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11:26 p.m

Sunday 04 September 2022

Books – Ahmed Gomaa:

The Ministry of Health and Population has distributed a treatment protocol to handle cases of “yellow disc” poisoning to the directorates of health affairs and hospitals at the level of the Republic.

The protocol prepared by the Central Department of Urgent and Critical Care at the Ministry included an introductory paper on the yield tablet, including its composition and use, how to be exposed and how to treat poisoning cases, guided by scientific evidence published by Egyptian and international universities in this regard.

The administration emphasized that it is circulated to all public, central and qualitative hospitals, and warned about the commitment to follow what is stated in the protocol.

The treatment protocol – which Masrawy obtained – was aimed at preventing the introduction of water into the patient’s stomach or the work of gastric lavage with a solution of potassium permanganate salt.

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Yield tablets consist of aluminum phosphide compound and are used to preserve crops against spoilage-causing pests. These tablets are kept in sealed containers away from moisture. When used, the storage space for the granules in sealed rooms or silos is calculated, and then the tablets are placed.

When the tablets are exposed to atmospheric humidity, phosphine gas rises to eliminate the pest affecting the pellets, and every precaution is taken to avoid inhalation of phosphine gas.

As for the mechanism of poisoning, the protocol referred to the inhalation of phosphine gas inside the storage room, or swallowing with the intention of suicide or neglect within the reach of children.

When the tablet is exposed to stomach acid, phosphine gas is released, a cytotoxic compound that inhibits vital cellular enzymes and causes direct tissue erosion and circulatory collapse, leading to direct effects on the heart muscle in addition to fluid loss.

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Treat cases of disc poisoning:

– The patient is given coconut oil or paraffin oil (from 2-5 bottles of 50 ml) if the patient can swallow or through the rail if he cannot swallow, and the oil is left in the patient’s stomach, as the oil contains the pill and the most important thing is that it maintains the bond between aluminum and phosphide, prevents the emergence of phosphine gas, which affects the heart muscle.

– Sodium bicarbonate (1-2 IV ampoules) is given as an initial dose before the result of the analysis appears to contain the resulting acidity.

– There is no antidote for treatment and activated charcoal is not given because it has no role.

The patient is transferred to an intensive care unit to receive the necessary support measures

– A blood gas analysis is done and the bicarbonate in the blood is corrected until it reaches 20

– Do an electrocardiogram and heart enzymes to show its effect on the heart. If it works effectively, intravenous solutions are given to increase the pressure. If there is a weakness or failure of the heart muscle, do not give intravenous solutions, because this will be an extra burden on the heart, and noradrenaline is given by means of a solution pump.

The patient is given an antispasmodic and an injection to reduce absorption

Put the patient on oxygen

Intravenous acetylcysteine ​​may be administered according to specific doses.

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