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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