OP COMPOUND POISONING
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A 65 year old male patient came to casualty with Consumption( profenofes) OP compound around 40 ml on 3/2/21 at Chityala
Patient was brought to casualty at 4.30 p. m. On 3rd feb
H/o 2episodes of vomitings
No h/o involuntary micturition/loose stools
7th feb
He also complained of left leg pain
He also complained of dry cough and chest pain
PAST HISTORY
N/k/c/o DM,HTN,CAD,Asthma
PERSONAL HISTORY
Diet:mixed
Appetite:normal
Sleep: adequate
Bowel and bladder movements:regular
Addictions: Toddy-1L/day
Chutta 2/day
ON EXAMINATION:
Pt conscious, coherent and cooperative
Pallor, Icterus,cyanosis, lymphadenopathy, clubbing, Edema-absent
VITALS
Temp- 98.6°F
BP- 120/70 mmhg
PR- 82 bpm
Rr- 18 cpm
Spo2- 98% at RA
Cvs- S1 S2 +,no murmurs
Cns- no fnd
Rs - BAE +
P/A : soft , non tender
Pupils : bilateral NSRL
Investigations :
PH - 7.38
PCO2- 37.9
PO2- 82.7
HCO3- 22.0
Spo2 : 93
D dimer - 10ng / ml
Serum cholinesterase : 4313U/L
HEMOGRAM :
HB: 12.7
TLC : 5100
RBC : 4.36million/cu3
RFT :
sr cr : 0.7
Urea : 24
Na+ : 142
K+: 3.7
LFT :
TB: 1.96
DB: 0.83
AST: 48
ALP : 188
TP: 6.5
ALB : 2.7
A/G : 1.02
INVESTIGATIONS:
ECG
CHEST XRAY
Impression:
A plain chest x-ray showing the well defined homogeneous opacity noted in the left lung lower zone.
Blunting of left costophrenic angle is noted
PROVISIONAL DIAGNOSIS :
OP compound poisoning
Treatment given
-Gastric lavage was done passing ryles tube until clear fluid is seen
-T. Activated charcoal 100 capsules via ryles
- inj. Intralipid 100 ml IV stat given
- inj.PAM 2 gms IV stat
- inj. Pantoprezole 40 Mg IV stat
- inj. Ondensetrone 4mg IV STAT
- INJ. GLYCOPYRROLATE 0.5ML IM stat
PLAN OF TREATMENT :
Inj. AROPINE 2cc in 10 ml NS/IV/ STAT
Ivf 0.9% NS, DNS @Urine output + 100
Inj. PAN 40 mg / IV / OD
Inj. PAM 1 GM /IV / TID
inj. Zofer 4mg/IV / TID
1000ml DNS in 12 hrs
DISCUSSION:
Profenofes is an organophosphate insecticide used in cotton fields, it is used to kill cotton aphid,cotton bollworm,white flies,tobacco budworm.
This compound has moderately severe toxicity causing relatively delayed respiratory failure and death.
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