The time and severity of the symptoms of organophosphorus pesticide poisoning are closely related to the entry route, the nature of the pesticide, the amount of entry and absorption, and the health of the human body. Generally, acute poisoning usually occurs within 12 hours. If high concentration or highly toxic organophosphorus pesticides are inhaled or taken orally, symptoms and even death can occur within a few minutes to ten minutes. The onset of skin contact poisoning is relatively slow, but severe symptoms can be manifested after absorption. Dizziness, headache, nausea, vomiting, salivation, sweating, blurred vision, fatigue, etc. may occur in the early or mild stage of this type of pesticide poisoning. Increased secretions, dry and wet rales and wheezing in the lungs, abdominal pain, diarrhea, trance, staggering, bradycardia, fever, chills, etc. Severe cases often include tachycardia, atrioventricular block, atrial fibrillation and other abnormal heart rhythms, increased or decreased blood pressure, cyanosis, dyspnea, foaming of the mouth and nose, and even blood (pulmonary edema), convulsions, coma, size Fecal incontinence or urinary retention, quadriplegia, loss of reflexes, etc., may be due to respiratory paralysis or associated with circulatory failure and death. Respiratory and ocular symptoms appear earlier in patients with inhalation poisoning, gastrointestinal symptoms often occur first in oral poisoning, and local sweating and contraction of adjacent muscle fibers are the initial manifestations of skin contact poisoning. Erythema-like changes often appear at the contact between dichlorvos and the skin, and gradually become blisters. The patient had itching and burning sensation. The clinical manifestations of organophosphorus poisoning in children are sometimes very atypical: some children mainly show neurological symptoms such as headache, vomiting, visual hallucinations, convulsions, coma, etc.; some mainly show digestive system symptoms such as vomiting, abdominal pain, dehydration, etc. In addition, some poisoned children are mainly characterized by circulatory system symptoms, such as slowing or increasing heart rate, blood pressure drop, and shock; There are wet and dry rales, wheezing, etc.; occasionally poisoned children only have a single symptom or sign as the main manifestation, such as high fever, abdominal pain, convulsions, limb flaccid paralysis, unstable walking leading to fall, systemic edema with changes in urine routine Therefore, it is sometimes misdiagnosed as encephalitis, meningitis, acute gastroenteritis, intestinal ascariasis-type dysentery, pediatric or neonatal pneumonia, nephritis, epilepsy, acute infectious polyradiculitis drugs (such as barbiturates) Opioid chlorpromazine (chloral hydrate) poisoning, etc.
Suspected cases must be thoroughly inquired about the contact history with organophosphorus pesticides. It is necessary to fully understand the children's food (breastfeeding), clothing, clothing, and places of play; carefully check whether the children have specific signs of organophosphorus pesticide poisoning, such as mydriasis (mydriasis may not appear in the early stage of poisoning, and occasionally poisoning occurs. The sick child does not have miosis or has transient dilation before miosis), muscle fasciculations, increased secretions such as sweating, salivation, lacrimation, pulmonary rales (acute pulmonary edema), erythema or blisters on the skin, etc. , Some organophosphorus pesticides have a special garlic odor or aroma.