The diagnosis of acute organophosphate or carbamate poisoning was based on the following: (1) a history of short-term exposure or contact; (2) the characteristic clinical signs and symptoms; (3) improvement of those signs and symptoms after treatment with atropine and pralidoxime; and (4) decrease in the cholinesterase activity in the serum. Normal values for the serum cholinesterase activity in this hospitals lalxiratory were 3,000 to 6,000 mU/ml. According to the classification of severity, poisoning was defined as severe when the lowest serum cholinesterase activity was less than 300 mU/ml, as moderately severe from 300 to 600 mU/ml, as mild from 600 to 1,500 mU/ml, and as very mild from 1,500 to 3,000 mU/dl.’ asthma inhalers
Respiratory failure was diagnosed as respiratory distress, hypoventilation, and arterial blood gas with a Pa02 of less than 50 to 60 mm Hg and a PaCO, of greater than 50 to 55 mm Hg accompanied by acidemia (pH<7.30).M Cardiovascular collapse (without effective cardiac output) was defined clinically as when peripheral pulsation could not be palpated and bhxxl pressure could not be detected by phlebomanometer, even if there was a heart rhythm on the ECG monitor. The criteria for pneumonia were that there were new pulmonary infiltrates not explained by any other means and with at least two of the following: (1) raised white blood cell count; (2) purulent bronchial secretions; and (3) positive Gram stain and culture of sputum.