Author(s): Chandra Indira Priyadarsini1, S. S. K. R. Bheemeshwara Rao2, M. B. R. Sarma3
BACKGROUND: Organophophorous poisoning constitutes one of the most frequent poisoning in clinical practice all over the country and especially in this area where agriculture is the chief economic occupation. Acute organophophorous poisoning ranks foremost in the list of agents which causes acute pesticide poisoning in the developing countries. Acute poisoning, accidental or due to deliberate ingestion or inhalation of these organophosphate chemicals is an important and one of the most common medical emergencies. Hence the present study is undertaken to assess severity of poisoning, management and outcome of organophosphorous poisoning cases admitted in Government General Hospital, Kakinada, A. P.
AIMS/OBJECTIVES: 1. Assessment of severity of Organophosphorous poisoning according to Driesbach’s criteria 2. To study the morbidity and mortality in these patients.
MATERIALS AND METHODS: In this descriptive study fifty patients with organophosphorous insecticide poisoning were evaluated by clinical examination. They were investigated, treated and their treatment outcome were analyzed.
RESULTS: 1. Chlorpyriphos and monocrotophos(together 66%) were the most commonly used pesticides. 2. 82% cases reached the hospital within 6 hours for commencement of treatment and were mostly of moderate to severe degree of OP poisoning while mild cases of accidental poisoning reached after 12 hours. Hence the mortality is high in the former group only. 3. When the severity of poisoning was graded by applying Dreisbach's criteria at the time of admission 34% had severe degree of poisoning, 26% had moderate poisoning while 40% of cases presented with mild degree of poisoning. (Most of the cases were accidental inhalation and skin contact exposure.) 4. Among the patients belonging to moderate to severe degree of poisoning 30% of patients were put on assisted mechanical ventilation, indications being uncontrolled pulmonary secretions, continuing hypoxia, not relieved with routine Oxygen therapy and respiratory paralysis. 5. The mortality rate in the present study is 14% (7 cases out of 50). All of them expired despite good ventilatory support and intensive medical care. 6. In this study among 17 cases of severe degree poisoning, 5 patients expired and the remaining 12 cases recovered with Intensive medical care and mechanical ventilatory support.