Organophosphorus agents
Organophosphate and carbamate insecticides are responsible for 100,000+ deaths worldwide, particularly in developing countries due to its availability. Organophosphorus agents can be broken down into three groups:
Month March 2019
Organochlorines
Chlorinated pesticides are widely used in agriculture but the most common source or organochlorines is Lindane, used for the treatment of head lice. Acute ingestion or repeated large dermal expose causes neurological toxicity which can lead to seizures and a coma.
Hydrogen peroxide
Hydrogen Peroxide is an oxidising agent used widely in domestic and industrial products. It causes damage by three main mechanisms: direct corrosive injury, oxygen gas formation and lipid peroxidation.
Hydrofluric acid
Hydrofluoric acid is found in car wheel cleaners, rust removal and glass etching solutions. Classically the person will present with pain out of proportion hours after dermal exposure.
Glyphosate toxicity
Glyphosate is a widely used herbicide. It can cause gastrointestinal corrosive symptoms and due to the surfactant that is present a severe metabolic acidosis, hyperkalaemia and cardiovascular collapse can occur.
Corrosive ingestions
Corrosive ingestion: Patients who are asymptomatic at 4 hours and tolerating oral fluids can be medically cleared. Symptomatic patients need to remain nil by mouth and are admitted for observation and further investigation within 24 hours. Management is then directed dependent on these findings.
Dressler syndrome
Dressler syndrome: Fibrinous or fibrinohaemorrhagic secondary pericarditis that occurs as a result of injury to the heart or pericardium, either from myocardial infarction (MI) or cardiac surgery. Also known as post myocardial infarction syndrome
Tuohy Needle
Tuohy Needle with Huber point: Non-coring type needle with a transversely curved wall and side hole giving it a long, sharp, curved tip. EB Tuohy (1946)
Funtabulous International Women’s Day
Some good old fashioned medical trivia FFFF, introducing the Funtabulous International Women's Day Quiz for 2019 with Dr Colleen Taylor
Funtabulously Frivolous Friday Five 191
Funtabulously Frivolous Friday Five 191 - Just when you thought your brain could unwind on a Friday, some medical trivia FFFF.
Pacemaker Panic #2
An ECG case of pacemaker failure. Can you guess the underlying cause of the Pacemaker Panic?
Lessons from Osler 004
Sir William Osler teaches us to treat the patient, not the disease. Even if the patient is difficult.