[Pre-hospital systematic treatment for patients with severe acute organophosphorus pesticide poisoning].
OBJECTIVE
To evaluate the feasibility, safety and effectiveness of on-spot systematic treatment for the patients with severe acute organophosphorus pesticide poisoning (SAOPP).


METHODS
Two hundred and twenty-three SAOPP patients were divided into two groups: pre-hospital treatment group (116 patients), in which rescue equipment and drugs were carried to the spot for the treatment of the patients; hospital treatment group (107 patients), in which the patients received emergency treatment after reaching the hospital. The pre-hospital group was sub-divided into group A and group B. In group A, gastric lavage was performed with aid of automatic lavage instrument, and in group B lavage was done by using suspending bucket. Antidotes including pralidoxime chloride and atropine were used simultaneously based on the patients' conditions. Cholinesterase (ChE) activity was dynamically monitored. When the symptoms disappeared, the length of atropinization, the total dosage of atropine and pralidoxime chloride, the recovery time of ChE, the mortality, hospital days, and the incidence of complications were analyzed.


RESULTS
The therapeutic effect in pre-hospital group was better than that in in-patient group in terms of disappearance of the symptoms, length of atropinization, recovery time of ChE, the total dosage of atropine and pralidoxime chloride, hospital days, and the mortality rate in group A was markedly lower than in-patient group(P<0.05 or P<0.01). The incidence of respiratory failure, heart injury, brain injury, and atropine poisoning were also lower in pre-hospital group compared with in-patient group (all P<0.01). However, there were no significant differences in intermediate syndrome, relapse, liver injury (all P>0.05). On the other hand, there were no significant differences in mortality rate and hospital days between two subgroups of pre-hospital treatment group(P>0.05).


CONCLUSIONS
Pre-hospital systematic treatment for SAOPP patients, due to its good effects, should be recommended as a safe and effective treatment strategy.
Wang
Wei-zhan
WZ
Emergency Department, Harrison International Peace Hospital, Hengshui 053000, Hebei, China.
Li
Ya-qin
YQ
Wang
Lan
L
Zhou
Feng-ju
FJ
Wang
Xue-zhong
XZ
Hu
Xiao-xia
XX
Wang
Mei-qin
MQ
Ma
Guo-ying
GY
Kang
Hong-shan
HS
Zhao
Lin-jun
LJ
Li
Jing
J
D000208:Acute Disease; D000328:Adult; D016638:Critical Illness; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D062025:Organophosphate Poisoning; D010575:Pesticides / Q000506:poisoning*; D011041:Poisoning / Q000628:therapy
D010575:Pesticides