The Importance of Emergency Medicine Education for the Decrease of Mortality of Organophosphate Poisoning

Abstract

Objectives: Organophosphates are commonly used as insecticides and pesticides throughout the world. Orgonaphosphate intoxications is not rare due to its intentional exposures. The aim of this study was to investigate the effects of emergency medicine education on the mortality of organophosphate intoxications. Materials and Methods: Patients admitted to the emergency deparment (ED) due to theorganophosphate intoxications between 01.01.1995 and 31.12.2006 were evaluated retrospectively. The study period was categorized into three period as foloows: ED without emergency medicine resident, ED with junior ED residents and residents from other departments working together, ED only with ED residents, respectively. Patients were classified to have mild and severe intoxications. The administration of pralidoxime and atropine and intubation processes of patients were recorded. Results: Methamidophos and Dichlorvos were the most frequent organophosphate compounds established in all organophosphate poisoning patients. The frequency of severe cases were 36.7%, 60.7% and 26.3%, respectively. The mortality rates were also 26.9%, 10.8% and 3.8%, respectively. In the first and second period, all patients were administered pralidoxime and atropine. Although there was not a standart administration protocole for pralidoxime and atropine in the first period, pralidoxime and atropine were given consistent with the recommondations of World Health Organization. In the third period, all the patiets with severe organophosphate intoxication had pralidoxime and atropine administration. Pralidoxime was administred to the 71.1% (n=42) of mild cases and atropine to the 67.1% (n=37). All the patients had pralidoxime and atropine consistent with the recommondations of World Health Organization. Conclusion: The care of patients with organophosphate intoxication were implemented more properly with the physicians trained on emergency medicine and experienced on toxicology.