Abstract:
Poisoning due to pesticides is an important cause of morbidity and mortality worldwide. About threemillion cases
of poisoning occur worldwide annually, mostly in developing countries withOrganophosphates poisoning (OPP)
being seen more commonly compared to others. With more than200,000 deaths each year in developing
countries. The study setting was Intensive Care Unit (ICU) ofMoi Teaching and Referral Hospital (MTRH), a
public referral hospital serving North Rift and WesternKenya. Sampled were patients admitted to ICU due to
poisoning, between 2006 and 2010, both yearsincluded. Objectives were to determine the number of poisoning
cases in the critical care setting, clinicalinterventions given and establish the patients’ management outcomes
among these patients at MTRH.The study adopted a retrospective records and charts review, where by poisoning
cases possibly due to carbamates, amitraz and organophosphate were reviewed. Cases were identified through
the use ofIntensive Care Unit admission register and forwarded to the department of health records for retrieval
ofthe case files. Data was collected by the researchers themselves by use of a predesigned patient recordsreview
check list and charts review. Results showed that the ages ranged from 1 year to 63 years oldpatients with a mean
of 25 +14.8years. The male to female ratio was 1.5:1. During the study period therewere total of 1063 ICU
admissions of whom 85 were poisoning cases. Categorizations of poisoning forpurposes of diagnosis or
management as organophosphate, amitraz or any other was rarely done henceall were usually treated as
‘organophosphate poisoning (OPP)’.Atropine injection and mechanicalventilation remained the mainstay
treatment of these poisoning cases. The mortality rate due topoisoning in ICU was 10.4% and none died in the
wards after being discharged from the ICU. Whetheror not PAM was used did not seem to make significant
difference. Though management of these caseswas found to be inadequate due to lack of protocols, clinical
judgment, some essential drugs andequipment it still yielded some positive outcomes.
