Management of organophosphorus pesticide poisoning in Assiut University Children's Hospital

Background
Acute organophosphorus (OP) pesticide self-poisoning is a major global problem. Although pesticide-poisoned patients make high demands on intensive care facilities in industrialized countries, it is in the developing world that practically all deaths occur.
Objective
The aim of this clinical audit is to study to how extent we are following the guidelines of management of OP poisoning in the emergency unit, intermediate care unit, and ICU at Assiut University Children's Hospital.
Patients and methods
The present study included 40 children presented with OP poisoning and admitted to the ICU and intermediate care unit of Assiut University Children's Hospital over a period of 6 months from the October 1, 2018 to March 31, 2019.
Results
The study included 40 patients with OP poisoning. Their ages ranged from 1 to 18 years, the most commonly presented age group was from 1 to 5 years. Ingestion was the most common type of exposure; accidental exposure was more common than self-harm; vomiting and diarrhea was the most common presentation; plasma cholinesterase enzyme was not done in 90% of cases; decontamination and atropinization were done in most of the cases. The most common complication was shock. Regarding the outcome of cases, 90% of the studied cases improved and 10% of them died.
Conclusion
International guidelines for the management of OP poisoning had been followed by personnel working at the emergency unit, intermediate care unit, and ICU at Assiut University Children's Hospital regarding treatment lines and that some of the defaults are due to poor resources and lack of medication.