Diagnostic and Therapeutic Problems of Parathion Poisonings

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Abstract
A successful outcome to poisoning by parathion not only depends upon the speed with which this medical emergency is diagnosed, but also upon the vigor with which combined atropine and 2-PAM [pralldoxime] therapy is initiated and maintained. In the handling of a 14 year old Negro girl who had purposely ingested approximately 450 mg of 15% parathion powder, several situations and pitfalls were encountered which illustrated the diagnostic and therapeutic problems. Initially, the collection of oxalated rather than heparinized blood and the analysis of stomach contents by spectrophotometric rather than gas chro-matographlc methods delayed the commencement of specific therapy. Later, with the goal of treatment being maintenance of adequate atropini-zatlon until all poison had been eliminated, continuous monitoring of urinary paranltrophenol rather than chollnesterase inhibition data provided the most valuable Information. Finally, since this was the 1st detection of parathionemia in man, the added diagnostic specificity of this was appreciated and demonstrated the feasibility of confirmation of the nature of gas chromatography peaks by epidemlological and chemical techniques.

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