Poisoning (Sources: SOPS)

Question 1

How does organophosphate poisoning present?

Answer 1

Muscarinic excess - cough, dyspnoea, resp failure, vomiting, diarrhoea, salivation, lacrimation, hypotension, bradycardia
Seizures

Question 2

How is organophosphate poisoning treated?

Answer 2

Basic PPE -gown, gloves, safety glasses- avoid touching body fluids
Remove clothes and wash body with soap and water if contaminated - this should not however prevent resus
Staff may be irritated by the hydrocarbon solvent - headache, eye irritation, nausea - mild and self-limiting - rotate staff and have good ventilation
Atropine for muscarinic excess: 1-2 mg (50mcg/kg in kids), doubling the dose every 2-3 mins until drying of resp secretions is seen
Control seizures with benzos
I+V if adequate oxygenation and ventilation are not rapidly achieved with oxygen and atropine