Cypermethrin poisoning detoxification method

Chlorpyrifos is a type of pesticide. If this pesticide is accidentally ingested, first aid should be given promptly. If treatment is delayed, it may even be life-threatening to the patient. First aid requires gastric lavage, which means reducing the pesticide content to a minimum. After gastric lavage, catharsis can be used, such as oral catharsis drugs, to promote the metabolism of some residual toxic substances in the intestines.

1. Gastric lavage

In case of oral pesticide poisoning, gastric lavage is the first choice. In view of the risks of gastric lavage, a routine informed consent form was signed. 1. Use a fully automatic gastric lavage machine to prepare gastric lavage solution with appropriate temperature. Two barrels (1L/barrel) of gastric lavage solution can be prepared at one time for use. According to the nature of the poison, choose the appropriate gastric lavage solution to avoid "adding fuel to the fire". Commonly used gastric lavage solutions: warm water, normal saline and 0.45% saline, which are often used for unknown poisons. Clean water is generally used, and the temperature is preferably between 30°C and 37°C. Water that is too warm will cause blood vessels to dilate, accelerating the absorption of poisons. Water that is too cold will stimulate the stomach wall, promote gastrointestinal motility, and cause poisons to enter the small intestine, increasing the chance of poison absorption. At the same time, water that is too cold will cause chills in the patient and worsen the condition.

2. The body position for gastric lavage is generally left lateral decubitus, with the pylorus in a high position, the head lower than the waist, and the mouth lower than the larynx to reduce the amount of gastric contents entering the intestinal cavity, reduce the absorption of toxins, and prevent gastric juice from accidentally entering the trachea. During gastric lavage, pay attention to changing body positions and gently massaging the stomach area, which will help remove toxins in the folds of the gastric cavity, otherwise there will be blind spots in gastric lavage. 3. Make sure the gastric tube enters the stomach and use a thicker gastric tube to avoid blockage of the side hole. Insert the gastric tube and confirm that it has reached the stomach. Generally, seeing the gastric contents is used as the "gold standard", and then quickly connect to the gastric lavage machine. First press the "suction button" to suck out the stomach contents. At this time, if the poison is unknown, a sample can be retained. Press the "flush key" again to flush in the gastric lavage solution. Gastric lavage should be performed repeatedly until the lavage fluid is clear and odorless, usually about 3-5L is required. If the amount of gastric lavage fluid is large, attention should be paid to electrolyte imbalance. 4. Notes on gastric lavage a. The time for gastric lavage does not have to be limited to the 6-hour emptying time of the stomach. b Gastric lavage: when the poison is not clear, the first aspirated sample should be retained for poison identification. c For patients in severe coma with obvious cyanosis, endotracheal intubation should be performed first, followed by gastric lavage through a gastric tube. d During gastric lavage, other rescue measures should be carried out at the same time. Gastric mucosal protective agents and acid-suppressing drugs can be used after gastric lavage. eFor comatose and uncooperative patients, perform routine gastric lavage using a gastric tube. fFor patients who have taken poison and are conscious, psychological counseling should be provided during the process of intubation and gastric lavage.

2. Catharsis

After oral administration or gastric lavage, laxatives are injected through a gastric tube to promote the excretion of residual toxins in the intestines. Commonly used ones include 500ml of 5% magnesium sulfate, or 500ml of 20% mannitol + 500ml of 5% isotonic saline. Traditional Chinese medicine such as rhubarb has a definite cathartic effect and can be used as appropriate.

3. Adsorption

Medicinal charcoal is the most commonly used adsorbent. Medicinal charcoal has the characteristics of small particles and large surface area, and is a safe and reliable adsorbent. It non-specifically binds to the poison to form a complex, making it unable to be absorbed. Can be used for many patients with oral poisoning. Dosage: 50-100g for adults, 1-2g/kg for children, add water to make a suspension, take orally or inject through a gastric tube, then suck out, repeat several times. Medicinal charcoal can be taken with solution or mannitol. The former accelerates the passage of medicinal charcoal through the intestines, and the latter makes it easier for patients to accept. It can also be placed in the stomach after gastric lavage at 30g (0.3g/100 tablets/bottle). Medicinal charcoal has few adverse reactions. In addition to its poor appearance, large doses can rarely cause intestinal obstruction; accidental inhalation into the lungs can cause serious complications. It is worth noting that some clinical doctors only use 20-30 tablets after gastric lavage, and the adsorption dose is far from enough because this is used for rescue, not ordinary medication. You can also use Smecta (montmorillonite powder), but the dosage must be greater than the usual dosage for treating diarrhea to ensure effective absorption.