Rescue of severe organophosphorus pesticide poison

e707004304 · Wysłany: Pon 11:46, 07 Mar 2011

Rescue severe organophosphorus pesticide poisoning Experience

min20 ~ 40mg intravenously,[link widoczny dla zalogowanych], with a capacity of atropine to 2h 750mg, in patients with decreased pulmonary rales, lower heart sound blunt, the pupil is 6ram. The body is not hot, urinary retention, blurred consciousness, continue to use atropine,[link widoczny dla zalogowanych], intravenously every lOmin5mg, and to oxygen, shock cord. Diuretic, anti-infection and to maintain water and electrolyte acid-base balance and other comprehensive treatment. Atropine to 8 pm the next day reached a total of 1lOOmg, patients with no sweat. No saliva, fever Mianchi, pulmonary rales disappeared, and moaned, feed water swallowing. That has reached atropinization. Each with a maintenance dose of intravenous 30min5mg afternoon 16:00 suddenly restless patients, delirium. Facial flushing, fever, body temperature 4O. 5 ℃, need to push people to stop restless legs, uneven breathing, stop using atropine, head ice packs, physical cooling, to give breathing _ = United needles, artificial hibernation. Pethidine lOOmg, promethazine 50mg, chlorpromazine 50mg, intramuscular injection in patients with quiet sleep after 30min. On August 18 morning 2:00 conscious patients, body temperature 36_8 ℃, pulmonary rales disappeared,[link widoczny dla zalogowanych], heart rate 9O times / min, the whole law. Can enter the milk and juice, 5 1 stool. Urine can be independent, atropine to each 6h1 times lmg intramuscular injection, given antibiotics to prevent infection. 9d discharged hospital treatment. 2 to discuss the rescue of organophosphorus pesticide poisoning 2.1 must first be timely, accurate, thorough gastric lavage. After diagnosis. Gastric lavage and application of specific antidote should be at the same time, gastric lavage should be side edge of medicine. Gastric lavage is timely,[link widoczny dla zalogowanych], correct and complete is to save the key to success, so for severe poisoning. Both must be found sooner or later, gastric lavage, repeated thorough Author: Lishu Chinese Medicine Hospital (136500) until the eluate is no longer the special odor of organic phosphorus pesticide until then to give magnesium sulfate catharsis. 2.2 The early application of rehabilitation can be agents of organophosphorus pesticides to a lasting anti-cholinesterase drugs. The enzyme can within a few minutes or hours, Pralidoxime organophosphorus pesticides can be restored inhibition of cholinesterase activity. With the body and the organic phosphorus pesticide free direct binding, a non-toxic substances from the urine excreted, thereby preventing the free organophosphorus pesticides continue to inhibit cholinesterase activity. Therefore, the sooner treatment efficacy possible. Pralidoxime role in skeletal muscle at the neuromuscular junction was most apparent after treatment quickly to stop muscle bundle fibrillation. Since the rapid excretion of drugs in the kidney. Effect is not lasting. Intravenous half-life of less than half an hour later, it needs adequate treatment of poisoning and repeated administration, usually about 6g is appropriate, not excessive; If overdose itself can inhibit the activity of cholinesterase. Organophosphorus pesticide poisoning increased level of individual patients can cause cardiac arrhythmia and toxic hepatitis. 4.3 The rational application of atropine pralidoxime can not directly confront the accumulation of acetylcholine in vivo role. Should be combined with atropine. Atropine can quickly lift the M organophosphorus pesticide poisoning-like symptoms, but also to lift part of the central nervous system symptoms, respiratory center can be excited. To wake up coma patients. In addition, large doses of atropine also has the effect of blocking nerve section. Organophosphorus pesticides to combat the excitement of ganglion role. Around the role of atropine as a strong anti-cholinergic drugs. Should be early, adequate and repeated sustained investment. Timely change. As soon as possible so that peak drug concentration in the blood and maintain stability. In general, toxicity, quantity, treatment and oral poisoning later, the dosage of atropine is large. Atropine is a reasonable application of a large number of organophosphorus pesticide poisoning rescue an important part; We believe in the application of atropine to achieve when the rather mild atropine poisoning, must not be timid. Less than the amount of acetylcholine in the body can cause a lot of accumulation, especially in poisoning a long time. Cholinesterase has been re-aged or invalid can be toxic agent such as dimethoate, atropine in adequate doses is more important. Organophosphorus pesticide poisoning in the rescue process. In case of atropine poisoning should immediately stop,[link widoczny dla zalogowanych], multi-stability or advocate the use of barbiturates. But not excessive. I try hibernation therapy received satisfactory results, hibernation therapy might be a calm, cool, improve microcirculation of the role, so that the normal metabolism of brain cells and improve the cerebral circulation of it. Due to fewer cases, lack of theoretical basis, pending further study. 2.4 Prevention is the emphasis on the rebound rebound organophosphorus pesticide poisoning symptoms improved after active rescue, poisoning symptom control, the condition deteriorated again repeated. Therefore, patients were rescued after the poisoning, not only should not be discontinued immediately, and does not response in the reduction, should be maintained medication 3-7d or more. Most scientific indications for withdrawal of blood cholinesterase activity returned to normal within. If so. Easily