Nnuru a Wɔde Di Dwuma, Organophosphate, ne Kuadwuma mu Nnuru a Wɔde Awuduru Mu Mmoa a Edi Kan¶

Acute exposure to agricultural, industrial, or concentrated household pesticides: especially organophosphate insecticides (such as malathion, parathion, chlorpyrifos, diazinon), carbamate insecticides (aldicarb, carbaryl, propoxur), organophosphate nerve agents, bipyridyl herbicides (paraquat and diquat), ne metal phosphide fumigants (aluminum anaa zinc phosphide): yɛ awuduru ho haw a ɛde nkwa to asiane mu. Unlike ordinary household poisons that only cause harm if swallowed, concentrated organophosphates and nerve agents absorb rapidly right through intact, unbroken skin, through the eyes, and via inhalation of spray mist or vapor, triggering a fatal neurological "cholinergic storm" within minutes.

This guide provides step-by-step field rescue and clinical protocols aligned with directives from the World Health Organization (WHO), the United States Centers for Disease Control and Prevention (CDC), the US Environmental Protection Agency (EPA), the Agency for Toxic Substances and Disease Registry (ATSDR), and the UK National Poisons Information Service (NPIS). Protecting yourself with nitrile or neoprene gloves before touching a contaminated victim, stripping away pesticide-soaked clothing, washing the skin for 15 minutes, and getting emergency atropine and pralidoxime (2-PAM) saves lives.

Yɛ eyi mprempren¶

Sɛ wɔde nnuru a wɔde kum nkoekoemmoa, nnuru a wɔde kum nkoekoemmoa a wɔahyɛ no den, nnuru a ekum nwura, anaa aduru a wɔde kum aburow apete wo so, ahwie agu so, ahome, anaa wamene obi a:

1. Protect yourself first: NEVER touch a pesticide-soaked victim or their vomit with bare hands: Move upwind and uphill away from chemical spray mist, clouds, or enclosed storage sheds immediately. Hyɛ nitrile, butyl rɔba, anaa neoprene nsateaa a nnuru ntumi nhyɛ mu (latex aduruyɛ nsateaa a ɛyɛ tratraa a wɔahyɛ da ayɛ no, organophosphate aduru hyɛn mu ntɛmntɛm) ansa na wode wo nsa aka nea wɔayɛ no bɔne no anaa wɔn ntade. Nkwagyefo a wɔde wɔn nsa ka ntade a wɔde organophosphate ahyɛ mu ma anaa wɔn honam ani a wɔn nsa da hɔ no taa hwe ase esiane awuduru a ɛto so abien nti.
2. Frɛ wo mpɔtam hɔ ntɛmpɛ nɔma ntɛm ara: Frɛ 911 wɔ United States ne Canada, 112 wɔ European Union nyinaa, anaa 999 wɔ United Kingdom (anaasɛ hwɛ yɛn nɔma ahorow a egye ntɛmpɛ nkyerɛwde a wɔde kyerɛw nsɛm). Tell the dispatcher clearly: "Suspected agricultural pesticide or organophosphate chemical poisoning: HAZMAT decontamination and high-dose Atropine required." Also call Poison Control (1-800-222-1222 in the United States) to read the EPA Registration Number or active ingredient off the chemical label.
3. Yi ntade, mpaboa, ne agude a efĩ wom ɔha biara mu nkyem 100 ntɛm ara: Sɛ woyi ntade a wɔde nnuru a ekum mmoawa ayɛ no fi hɔ a, eyi nnuru no ɔha biara mu nkyem 80 kosi 90 fi hɔ ansa na atumi afa honam ani. Fa shears anaa scissors di dwuma de twitwa ntade ne pants sen sɛ wobɛtwe afa nea wɔayɛ no bɔne no ti so (a ɛpopa nnuru fa aniwa, hwene, ne n’ano). Seal all removed clothing and leather boots (leather absorbs pesticides permanently and can never be decontaminated) inside double heavy-duty plastic bags.
4. Wash skin and hair with abundant soap and running water for 15 full minutes: Place the victim under a shower, garden hose, or emergency drench station and wash from head to toe with mild liquid soap or dish detergent and lukewarm/cool water for 15 minutes. Hwɛ yiye titiriw wɔ honam ani nsensanee, nsateaa nnadewa, ti nhwi, ne aso akyi. Do not scrub raw skin with stiff brushes, and do not use scalding hot water, which dilates skin blood vessels and speeds up poison absorption into the bloodstream. Sɛ nnuru a wɔde kum mmoawa petepete aniwa no mu a, fa nsu a ɛnyɛ den anaa nkyene a ɛfata hohoro aniwa no simma 15 (hwɛ aniwa mu apirakuru).
5. Maintain the airway, turn on the side, and NEVER do mouth-to-mouth resuscitation: Organophosphate victims drown in their own profuse saliva, bronchial mucus ("bronchorrhea"), and vomit. Place an unconscious or drooling victim on their side in the recovery position so frothy lung secretions drain out of the mouth. If the heart stops or breathing ceases, perform hands-only chest compressions (CPR a wɔde yɛ adwuma) or use a bag-valve-mask (BVM): never perform direct mouth-to-mouth rescue breathing, which exposes your mouth to lethal pesticide vapor and vomit.
6. Administer an autoinjector if available (DuoDote / Mark I / Atropen): If the incident involves military/industrial nerve agents or agricultural response teams equipped with DuoDote or ATNAA (Atropine + Pralidoxime) autoinjectors, inject straight through the outer thigh muscle immediately if the victim shows difficulty breathing, pinpoint pupils, profuse drooling, muscle twitching, or seizures.

Emergency field decontamination and toxidrome triage flowchart¶

flowchart TD
    Start["Suspected Pesticide, Insecticide, Herbicide, or Nerve Agent Exposure"] --> SceneSafe{"Is the scene safe and are rescuers wearing Nitrile/Neoprene PPE?"}

    SceneSafe -->|No: Vapor cloud, enclosed shed, or bare hands| Evac["Move upwind to fresh air immediately<br/>Put on Nitrile/Neoprene gloves (NEVER thin latex)<br/>Call 911 / 112 / 999 for HAZMAT & EMS"]

    SceneSafe -->|Yes: Upwind with chemical-resistant gloves| Decon["Immediate 80%-90% Source Removal<br/>Cut off all contaminated clothing and discard leather boots<br/>Wash skin & hair with soap and cool/tepid water for 15 minutes"]

    Evac --> Decon

    Decon --> ToxClass{"Identify Chemical Class by Symptoms or Container Label"}

    ToxClass -->|Pinpoint pupils, profuse drooling/sweating, wet lung crackles,<br/>vomiting, diarrhea, slow pulse, muscle twitching| Chol["Organophosphate or Carbamate ('Cholinergic Crisis')<br/>Place in side-lying recovery position to drain lung fluid<br/>Administer Atropine (doubling IV doses every 3-5 min until lungs are dry)<br/>+ Pralidoxime (2-PAM) for Organophosphates + Benzodiazepines for seizures"]

    ToxClass -->|Swallowed blue/green foul-smelling liquid herbicide;<br/>severe burning mouth/throat Ulcers| Paraquat["Paraquat or Diquat Herbicide<br/>Oral fuller's earth or Activated Charcoal immediately (if within 1 hour)<br/>WITHHOLD supplemental Oxygen unless SpO2 < 85%-88%<br/>Emergency ICU hemodialysis / hemoperfusion"]

    ToxClass -->|Garlic/rotten-fish odor after swallowing grain fumigant pellets;<br/>rapid shock and arrhythmias| Phosphide["Aluminum / Zinc Phosphide ('Phosphine Gas' Poisoning)<br/>DO NOT give water or water-based liquids by mouth<br/>Ventilate ambulance/ED; manage cardiogenic shock & acidosis"]

    ToxClass -->|Sudden grand mal seizures with NO drooling/pinpoint pupils<br/>after flea/tick spray or agricultural spray| Pyreth["Organochlorine (Lindane/Endosulfan) or Pyrethroid<br/>15-minute soap wash (Vitamin E oil eases skin paresthesias)<br/>IV Benzodiazepines (lorazepam/diazepam) to stop GABA-block seizures"]

Pathophysiology of the "Cholinergic Storm": Organophosphates and Carbamates¶

Organophosphates (originally developed in the 1930s and 1940s as both agricultural insecticides and military nerve agents like Sarin, Soman, Tabun, and VX) and carbamates are the leading cause of fatal pesticide poisoning worldwide, responsible for over 100,000 deaths annually.

How Acetylcholinesterase (AChE) inhibition floods the nervous system¶

In a healthy human body, whenever a nerve wants to tell a muscle to contract or a gland to secrete fluid, the nerve terminal releases a microscopic puff of the neurotransmitter acetylcholine (ACh) across the synaptic gap. Within a fraction of a millisecond after that message is delivered, a specialized housekeeping enzyme called acetylcholinesterase (AChE) chops the acetylcholine molecule in half (into choline and acetic acid), turning the switch OFF so the muscle can relax and the gland stops secreting.

1. Phosphorylation of the "OFF" switch: Organophosphates and carbamates bind directly to the active serine site of the acetylcholinesterase enzyme, completely paralyzing the enzyme.
2. Relentless Acetylcholine Flood: With the "OFF" switch broken, intact acetylcholine accumulates to massive, toxic levels inside every cholinergic synapse in the body: firing the muscarinic receptors (parasympathetic glands, lungs, heart, eyes, gut), the nicotinic receptors (skeletal muscles and sympathetic ganglia), and the central nervous system non-stop until the victim's lungs fill with fluid and their diaphragm paralyzes.
3. Why Organophosphates are permanent ("Aging") while Carbamates are temporary:
4. Carbamate insecticides (carbaryl [Sevin], aldicarb, propoxur, methomyl) form a reversible carbamyl bond with the AChE enzyme that spontaneously hydrolyzes and releases on its own within 24 to 48 hours.
5. Organophosphate insecticides and nerve agents (parathion, chlorpyrifos, malathion, diazinon, dichlorvos, fenthion) form a rock-solid phosphorus bond that undergoes a permanent chemical transformation called "Aging" (loss of an alkyl group). Once an organophosphate-enzyme bond "ages" (which takes anywhere from 2 minutes for Soman nerve agent to 12 to 48 hours for agricultural insecticides), the enzyme is permanently dead forever. If the patient does not receive the reactivating antidote Pralidoxime (2-PAM) before aging completes, their body has to manufacture brand-new enzyme molecules from scratch over 2 to 6 weeks.

Recognizing the Three-Part Cholinergic Toxidrome: DUMBBELS & Monday-to-Friday¶

Because excess acetylcholine fires three different sets of receptors at the same time, clinicians look for three distinct symptom clusters:

1. Muscarinic Receptor Overstimulation: "DUMBBELS" or "SLUDGE + Killer Bs"¶

Muscarinic stimulation turns on every fluid-secreting gland and smooth muscle in the body. Remember the mnemonic DUMBBELS (or SLUDGE):

• D: Diarrhea and Diaphoresis: Explosive watery diarrhea and drenching, head-to-toe sweating.
• U: Urination: Involuntary loss of bladder control.
• M: Miosis (Pinpoint Pupils): Both pupils constrict down to tiny 1-millimeter pinpoints, causing dim, blurry vision and aching brow pain (ciliary spasm).
• B: Bronchorrhea (The #1 Killer): The mucus glands lining the bronchial tree pour out liters of thin, frothy fluid into the lungs, literally causing the patient to drown in their own lung secretions from the inside out (audible wet crackles and bubbling rales across both lung fields).
• B: Bronchospasm (The #2 Killer): Intense constriction of airway smooth muscle causing severe wheezing and inability to move air.
• B: Bradycardia (The #3 Killer): Profound vagal nerve slowing of the heart rate down to 30 to 45 beats per minute, leading to hypotension and asystolic cardiac arrest. (Together, Bronchorrhea, Bronchospasm, and Bradycardia are known in emergency medicine as the "Three Killer Bs" because they are what actually kill the patient: and what Atropine specifically reverses).
• E: Emesis: Relentless vomiting and severe abdominal cramping.
• L: Lacrimation: Continuous tearing from both eyes.
• S: Salivation: Frothy drooling pouring from the mouth.

2. Nicotinic Receptor Overstimulation: "Days of the Week" (MTWtFS)¶

While muscarinic receptors slow the heart and flood the lungs, simultaneous stimulation of nicotinic receptors on skeletal muscles and adrenal/sympathetic ganglia causes neuromuscular depolarization blockade. Remember the days of the week (M-T-W-t-F-S):

• M: Mydriasis (rare early sympathetic pupil dilation): Occasionally seen early before muscarinic pinpoint miosis dominates.
• T: Tachycardia: Early sympathetic adrenaline surge can temporarily cause a fast heart rate and high blood pressure before vagal bradycardia takes over (never withhold atropine in a wet, drooling patient just because their heart rate is currently fast).
• W: Weakness (Flaccid Paralysis): After brief overstimulation, the neuromuscular junction depolarizes and locks up, causing profound skeletal muscle weakness and paralysis of the diaphragm and intercostal breathing muscles.
• t: Tremors and Hypertension.
• F: Fasciculations (Worm-like Muscle Twitching): Visible rippling, worm-like involuntary twitches across the eyelids, tongue, calves, chest, and shoulders: a pathognomonic nicotinic sign that atropine cannot fix (requires Pralidoxime / 2-PAM).
• S: Seizures and Sweating.

3. Central Nervous System Toxicity: Anxiety, Coma, and Status Epilepticus¶

Lipid-soluble organophosphates cross the blood-brain barrier rapidly, causing agitation, restlessness, slurred speech, confusion, ataxia, central respiratory drive depression, deep coma, and violent cholinergic status epilepticus seizures (treated with intravenous benzodiazepines like diazepam, lorazepam, or midazolam).

Master comparison of Agricultural Pesticides and Household Insecticides¶

Ayaresabea Nnuru a Wɔde Ko Tia Organophosphate Awuduru Ho Nhyehyɛe¶

Sɛ ɔyarefo bi a ɔwɔ organophosphate anaa carbamate awuduru a emu yɛ den ba adwumayɛbea a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu a, sikɔne kakraa bi na ɛho hia. Nnipa a wɔsan nya nkwa no di nhyehyɛe a ɛyɛ katee akyi: Efĩ a wɔde fi nipadua mu + Mframa kwan so ahobammɔ \(\rightarrow\) Atropine Doubling Regimen \(\rightarrow\) Pralidoxime (2-PAM) \(\rightarrow\) Benzodiazepines.

1. Atropine Doubling Regimen: Titrating to "Ahurututu a Ɛyow," ƐNYƐ Asuafo Kɛse¶

Wɔ komayare a wɔtaa yɛ anaasɛ bradycardia a ɛnyɛ den mu no, nnuruyɛfo ma atropine miligram 0.5 kosi 1 kosi miligram 3 a ɛboro so. Wɔ organophosphate awuduru a emu yɛ den mu no, miligram 3 yɛ ade a ɛtɔ gu bokiti mu: ayarefo taa hia atropine a wɔde fa ntini mu 20, 50, anaa bɛboro miligram 100 mpo wɔ nnɔnhwerew kakraa a edi kan no mu na ama wɔatumi atra ase.

• Sɛnea atropinization a ɛkɔ soro ntɛmntɛm yɛ adwuma:
• Nnuruyɛfo de Atropine** miligram 1 kosi 3 a wɔde fa ntini mu ntɛm ara wɔ mpanyimfo mu (0.02 kosi 0.05 mg/kg wɔ mmofra mu) na efi ase.
• San fa afiri a wɔde tie asɛm no susuw ɔyarefo no koko ho simma 3 kosi 5 biara.
• Sɛ ahurututu mu mpaapaemu a ɛyɛ nsu (ahurututu mu akisikuru), ahurututu mu akisikuru (ahurututu mu akisikuru), anaasɛ mogya mmoroso/koma a ɛyɛ mmerɛw ( .HR < 80 bpm) kɔ so tra hɔ simma 3 kosi 5 akyi, DOUBLE dodow a atwam (sɛ nhwɛso no: \(2\text{ mg} \rightarrow 4\text{ mg} \rightarrow 8\text{ mg} \rightarrow 16\text{ mg} \rightarrow 32\text{ mg}\) simma 3 kosi 5 biara) kosi sɛ wobenya "Atropinization" awie, na afei woafi ase ayɛ IV a ɛkɔ so dɔnhwerew biara atropine a wɔde ma (ɔha biara mu nkyem 10 kosi ɔha biara mu nkyem 20 wɔ nneɛma a wɔde gu mu nyinaa mu dɔnhwerew biara).
• Dɛn ne Atropinization awiei ankasa?:
• Ahurututu mu tew wɔ auscultation so (bronchorrhea ne ahurututu a wogyae koraa sɛnea ɛbɛyɛ a ɔyarefo no betumi ahome na wɔama no mframa a ɔmmɔ mmɔden biara).
• Koma a ɛbɔ boro 80 wɔ simma biara mu ne systolic mogya mmoroso boro 80 kosi 90 mmHg.
• Abasa (axillae) a ɛyɛ nwunu.
• Ayaresa mu mmara a ɛho hia: MMA NNnyae atropine a wɔde ma no DA esiane sɛ ɔyarefo no ani so trɛw anaasɛ esiane sɛ ne koma bɔ 110 simma biara nti sɛ wɔn ahurututu da so ara yɛ nsu a ɛyɛ nsu ahyɛ mu ma a. Aniwa a ɛtrɛw no nyɛ awiei a wotumi de ho to so (titiriw sɛ wɔde nnuru a ekum nkoekoemmoa petepete aniwa no mu tẽẽ a), na hypoxia anaasɛ ehu ankasa de koma a ɛyɛ den ba. Wode atropine sa yare kosi sɛ ahurututu no bɛyow.

2. Pralidoxime (2-PAM / Obidoxime): Ntini a Abubu no Bue¶

Esiane sɛ atropine siw muscarinic receptors (ahurututu no ma ɛyow na ɛsiesie koma no bɔ) nkutoo na ɛwɔ nsunsuanso biara wɔ nicotinic skeletal muscle receptors so nti, ɔyarefo a atropinized koraa a n’ahurututu ayɛ kusuu no da so ara betumi awu nicotinic diaphragm ne respiratory muscle paralysis.

• How Oximes work: Pralidoxime (2-PAM) (dosed at 1 to 2 grams IV over 15 to 30 minutes in adults, or 20 to 50 mg/kg in children, followed by a continuous IV infusion of 500 mg/hour or 8 to 10 mg/kg/hour) acts as a molecular crowbar. It attacks the phosphorus atom of the organophosphate molecule, pulling it off the acetylcholinesterase enzyme and restoring full natural enzyme activity at both skeletal muscles and muscarinic sites: provided it is given before irreversible "aging" locks the bond permanently.
• Intubation warning (Never use Succinylcholine): If an organophosphate or carbamate patient requires rapid-sequence endotracheal intubation, clinicians must never use the paralytic drug succinylcholine, because succinylcholine is normally broken down by plasma butyrylcholinesterase (pseudocholinesterase). Since the pesticide has destroyed all cholinesterase enzymes, a single dose of succinylcholine causes hours of prolonged paralysis. Instead, non-depolarizing neuromuscular blockers (such as rocuronium) are used.

3. Watching for the "Intermediate Syndrome" (24 to 96 Hours Later)¶

Even after a patient survives the initial Day 1 cholinergic crisis and appears to be recovering well in the hospital, 10 to 40 percent of patients poisoned by highly lipid-soluble organophosphates (such as fenthion, dimethoate, parathion, or chlorpyrifos) suddenly develop the "Intermediate Syndrome" 1 to 4 days (24 to 96 hours) after exposure:

• Sudden delayed paralysis: Without recurrent drooling or wet lungs, the patient develops acute paralysis of the neck flexors (inability to lift their head off the pillow: the earliest warning sign), cranial nerves, proximal shoulder/hip muscles, and respiratory muscles (diaphragm), requiring immediate re-intubation and mechanical ventilation for 5 to 15 days until neuromuscular junctions recover.
• Organophosphate-Induced Delayed Neuropathy (OPIDN): Occurring 1 to 3 weeks after certain exposures, causing cramping calf pain, numbness, tingling, and "stocking-and-glove" foot drop/wrist drop weakness.

How to Use Autoinjectors: DuoDote, Mark I, and Atropen¶

In military, hazardous materials (HAZMAT), emergency medical services (EMS), and certain industrial agricultural settings, responders carry spring-loaded intramuscular autoinjectors designed to deliver Atropine and Pralidoxime (2-PAM) through clothing into the outer thigh within seconds of an organophosphate or nerve agent exposure.

Dosing by Severity and Autoinjector Type¶

1. Adult Autoinjectors (DuoDote or ATNAA / Mark I Kit):
2. Each DuoDote single-barrel autoinjector delivers 2.1 milligrams of Atropine and 600 milligrams of Pralidoxime Chloride sequentially through a single needle (the older Mark I Kit uses two separate injectors: Injector #1 contains 2 mg Atropine, and Injector #2 contains 600 mg Pralidoxime).
3. Mild to Moderate Symptoms (pinpoint pupils, runny nose, drooling, tightness in chest, nausea, but patient is still walking and speaking): Administer 1 DuoDote (or 1 Mark I set) into the mid-lateral outer thigh (vastus lateralis). Wait 10 to 15 minutes; if symptoms do not improve, seek medical care for additional doses.
4. Severe Symptoms (unconsciousness, convulsions/seizures, severe respiratory distress/gasping, apnea, or flaccid paralysis): Immediately administer 3 DuoDote autoinjectors (or 3 Mark I sets) in rapid succession into the outer thigh, plus 1 Diazepam (CANA 10 mg) or Midazolam (10 mg) anticonvulsant autoinjector even if visible seizures are not obvious (as paralyzed nerve-agent victims frequently suffer non-convulsive status epilepticus in the brain).
5. Pediatric Atropen Weight-Based Dosing:
6. Young children exposed to organophosphates or nerve agents require weight-scaled Atropen autoinjectors (available in 0.25 mg [yellow label, for infants under 7 kg / 15 lbs], 0.5 mg [blue label, for children 7 to 18 kg / 15 to 40 lbs], 1.0 mg [dark red label, for children 18 to 41 kg / 40 to 90 lbs], and 2.0 mg [green label, for over 41 kg / 90 lbs]).
7. Important life-saving rule: If a child has life-threatening organophosphate or nerve agent poisoning (frothy lung secretions, gasping, coma, or seizures) and only an adult 2 mg Atropine / DuoDote autoinjector is available on scene, administer the adult autoinjector to the child immediately. Temporary atropine tachycardia and dry skin are completely survivable, whereas untreated cholinergic respiratory arrest is fatal in minutes.

Step-by-Step Autoinjector Injection Technique¶

• Step 1: Check the outer thigh pocket: Quickly feel the mid-outer thigh to make sure you are not injecting into a wallet, keys, smartphone, or thick belt buckle.
• Step 2: Pull off the gray safety cap: Hold the DuoDote barrel in your fist with the green tip pointing downward (never put your thumb over the green needle end). Pull the gray safety release cap straight off the back.
• Step 3: Jab firmly at a 90-degree angle into the mid-outer thigh: Swing and press the green tip firmly into the meaty outer thigh midway between the hip and the knee until you hear and feel the spring click.
• Step 4: Hold firmly in place for 10 full seconds: Count slowly to 10 ("one-one-thousand, two-one-thousand...") so both chambers (atropine and pralidoxime) empty completely into the muscle.
• Step 5: Bend the needle into a hook and pin it to the victim's collar: Pull the injector straight out, massage the thigh for a few seconds, and bend the exposed needle into a "J" hook against a hard surface so you can hook the empty autoinjector onto the victim's shirt pocket or triage tag. This tells arriving paramedics and emergency physicians at a glance how many doses of atropine and 2-PAM the patient has already received.

Nsɛm a wɔtaa bisa¶

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This guide is for informational purposes and does not replace professional medical evaluation or hands-on training. Because severe chemical poisonings can cause sudden respiratory arrest, we recommend taking an accredited first aid and CPR course through the International Federation of Red Cross and Red Crescent Societies (IFRC), your national Red Cross society, St John Ambulance, or a certified local training provider.

Sources a wɔhwɛɛ mu¶

• World Health Organization (WHO): Clinical Management of Acute Pesticide Intoxication: Organophosphorus, Carbamate, and Paraquat Poisoning Guidelines.
• Centers for Disease Control and Prevention (CDC, United States) & Agency for Toxic Substances and Disease Registry (ATSDR): Medical Management Guidelines for Nerve Agents and Organophosphate Pesticides and Paraquat Clinical Guidance.
• US Environmental Protection Agency (EPA, United States): Recognition and Management of Pesticide Poisonings (6^th Edition).
• National Poisons Information Service (NPIS, United Kingdom) & UK Health Security Agency (UKHSA): TOXBASE Clinical Management of Organophosphates, Carbamates, Paraquat, and Metal Phosphides.

Akwankyerɛ ahorow a ɛfa ho¶

• Mmoa a edi kan a wɔde ma awuduru ne awuduru a wɔde siw ano triage
• Ɔhyew a emu yɛ den ne nnuru a ɛma honam ani yɛ hyew
• Hydrofluoric acid, rust remover, and industrial chemical burns
• Aniwa mu opira ne nnuru a wɔde gugu aniwa so
• CPR ne ahomegye a wɔde gye nkwa ma mpanyimfo
• Nnɔmba a egye ntɛmpɛ sɛnea ɔman biara te