Concluded Case

A 19yr young girl presented with a/h/o suicidal ingestion of chlorphos..around 50-100ml.. O/E drowsy.. Occasionally responding to v/c.. BP 151/98mmhg HR 135/Min Spo2 90%on 5lt o2 B/l gross crepts + GCS E4M5V5 B/L pupil pin point LR + With intermittent fasiculations.. I admitted her under my care in ICU. Pt was intubated in ER and putted on mechanical ventilation as pts condition deteriorated very soon.. She became unconscious,, not responding,, with b/l chest gross crepts ++.. (ARDS with pul edema?) with persistent seizures.. E1M1V1 She was putted on Pralidoxime infusion,, Atropine infusion,, Lasix,, epsolin,, dexamethasone,, esmolol,, soda bicarb,, magnesium sulphate intermittent bolus doses.. Now after 12 hrs of therapy.. Her GCS has improved,, E4VtM5.. Vitals stable.. Fighting for extubation.. Moving all limbs.. Any more suggestions plz..

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Concluded answer

It was a case of organophosphate poisioning with ARDS with pul oedema.. Patient was treated with mechanical ventilation,, Iv pralidoxime,, Iv atropine,, Iv broad spectrum antibiotics,, Iv soda bicarb,, Iv mgso4,, Iv esmolol,, Nebulization,, Chest physiotherapy,, Now patient is stable after 72 hours and being shifted to my gen female ward..

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Sinus tachycardia...with st dep in v3 v4 v5 v6....

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

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Good management.....

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Ecg S.Tachy Rate related St depression chest leads Nice work sirji

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Congratulations sir for handling such a risky case

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Nice handling

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Inj xone IV BD inj Atropine infusion for 7 days (Taper n stop) Inj Pam for 3 days Inj Glycopyrolate 1amp IV TDS Inj mgso4 12gm IV infusion OD up to decreased secretions and regained consciousness Inj fosolin 1amp IV TDS Inj Para SOS

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Gd case and gd handling sir.... Plz do ct for a day w mech.venti cz xray is showing lot of edema may be she ll nt maintain the sat after extubation...dun be in hurry sir after all ur efforts take time ur time to settle her.......HOPE MLC DONE most imp...

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Congrats for your knowledge n willingness to handke n manage this case .

Thanks a lot sir for ur kind words
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Nyc case update.. managed well ECG shows Sinus Tachy

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