of status asthmaticus, a life-threatening exacerbation of asthma. Key aspects include:
- Status asthmaticus is characterized by increasing chest tightness, wheezing, dyspnea and hyperinflation that is poorly relieved by usual inhalers.
- Management involves intravenous hydrocortisone to reduce inflammation, nebulized salbutamol and ipratropium bromide treatments, humidified oxygen, and intubation/ventilation if needed. Antibiotics are also given if infection is present. Fluid management addresses dehydration and acidosis.
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This document discusses the management of childhood poisoning. It notes that poisoning is commonly accidental in young children and can occur through ingestion, inhalation, or dermal exposure. Initial management focuses on stabilizing the airway, breathing, and circulation. Depending on the poison, techniques may include activated charcoal, gastric lavage, whole bowel irrigation, or enhanced elimination. Specific poisons like kerosene often cause inhalation injuries and require airway support. Caustics can cause burns that require endoscopy and monitoring for perforation. Overall the document outlines the general and specific approaches to treating different types of childhood poisonings.
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Organophosphate poisoning by dr. joshua cherukuri
- 2. Inhalation Ingestion Dermal contact
- 3. Pathophysiology • Organophosphates share structural similarity with acetylcholine and binds covalently with cholinesterase molecule, leads to accumulation of acetylcholine at synapses causes overstimulation in CNS and PNS.
- 4. activity are used for confirming • OP poisoning has toxicological effects on body systems 1. Cardiovascular system 2. Respiratory system 3. Neurological system 4. Endocrine system
- 5. Death from acute severe poisoning occurs due to respiratory compromise. Most Significant muscuranic effects are and Respiratory depression
- 6. suggests
- 7. SLUDGE SYNDROME alivation acrimation rination efecation astric Cramps mesis
- 8. • OP poisoning has effects on reproductive and nervous system Reproductive effects : - In Men, exposure to OP has poor semen and sperm quality, decreased seminal volume and % of motility, decreased sperm count per ejaculate. - Prenatal exposure leads to impaired fetal growth and development.
- 9. Neurotoxic Effects 1.Cholinergic syndrome 2.Intermediate syndrome 3.OP-induced delayed polyneuropathy 4.Chronic OP induced delayed polyneuropathy
- 10. OP POISONING - SYMPTOMS & LEVEL OF TOXICITY MILD MODERATE SEVERE Shortness of breath Limitation of activity Coughing Lacrimation Bradycardia Sweating Runny nose Colic pain Diarrhea Vomiting Restlessness Weakness Pallor Altered consciousness Muscle twitching Convulsions Respiratory failure Pulmonary edema Paralysis Cyanosis Deep coma
- 11. GOALS OF TREATMENT Reduce absorption of toxins Enhance elimination Neutralise toxins already present in the body
- 12. DECONTAMINATION 1. Remove all clothing and gently cleanse patient. 2. Use personal protective equipment i.e., Neoprene gloves and gowns 3. Use charcoal catridge masks for respiratory protection when decontaminating patients who are significantly contaminated. 4. Irrigate eyes of patient who had ocular exposure using normal saline.
- 13. TREATMENT • Atropine remains the mainstay of therapy as it dries up respiratory secretions and getting bronchial muscles to relax. 1.Atropine :To reverse cholinergic activity, improve cardiac and respiratory functions 2.Clonidine :Decreases HR in tachycardia 3. Pralidoxime :Antidote for OP poisoning 4. Sodium bicarbonate :For alkalisation and correcting metabolic acidosis
- 14. 5. Magenesium sulfate :On first day of admission 6. Benzodiazepines :Provide sedation, To controll agitations and seizures 7. Cathartics :Decrease absorption of substances by expulsion of poison from GI tract 8. Sodium bicarbonate :for alkalisation and correcting metabolic acidosis 9. Glycopyruvate :Given along with atropine