Mass ethion poisoning with high mortality

Figures & data

Table 1. Patient data

Parameter	Patient 1 male, 55 yrs	Patient 2 male, 14 yrs	Patient 3 male, 55 yrs	Patient 4 male, 28 yrs	Patient 5 male, 35 yrs
Level of consciousness at the time of admission	Conscious	Conscious	Conscious	Stupor Glasgow coma scale E2V3M4	Comatose coma scale E1V1M3
Plasma cholinesterase (U/L) *	2899	234	265	116	173
RBC cholinesterase (U/L) **	1404	716	610	0	0
Routine biochemical, hematological, and other investigations ***	Normal	Normal	Normal	Respiratory acidosis on admission; Leucocytosis and anemia on day 15	Normal
Dose for atropinization (mg)	30	50	30	50	85
Total dose of Atropine given (mg)	336	618	206	432	1000
Total dose of PAM given (g)	15	12	12	15	20
Duration of Hospitalization (days)	25	25	27	54	60
Stay in ICU (days)	2	2	2	28	45
Need of ventilatory support (days)	No	No	No	Yes (19)	Yes (40)
Whether tracheostomy done	No	No	No	Yes	Yes
Complications	Nil	Nil	Nil	Bilateral mid-zone pulmonary consolidation	Cardio-respiratory arrest, hypoxic brain damage
Outcome	Complete recovery	Complete recovery	Complete recovery	Complete recovery	Died after 8.5 months

*Normal value 2900–5800 U/L.

**Normal value 1700–2300 U/L.

***Include routine hematology and urine analysis, random blood sugar, liver and renal function tests, arterial blood gases, chest X-rays, and ECG.

Fig. 1.  Serial plasma cholinesterase levels in ethion poisoning cases.

Fig. 2.  Serial RBC acetylcholinesterase levels in ethion poisoning cases.