Kala Pathar Poisoning Management

Kala Pathar Poisoning Management:

Investigations.

Complete blood count ( TLC will be decreased)
CPK ( creatine phosphokinase ) will be increased
Renal function test (will show increased urea and creatinine)
Serum Electrolyte (will show hyperkalemia, hyperphosphatemia, and hypocalcemia)
Arterial blood gas (ABG) will reveal metabolic acidosis
Urine examination will reveal (Proteinuria, hemoglobinuria, haemosidrinuria

Management.

There is no specific Antidote available so treatment will be supportive and symptomatic.

AIRWAY: Perform tracheostomy and monitoring of ABGs

BREATHING: Assure O2 and assisted ventilation if required

CIRCULATION: Intravenous access by introducing wide bore I/V line. Assess fluid status by pulse rate, JVP and blood pressure (in both sitting and supine conditions), urine output by catheterizing the patient

Gastric lavage: perform gastric lavage by activated charcoal (2gm) every 6 hours.

FOR Laryngeal Edema and ARDS: give injection hydrocortisone sodium succinate, 500mg five times a day + injection pheniramine maleate 4mg every 8 hrs.

FORCED DIURESIS :give 5-6 litres of I/V fluids +inj Sodium bicarbonate 75 mmol +inj Furosemide 20mg every 8 hours .give inj Mannitol 250cc if oligouric

For Hyperkalemia: give inj calcium gluconate 8 hourly salbutamol nebulization every 3 hours.

Cardiac Support: if hypotension persists, adequate fluid resuscitation, give inj Dopamine infusion at the rate of 6-8 micrograms/kg body weight per minute in order to maintain systolic blood pressure above 90mmHg

Repeat the investigations

Refer to Psychiatrist for patient counseling.