A case report of successful treatment following rice pill poisoning in a 60-year-old woman

Authors
Masih Shakeri 1
Zhila Rahmanian 1
Heshmatollah Shakeri 1
Hossein Ali Rostami Pourfard 1
Shahram Shafa 1
Farideh Mogharab 2
Navid Kalani 3
1 Research center for non. Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
2 Assistant Professor of Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran
3 Instructor, Department of anesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran
10.22034/pjms.2022.700478
Abstract
Introduction: Acute poisoning is a major global problem and one of the leading causes of death. Aluminum phosphide
(ALP), which is known as rice pellet in Iran, has a very high lethality. ALP poisoning has no specific antidote. However, previous studies have suggested some treatments such as gastric lavage with sodium bicarbonate and charcoal consumption. The present study reported a case of successful treatment of rice pill poisoning.
Case Report: The patient, a 60-year-old woman, referred to the emergency room of Motahhari Hospital due to abdominal pain. Clinical examination of the patient revealed that the patient had experienced abdominal pain due to vomiting without hematuria due to taking rice pills. The patient was fully conscious at the time of admission and vital signs BP 110/70 _RR :20_PR :86_O2SAT: 92 were recorded. The patient was first NPO and a nasopharyngeal tube was inserted. 150 cc of normal saline with olive oil was given to the patient via NG. Pantoprazole vitamin C ampoule, indasterone ampoule, 8 units of regular insulin with 50% dextrose water and one gram of ceftriaxone and calcium gluconate were injected into the patient. NAC tablets were administered orally to the patient. Due to dehydration, the patient was injected with 3000 cc of 1.3-3.2 with 40 mEq of potassium chloride. Catheterization was performed for the patient, who according to the initial tests PH: 7/136 _ PCO2: 36 / 2_ HCO3: 2.12, 300 cc of sodium bicarbonate in 500 cc of normal saline for two hours and also 60 cc Sodium bicarbonate was given to the patient in liters. Then the patient's NG was taken out and according to the order of the specialist, a biocarb vial was started for the patient according to the VBG test. As the condition improved, the patient was transferred to the ward.
Conclusion: In patients with rice pill poisoning due to the lack of specific antibodies in the treatment of this group
of patients need rapid diagnosis and supportive therapies. The results of this study showed that rapid emptying and dilution of gastric contents, administration of olive oil, bicarbonate, stabilization of cell membrane potential and other therapeutic measures can save the lives of patients.
Keywords
Treatment
Poisoning
Rice Pills
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