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 Wysłany: Sob 0:52, 02 Kwi 2011 Temat postu: Successful salvage of acute severe dichlorvos pois |
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Successful salvage of acute severe dichlorvos poisoning case report
. 100 ml of dichlorvos from the service due to a half hour in at 11:00 on April 1st, 2001 admission. Half an hour before admission because of an altercation with his family, 100 ml of dichlorvos from the service, immediately after taking the nausea, vomiting, call in the hospital on the way there should not be. Physical examination: body temperature 37 ℃, pulse of 90 copies, breathing 26 times / min, blood pressure 10.7/6.6kpa, confusion, irritability. The skin moist, double the size of the pupil, such as tip, lips cyanosis, vomit a lot of white foam. Lungs filled with a lot of wet rales. Sector size of the normal heart, heart rate 90 beats / min. Abdomen negative. Laboratory tests: blood urea nitrogen 6.19mmol / L, creatinine 69.72omol / I. . , Total bilirubin 31.71/anol/I. . , Direct bilirubin 5.37 ~ rnol / I. . , AI. T30.26u / L, ASP123.85u / L, UDH324.91u / L,[link widoczny dla zalogowanych], serum sodium: 13o. 3retool / L, potassium 3.47mmol / L, serum chloride 96.3mmol / L, HBSAg negative. 2. After treatment by decreasing the amount of maintenance, Sixth day after admission, consciousness recovery, to answer the questions correctly and eating. A total of 18 patients hospitalized, discharged. 3. Discussion of dichlorvos is highly toxic organophosphorus pesticides, human oral median lethal dose was 10 ~ 100mg/kg. After the drug into the body of the ester solution and the AChE phosphorylation sites combined into cholinesterase, which is relatively stable, and no ability to break down acetylcholine. Thus causing the accumulation of acetylcholine excitatory cholinergic nerve after the first series of muscarinic inhibition, nicotinic and central nervous system symptoms. In severe cases, coma and even respiratory failure and may die. The cases of oral poisoning with symptoms of nausea and vomiting as the first order of consciousness, foaming at the mouth, miosis, bilateral pulmonary rales large as the main performance, severe dichlorvos poisoning diagnosis was established. The toxic poisoning cases treated by general handling, the main effect is the application of antidote atropine. Although the application of atropine is difficult to have a unified model. Our experience is: Once the diagnosis of atropine as soon as possible, and maintain adequate enough time to closely observe the patient's condition and adjust the dosage of atropine. Only one hospital to the patient with water immediately after the gastric lavage, catharsis, diuresis, inadequate absorption of atropine attention, but also to prevent the atropine poisoning. Oxygen, suction, intravenous injection of large doses of atropine cause
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