Analysis of emergency laboratory parameters of various poisonings in tertiary care teaching hospital

Aim: India is predominantly an agricultural country; pesticides and insecticides are abundantly used during cultivation. The adult mortality rate due to mixed drug poisoning in rural south India is 0.97/1000 persons/year. Only 70%–80% of patients admitted to hospitals survive. The present study is undertaken to identifying the association of laboratory parameters with different poisoning etiologies which may help in predicting the need for ventilator support to reduce the mortality by timely entry into emergency department (ED). Materials and Methods: A prospective study on the mixed poisoning of 964 cases was done in the ED at Narayana Medical College Hospital, Nellore, Andhra Pradesh, for 8 years (from 2009 to Jan 2016). Clinical and laboratory data were recorded for all patients on admission (time 0) and 24 h later (time 24). The severity of patients graded according to the Glasgow Coma Scale (GCS) classification. Results: Among 964 patients, in the present study, the majority of the patients in the study group were males, and higher age group affected was 40–50 years. Agricultural farmers and rural residents were highly consumed pesticides. In the study, ingestion poisoning 95% had common occurrences than inhalation poisoning 5%. In severity categorization, we observed that 28.4% of patients were in mild condition, 55.6% in moderate, and 16% in severe. Mean, GCS scoring system was statistically significant between time 0 and time 24 in the survivors. Low GCS at admission was vulnerable for ventilator support. Cholinesterase activity was measured significantly depressed in the Grade 1, 2, and 3. Conclusions: The present study concludes that the need for ventilatory support in organophosphoros poisoning was significantly more in patients who consumed chlorpyrifos methyl parathion compounds, airway edema secondary to hair dye poisoning, presence of cholinergic crisis, GCS score of <6, and cardiovascular collapse secondary to aluminum poisoning.