上次提過除草劑中毒(Paraquat inoxication 除草劑中毒),一定很多人疑惑,那如果是有機磷中毒的處理方式呢?

在急診:

1.Decontamination from skin

2.Set IV line with N/S

3.Check CBC & Dc, Bio, ChE

4.ABG

5.On N-G tube: Gastric irrigation,Activated charcoal (1gm/kg)

6.CXR

7.EKG

8.ChE < 10% of normal value or ChE < 1000 Start PAM infusion 10ml/hr

9.Atopine infusion: 0.5 ml-1.5 ml/hr if SLUDGE syndrome (salivation, lacrimation,urinary incontinence, gastrointestinal cramping and diarrhea, emesis)

進了ICU之後:

1.Ringer's solution 1000ml IVD Qd

 D5W 1000 ml IVD Qd

  N/S 1000 ml IVD Qd

2.KCL 40 meq IVD Qd

3.NPO, N-G keep open

4.On Foley catheter

5.On CVP check q 2h

6.PAM infusion 10ml/hr

7.Tagamet 1 Amp v q 8 h

8.Atropine infusion 0.5 mg/hr if SLUDGE syndrome and/or Heart rate < 60 times/min(salivation, lacrimation, urinary incontinence,gastrointestinal cramping and diarrhea, emesis)

9.ABG qd & prn

10.Na, K qd

11.ChE qd

12.If on ventilator: CMV, TV 12ml/kg, RR 16, FiO2 40% I/E: 1/2

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