Organophosphate Poisoning

Question 1

In the circumstance of potential Organophosphate Poisoning, what is the key word to look for?

Answer 1

Anticholinesterase.

Question 2

What should be done with the container once identified, if suspected OP poisoning?

Answer 2

Identify trade and generic names and contact poisons information centre.

Question 3

What safety considerations should be made for treating and transporting these patients?

Answer 3

Minimise number of staff exposed, attempt to minimise transfers between vehicles, use appropriate PPE.

Question 4

What general care should be done for these patients?

Answer 4

Pt should remove contaminated clothing and wash skin thoroughly with soap and water.

Question 5

How is evidence of suspected OP poisoning confirmed?

Answer 5

“anticholinesterase” on the label + cholinergic effects: salivation, bronchospasm, sweating, nausea, or bradycardia

Question 6

What excessive cholinergic effects require immediate treatment?

Answer 6

1. Salivation compromising the airway or bronchospasm
   AND / OR
2. Bradycardia with inadequate or extremely poor perfusion

Question 7

If confirmed OP poisoning, but no excessive cholinergic effects, what is the management?

Answer 7

Tx to nearest appropriate hospital with notification, to allow for pt decontamination and isolation.
Monitor for excessive cholinergic changes.

Question 8

If confirmed OP poisoning AND one or more of excessive cholinergic effects, what is the management?

Answer 8

1. Early MICA request

2. Atropine

Question 9

What is the role of Atropine in OP poisoning?

Answer 9

Atropine is a muscarinic antagonist that blocks the effects of acetylcholine at the post-ganglionic cholinergic receptors.

Question 10

What does the acronym DUMBBELLS signify in OP poisoning?

Answer 10

Diarrhoea
Urination
Miosis
Bradycardia
Bronchospasm
Emesis
Lacrimation
Limp
Salivation, sweating