Dichlorvos poisoning in adults and children

Currently, dichlorvos poisoning is increasingly observed. This is due to its wide distribution in everyday life, in industry, and in agriculture. In order to prevent serious consequences, to save the life of the victim, you need to know the causes of poisoning, the circumstances in which it can happen. In addition, it is important to know the basic principles of diagnosis, emergency care and treatment of poisoning.

Epidemiology

Although the actual frequency of organophosphate poisoning is difficult to establish because of problems with collecting data for surveillance, it is estimated that 250,000 to 350,000 people die from poisoning of the WCF worldwide. Intentional poisoning accounts for about 51% of cases. Unintentional poisoning accounts for 21.7% of cases, and in 26.5% of cases the circumstances of the poisoning are unknown. A significant number (50.2%) of deliberate poisoning was associated with suicide. Non-suicidal cases accounted for 47.4% of cases, and deliberate illegal poisoning - 2.4% of cases. The mortality rate for the entire group was 3.4%. [1], [2]

Causes Dichlorvos poisoning in adults and children

The main reason for dichlorvos poisoning is the ingress of this poison into the human body, penetration into the blood. In this case, poison can enter the body in various ways - through the skin and mucous membranes, through the digestive tract and respiratory tract. The circumstances in which the poison enters the body can be different. Conventionally, several groups of these reasons can be distinguished - ingestion of poison into the body through negligence in domestic conditions (improper storage, maintenance together with food). Often children drink poison if their parents left it unattended (for children, trying everything new is a completely natural reaction, and this must be understood). This also includes non-compliance with the rules for the use of dichlorvos, when people do not use personal protective equipment when working with it, exceed concentrations, do not read instructions, etc.

Chronic poisoning most often occurs due to the fact that the poison systematically, for a long period of time, enters the human body. These are most often cases of professional activity when a person is forced to work with these poisons. Chronic poisoning is considered an occupational disease in some professions. In this case, it is also important to observe safety precautions, use only working equipment, turn on hoods, ventilate the room, and observe all safety precautions. Use personal protective equipment.

There are also cases of intentional poisoning with the aim of committing suicide, murder.

Risk factors

The risk group includes people who regularly experience dichlorvos in connection with their professional duties. As additional risk factors, children's age should be considered. Children under the age of 3 years are especially at risk, because they have an extremely high curiosity, they can drink poison, it can get into their eyes, on the mucous membranes. Also at risk are elderly people with neurodegenerative disorders, sclerosis, people with impaired neuropsychic reactions, inappropriate behavior, and mental illness.

Pathogenesis

Poisoning is accompanied by violations of the basic metabolic processes at the cellular, tissue, and body levels. 

Organophosphorus compounds irreversibly bind to plasma acetylcholinesterase, red blood cells, and cholinergic synapses  [3] in the central nervous system and PNS. Reduced cholinesterase activity in red blood cells or plasma suggests exposure to dichlorvos. [4], [5]

Most of the symptoms and signs of dichlorvos poisoning are the result of over-stimulation of muscarinic receptors. Signs such as tachycardia and high blood pressure, which are sometimes observed in acute poisoning and are not entirely understood, are associated with an overwhelming cholinergic effect on the central nervous system, sympathetic ganglion synapses, or adrenal medulla. [6]

The pathogenesis is based on the direct penetration of poison into the body in one of three ways (through the skin, through the respiratory tract and digestive tract). Damage depends on how the poison has entered the body. When penetrating through the respiratory tract, damage to the mucous membranes of the respiratory tract occurs with the further development of inflammatory processes, the accession of infection. Common complications are chemical burns, tracheitis, bronchitis, pleurisy. Penetration through the skin is accompanied by damage to the skin, chemical burns, dermatitis. With the penetration of poison through the digestive tract, the digestive organs are affected, dyspeptic disorders, gastritis, and ulcers develop.

Then the poison is absorbed through the mucous membranes and walls of the internal organs, their penetration into the bloodstream, as well as further spread throughout the body. This entails a violation of metabolic processes in the body. First of all, the kidneys and liver suffer, since they bear the main burden of processing and neutralizing the poison, it is carried out. 

Many organophosphates are easily converted from thions to oxons. This transformation occurs due to the replacement of oxygen by sulfur in the environment under the influence of oxygen and light, as well as in the body, mainly under the influence of liver microsomes. Oxones are generally more toxic than thions, but oxons are more easily destroyed. [7] Inflammatory processes develop, against the background of inflammation, dehydration develops (a large amount of water is removed from the body). The water-salt balance is disrupted, the destruction of cells, tissues.

Symptoms Dichlorvos poisoning in adults and children

Typical symptoms of organophosphate poisoning include salivation, lacrimation, urination and bowel movements, stomach cramps, and vomiting (SLUDGE). Symptoms are also traditionally classified as acute (from several minutes to several hours) and delayed or late (from several days to several weeks). [8]

Remedy for cockroaches is quite possible to poison. Symptoms of poisoning are similar to those for poisoning with dichlorvos, carbososomes, and other phos. This is due to the fact that most of the means of cockroaches in their composition contain organophosphorus compounds. Possessing toxic properties. Poisoning may indicate a headache, dizziness, narrowing of the pupil, nausea, vomiting, chemical burn. Gradually, confusion develops, up to a complete loss of consciousness. Hallucinations may occur, delirium. Often, the heartbeat, pulse increases, breathing quickens, body temperature decreases or rises, blood pressure. People prone to allergic reactions may develop progressive edema, suffocation, anaphylactic shock.

The first signs are a general deterioration in well-being, nausea, headache. A light metallic taste may appear in the mouth, which indicates poisoning, blood disorders, and destruction of hemoglobin. It is also worth noting that the first signs are dizziness, increased heart rate, shortness of breath, lack of air.

• Acute abdominal syndrome

When poisoning, there are signs of an acute abdomen. This is a syndrome that relates to surgical pathologies and requires immediate surgical intervention. Otherwise, peritonitis develops, in which the entire abdominal cavity is affected, and infectious and toxic damage to the internal organs develops. If emergency first aid is not provided, a fatal outcome occurs in the first 2-3 hours.

• Rhinitis

Dichdophos poisoning can be accompanied by the development of rhinitis in the event that the poison enters the body through the respiratory tract. First of all, the mucous membrane is damaged, in particular, a chemical burn develops. This can lead to an inflammatory process, or an allergic reaction. When rhinoscopy, signs of rhinitis are found - swelling of the mucous membrane, irritation, hyperemia. 

Symptoms such as nasal congestion, difficulty breathing at night, snoring, and a runny nose also appear. The inflammatory process, edema tends to spread, and can cause the development of the inflammatory process and other organs. Inflammation and infection can spread in two directions - ascending and descending. In the first case, inflammation spreads to the lower respiratory tract, tracheitis, tracheobronchitis, bronchitis, pneumonia, pleurisy, lung obstruction, alveolitis, and other diseases of the lower respiratory tract develop. With the spread of inflammation in an ascending manner, upper respiratory tract diseases develop, in particular, rhinitis, rhinosinusitis, sinusitis, frontal sinusitis develop, inflammation and edema can be transmitted through the Eustachian tube into the ear. In this case, the pathology of the middle ear develops (otitis media, tubootitis, etc.).

• Neurological manifestations

Three types of paralysis are described. Type I paralysis, characterized by weakness, fasciculations, cramps and twitching, occurs acutely with cholinergic symptoms. Paralysis II type observed in 80-49%  [9],  [10] occurs 24-96 hours after poisoning  [11] and is characterized by paralysis proximal neck and respiratory muscle recovery after 1-2 weeks. Type III paralysis, characterized by distal weakness, occurs 2-3 weeks after poisoning with recovery for weeks or months. [12] Weakness of certain muscle groups in places where skin is exposed,  [13] cranial nerve  [14] palsy, supranuclear gaze paralysis,  [15] reported isolated laryngeal paralysis  [16] and diaphragmatic paralysis. [17]

Anxiety, delirium, agitation, convulsions or coma can occur during acute exposure, while neuropsychiatric symptoms and signs called chronic organophosphate disorders can occur during chronic exposure. [18] Extrapyramidal manifestations, ocular signs, ototoxicity, manifestation as Guillain-Barré syndrome are also described. [19]

• Cardiovascular manifestations

Cardiac manifestations are observed in approximately two thirds of patients with dichlorvos poisoning. [20] Common electrocardiographic signs are QTc lengthening, ST-T segment changes, and T wave abnormalities.  [21] Other heart manifestations include sinus bradycardia or tachycardia, hypotension or hypertension, supraventricular and ventricular arrhythmias, and ventricular premature complexes and non-cardiogenic pulmonary edema. [22] [23]

Death from cardiac causes during dichlorvos poisoning occurs either due to arrhythmias, or due to severe and refractory hypotension. [24] Although shock is mainly vasodilating,  [25] peripheral vascular endocardial ischemia with cardiogenic shock leads to death. [26]

• Respiratory symptoms

Respiratory symptoms are common with dichlorvos poisoning. The muscarinic effects of salivation, rhinorrhea, bronchorrhea and bronchospasm contribute to hypoxemia and shortness of breath. Nicotine effects lead to muscle weakness and paralysis and predispose to hypercapnic respiratory failure. The central effects of agitation, anxiety, and seizures further impair respiratory function.

In large cohorts, respiratory failure occurs in 24-66% of patients. [27] Other factors contributing to respiratory failure include pneumonia, cardiovascular collapse, acute pulmonary edema, and acute respiratory distress syndrome. [28], [29]

Gastrointestinal symptoms occur in the early stages of organophosphate poisoning and are quickly eliminated with treatment with atropine. There are concerns that atropine slows down the passage through the intestines and prolongs the toxicity of organophosphorus compounds.

Pancreatitis is not uncommon in cases of poisoning of OP and is found in 12.8%. [30] Also described metabolic complications, such as hyperglycemia and glycosuria  [31] and intoxication with organophosphorus compounds, manifested as diabetic ketoacidosis. [32]

• Dichlorvos poisoning

Poisoning with dichlorvos vapor causes primarily damage to the mucous membranes. Mostly the respiratory system is damaged. Also, part of the pathology occurs in the skin. Poisoning with dichlorvos, including fumes, can have serious consequences. 

Dichlorvos poisoning in children

Dichlorvos poisoning manifests itself in the same way, both in children and in adults. The characteristic features of poisoning are vomiting, diarrhea, abdominal pain, headache, dizziness, general weakness, decreased activity, and appetite. Sweating increases, palpitations speed up, the body becomes covered with cold sweat, the pupils dilate, and coordination of movements is disturbed. Choking may develop, especially if the child has a tendency to allergic reactions, there is a history of bronchial asthma. Gradually, the symptoms increase, intensify.

It must be borne in mind that poisoning in a child proceeds much harder, develops faster and more intensively. It is worth noting that the most dangerous condition is diarrhea and vomiting, since dehydration of the body occurs very quickly. If vomiting and diarrhea do not stop for 24 hours, death can occur. Self-medication is not worth it, you must call a doctor and provide the child with qualified medical care. Correct diagnosis is very important. Since knowing the cause of the pathology, you can quickly find an effective remedy, introduce an antidote (atropine). This will prevent serious health problems and serious complications. [33]

In the course of diagnostics, three groups of methods are mainly used: methods for diagnosing skin lesions, methods for diagnosing pathology of the respiratory tract, and methods for diagnosing damage to the digestive system (depending on how the poison entered the body). If you suspect damage to the digestive system, or the development of any gastrointestinal disease, gastroscopy, radiography, ultrasound, and colonoscopy may be required.

If poison enters the airways, injuries and diseases of the respiratory system develop. The following research methods are used: spirogram, x-ray. Sometimes they resort to such methods as functional tests, fluorographic studies.

With skin pathologies, the main research method is examination of the skin and mucous membranes. Additionally, toxicological studies, scrapings, biochemical studies, bacteriological culture of the skin or mucous membranes can be used.

Regardless of how the poison got into the body, other methods may be required (various methods for studying the cardiovascular, nervous, and musculoskeletal systems). It is these systems that are most susceptible to the effects of poison, and experience various complications. Apply: electrocardiogram, angiography, ultrasound of the heart, magnetic resonance imaging and computed tomography.

Dichlorvos poisoning during pregnancy

Pregnancy is one of the most important life cycles of a woman. This is not a disease, as many believe, however, the body functions in a state of increased stress. Due to the fact that the state and needs of the body change, as well as toxicosis, hormonal and autoimmune pathologies develop, poisoning can occur much faster, including minimal dichlorvos concentrations.

You should call an ambulance as soon as possible, it is better not to self-medicate. But if the condition is serious, emergency assistance must be provided before the ambulance arrives. The main thing is to stop the further penetration of poison into the body, you need to remove, neutralize those toxins that have penetrated the body. The essence of first aid is to rinse the stomach. By pressing the fingers on the root of the tongue, induce vomiting. Then you should give a warm drink, to ensure peace. Further treatment for dichlorvos poisoning during pregnancy is provided by a doctor, namely: it is necessary to eliminate those pathological phenomena that occur in the human body. [34]

Symptomatic treatment may be required aimed at eliminating the pathology of the kidneys, liver, and gastrointestinal tract. In a medical institution, the stomach is washed with potassium permanganate, tannin. Give laxatives. During the day, it is not recommended to eat anything, you can only drink. A woman requires mandatory hospitalization and further inpatient treatment. Be sure to inject physiological saline, and if necessary, in the complex with glucose and vitamins, to provide nourishment of the body, and also give sorbents. Any medicine is used exclusively as directed by a doctor, as they can have serious side effects.

In one retrospective study, 21 cases of organophosphate poisoning during pregnancy were analyzed. Two women (9.52%) died from organophosphate poisoning during the acute stage of poisoning. One woman had a miscarriage. The remaining 15 women did not have significant complications during pregnancy or childbirth. None of the children had congenital malformations or neurological deficits. However, long-term follow-up of newborns in this study was not conducted. [35]

Complications and consequences

The consequences can affect any organs. Complications arise quite often. First of all, these are chemical burns, rhinitis, diseases of the upper and lower respiratory tract, digestive disorders, respiratory processes, blood circulation, heart activity. The risk of developing complications of the liver and kidneys increases, especially in pregnant women. A transplacental route of penetration of poison into the body is possible, and therefore the risk of developing fetal pathology increases. An allergic reaction, anaphylaxis, peritonitis are also possible. Otherwise, if timely first aid is provided to the patient, neutralize the toxin, provide emergency care, the prognosis will be favorable. If emergency care is not provided,  dichlorvos poisoning  can lead to the development of severe pathology of the kidneys, liver, up to renal and liver failure, which subsequently leads to death, multiple organ failure.

Coma is observed in 17-29% of patients and can last from several hours to several days. [36],  [37] Dichlorvos poisoning can also manifest as a brain stem stroke. [38] However, some patients experience a change in consciousness or coma several days after poisoning, especially after a period of “normal” consciousness. This clinical phenomenon called delayed organophosphate encephalopathy (DOPE) or the “central nervous system intermediate” is likely akin to type II paralysis. A coma with missing brain stem reflexes or encephalopathy was registered after 4 days of normal consciousness and spontaneously resolved after 4 days. [39], [40]

Diagnostics Dichlorvos poisoning in adults and children

Dichlorvos refers to FOSam - organophosphorus compounds. Like other substances of this group, the basis of diagnosis is primarily the identification of those substances that caused poisoning, the determination of their quantitative indicators. To do this, a toxicological study is used. A biochemical study is also used to identify changes that have occurred in the body under the influence of poison.

Other clinical, instrumental, and laboratory research methods are also additionally applied. A differential diagnosis is required, which allows us to distinguish the signs of dichlorvos poisoning from poisoning with other substances of a similar action. [41]

Usually, the ambulance doctor makes the initial diagnosis, who provides emergency care. Then, the specified diagnosis can already be made by the doctor of the department where the victim was hospitalized, based on additional studies. A diagnosis is needed for diagnosis. The patient should describe to the doctor as much as possible all the symptoms, say what substances he had to deal with. This can greatly facilitate the diagnosis. It is also important to describe to the doctor as much as possible your condition, your subjective feelings, to accurately report what kind of help was provided on the spot (although usually during hospitalization such information along with the initial diagnosis is transmitted to the attending physician).

Then a standard examination, a patient survey is carried out, the results of laboratory and instrumental studies are analyzed.

Usually during the examination, classic research methods are used, such as palpation, percussion, auscultation. During palpation, probable lesions are probed for an inflammatory reaction, hyperemia, swelling of the tissues. In parallel, local temperature is estimated. During auscultation, the doctor listens for breathing, a heartbeat (on the basis of which it can be concluded about the severity of the pathological process). With percussion, you can also detect various injuries, for example, foci of inflammation, swelling, seals, and places of accumulation of exudate.

Analyzes

As mentioned above, the main research methods are toxicological analysis and biochemical research. In the course of toxicological analysis, the name, qualitative and quantitative characteristics of the toxin that caused the poisoning are revealed. [42] In the course of biochemical studies, those changes that have occurred in the body under the influence of poison are identified. If necessary, to obtain more detailed information, other research methods are also used:

• blood test (clinical, biochemical, sugar); [43]
• urinalysis (clinical, according to Necheporenko, daily monitoring of urine output);
• fecal analysis;
• wash water analysis;
• biopsy;
• histological and microscopic examination (biopsy, scraping, body fluids);
• immunogram;
• serological, immunological, allergological methods of research;
• bacteriological crops;
• virological diagnostics;
• rheumatic tests and analyzes on tumor markers.

These analyzes can be in demand during further diagnosis and in eliminating the consequences that arose under the influence of poison in the body. Often, rehabilitation treatment lasts quite a long time, much longer than the basic treatment for poisoning. Poisoning provokes an exacerbation of chronic pathologies, entails the development of new serious diseases, internal injuries, and injuries.

Instrumental diagnostics

It happens that the data of the survey and examination is not enough for diagnosis and the selection of adequate treatment. Therefore, to refine the data, instrumental methods of research are prescribed, which depend on which organ or system of organs the possible pathology is located in and what functional changes have occurred. The results of laboratory studies may indicate the need for further instrumental studies.

Differential diagnosis

This is an important stage in the general diagnosis and diagnosis of the diagnosis, the essence of which is to differentiate the symptoms of one disease from the signs of another disease with similar manifestations. In the course of differential diagnosis, such research methods may be required:

• gastroscopy,
• X-ray of the digestive tract,
• Ultrasound of the abdomen
• colonoscopy.
• spirogram
• roentgenogram
• functional tests
• fluorographic study.
• electrocardiogram
• angiography
• Ultrasound of the heart,
• magnetic resonance imaging and computed tomography.
• rheography.

Treatment Dichlorvos poisoning in adults and children

Treatment takes place in several stages:

• cessation of intake of poison in the body;
• removal of toxins from the body;
• poison neutralization;
• detoxification therapy;
• pathogenetic, symptomatic treatment;
• rehabilitation treatment.

In many ways, the treatment depends on how the poison got into the body. With the penetration of poison through the digestive system, the digestive system, urinary organs, and the liver suffer in the first place. Comprehensive treatment is required.

When penetrating through the respiratory tract, the lungs, bronchi, and mucous membranes of the respiratory tract are affected primarily. Treatment is required aimed at eliminating the pathology of the respiratory tract.

When penetrated through the skin, a chemical burn occurs, which requires appropriate therapy.

What to do with dichlorvos poisoning?

The first thing to do is to neutralize the poison, stop its effect on the body. To do this, it is necessary to provide the first emergency aid to the victim: induce vomiting, carry out gastric lavage to a state of "clean water". Then, further detoxification therapy is carried out (sorbents, other substances of a similar action are injected into the body). After the threat of life has passed, maintenance therapy is carried out (aimed at stabilizing vital functions, normalizing the state of the body).

Then follows recovery therapy. Usually, treatment continues even after there are no visible symptoms of poisoning. Mostly etiological therapy is used, which is aimed at eliminating the cause, since almost all pathologies developing in the body after poisoning are a consequence of the pathological process that occurs in the body as a result of poison ingress. [44]

What to do if the child has breathed on dichlorvos?

With any type of poisoning, you need to act immediately, the life of the victim depends on this. If the child has breathed in diclofos, and you do not know what to do, you need to call an ambulance. Before her arrival, it is necessary to provide access to fresh air, to stop exposure to the toxin. Then you should induce vomiting, ensure a plentiful drink. You can drink a sorbent, for example, activated carbon, which binds and removes toxins from the body.

Before the arrival of the doctor, you need to ensure the victim peace. You can give a warm tea. You can offer warm milk, because it is it that is a tool that provides the removal and absorption of toxins. Egg protein has similar properties.

First aid for poisoning after spraying dichlorvos

Immediately you need to call an ambulance, in the meantime, try to alleviate the condition yourself. The bottom line is to neutralize the poison and remove it from the body. To do this, cause vomiting, then give the victim a sorbent (activated carbon, sorbex, enterosgel). Gastric lavage and activated charcoal are commonly used decontamination procedures, but their value has not been conclusively proven in case of poisoning with organophosphorus compounds. [45] Of alternative means, egg protein, milk, jelly, mucous drinks have similar properties. The patient is provided with plenty of drinking, peace, warmth.

If it gets on the skin, a burn develops, since dichlorvos is a quite potent substance that can cause burns and irritation of the skin, mucous membranes. If the substance gets on the skin, wash it with plenty of water, and then grease with a thick layer of oily cream, or petroleum jelly. The damaged area is covered with a sterile dressing and contact a trauma center.

Raid Poisoning

Raid is the commercial name of a product that is manufactured by the industry. It can be found practical in any store. Available in powder form, special plates, spray aerosol. Used for bullying cockroaches, ants, fleas and other insects. As a basis, diclofos is used. Also the composition includes various additives, flavorings. For example, you can buy a product with the scent of lavender, lemon and others.

Since dichlorvos is part of the composition, the product remains toxic and potent. The actions for raid poisoning are the same as for pure dichlorvos poisoning. It is necessary to stop the effect of the poison on the body: if necessary, take the person out of the room, ventilate the place of poisoning. Then they neutralize the poison (cause vomiting, give the person a sorbent, a plentiful drink). Be sure to call an ambulance.

Antidotes

Atropine acts as an antidote. It is administered when the first signs of poisoning appear subcutaneously in an amount of 2-3 ml. 0.1% atropine sulfate is used. With severe poisoning, 2-3 ml of 0.1% atropine is administered intravenously (repeatedly) and alox intramuscularly in an amount of 1 mg / kg. The drug is administered every 13 hours until signs of atropination appear.

The choice of anticholinergics depends on which receptors are most affected - central, peripheral or both. Although atropine is a logical choice, as it acts on central and peripheral cholinergic receptors, side effects or allergic reactions may interfere with its use. [46] In such situations, the use of glycopyrrolate or scopolamine is recommended. Atropine and glycopyrrolate appear to be equally effective. [47] However, since glycopyrrolate does not cross the blood-brain barrier, benzodiazepine or a specific antimuscarinic drug with good penetration into the central nervous system, such as scopolamine, may be required to counteract the central effects. With intravenous administration of scopolamine in case of poisoning with dichlorvos, severe extrapyramidal symptoms are sometimes observed. [48] However, given the selective effect, scopolamine is considered inferior to atropine and karamifen. [49], [50]

Given the irreversible binding of dichlorvos to acetylcholinesterase, the choice of muscle relaxant for poisoning with organophosphorus compounds is also important. In several studies  [51],  [52],  [53] reported prolonged neuromuscular blockade and apnea in acute or chronic exposure dichlorvos due to decreased metabolism of succinylcholine by inhibiting cholinesterase insecticide. 

Oximes are nucleophilic agents that cleave covalently bound organophosphorus compounds from the conjugate of OP-acetylcholinesterase, thereby releasing acetylcholinesterase. [Oxymotherapy for dichlorvos poisoning has been the subject of numerous trials and a meta-analysis. Although there is a pharmacological basis for the use of oximes in organophosphate poisoning, recent systematic reviews show that available data are insufficient to indicate whether oximes are useful. [54], [55]

Medication

When the first signs of poisoning appear, a number of medications may be required. But their use requires the observance of precautionary measures, in particular, to give the victim only the most necessary means to maintain life and prevent a serious condition. Then all the necessary funds are prescribed by the doctor.

Poisoning may be accompanied by an allergic reaction, edema. In this case, antiallergic drugs are prescribed. First of all, this is a well-known drug - suprastin. It is taken 1 tablet 2-3 times a day, in case of an attack - 2 tablets once. Suprastin has one significant drawback - it can cause drowsiness and a delayed reaction.

Pain medications such as novocaine are prescribed to relieve pain. A solution of novocaine 1% is administered intramuscularly. Once administered from 0.5 to 1 ml intramuscularly.

With cramps, convulsions, baralgin is prescribed 0.5-1 ml intramuscularly.

As an sorbent, to eliminate toxins, autoantibodies and metabolic products from the body, it is recommended to take ordinary activated carbon, or white coal (sorbex). As a result of the intake, the body is cleaned, the symptoms of intoxication gradually disappear. Activated charcoal requires 5-6 tablets, and sorbex enough 1-2 tablets per day.

Vitamins

Vitamins contribute to faster recovery. Therefore, they are necessarily needed at the stage of rehabilitation treatment. Assign after the action of the poison is neutralized, the basic vital signs are normalized and stabilized, the body began to recover. It is recommended to take vitamins in the following daily concentrations:

• Vitamin PP - 60 mg
• Vitamin A - 240 mg
• Vitamin E - 45 mg
• Vitamin C - 1000 mg.

Vitamins A and E are especially important after poisoning, since they have an antioxidant effect, eliminate and neutralize toxins, free radicals, and metabolites. Accordingly, they are able to eliminate the effects of intoxication. Vitamin C is a powerful source of energy, has antioxidant properties, and promotes tissue repair.

Physiotherapeutic treatment

May be part of a comprehensive treatment. Itself is practically not assigned. Physiotherapeutic treatment is used mainly in the course of rehabilitation treatment, since it helps to cope with the consequences of poisoning quite efficiently and in a short time, and also allows you to accelerate recovery processes in the body.

The choice of method depends on the nature of the damage, as well as on how the poison penetrated the body. The main methods of physiotherapeutic treatment are treatment with ultrasound, microcurrents, waves of various lengths, electrophoresis.

If the poison entered the body through the skin, provoked a chemical burn and is accompanied by damage to the skin, special therapeutic cosmetic procedures, cryotherapy, thermal procedures, peeling, laser procedures, phototherapy are indicated.

Alternative treatment

Alternative remedies that are often included in complex treatment have proven themselves well. Particularly effective in the recovery phase. Apply various mixtures, balms, decoctions intended for oral administration. They quickly remove the inflammatory and infectious process, prevent the development of infection, and promote the elimination of toxins, metabolites, and autoimmune complexes. 

Herbal treatment

Field horsetail is widely used in medicine. It is especially often used if the poison penetrated into the gastrointestinal tract through the stomach, oral cavity. It is used to treat digestive disorders, inflammation,  [56] relieve the effects of intoxication, overcome seizures, cramps. It must be borne in mind that horsetail has hemostatic properties, so it is not recommended for people with a tendency to thrombosis. The main forms of application are powder, decoction, tincture. The powder is ground roots, which are often added to tea, coffee, decoctions. Infusions and decoctions are drunk in the morning on an empty stomach.

Lavender is also often used to overcome the effects of intoxication. It is necessary to strictly observe the dosage, adhere to the recommended treatment regimen. It relieves spasm and reduces pain,  [57] and also helps to normalize the condition. [58]

Field hops are used to treat intoxication, eliminate digestive disorders, normalize the composition and function of the blood. [59] Apply 200 ml in the morning and evening. Do not exceed dosage.

Homeopathy

Homeopathic remedies are widely used to treat the effects of poisoning. When taking homeopathy, you need to take into account that numerous side effects can develop, so you need to strictly observe safety precautions (consult your doctor).

Prevention

Prevention - compliance with the rules of working with dichlorvos, raid and other means that contain dichlorvos. Especially if there are children in the house, because they often drink, or inhale an excessive amount of poison, which leads to poisoning. If poison enters the body, first aid should be provided as soon as possible. In no case is it recommended that you leave it with food, as the product can be mistakenly added to food.

• How much to ventilate the room after dichlorvos?

After dichlorvos, the room must be thoroughly ventilated. If you do not know exactly how much to ventilate, you need to use average indicators. So, usually in order for the smell to completely weather, you need at least 12 hours. It is also recommended to additionally treat the room with a damp cloth, carry out wet cleaning.

Forecast

If timely to provide first aid to the patient, neutralize the toxin, and then carry out the necessary detoxification, supportive and restorative treatment, the prognosis will be favorable. Dichlorvos poisoning  ends in death only if first aid is not provided in a timely manner.