Complications

Complication
Timeframe
Likelihood
short term
high

The most frequent complication of treatment is atropine overdose, which manifests as delirium, paralytic ileus, and fever.

Management involves stopping atropine until these symptoms resolve, and to restart it when cholinergic signs occur.

short term
medium

Common in anticholinesterase poisoning and usually indicates tissue hypoxia.

Treatment should include adequate oxygenation and ventilation and ensuring adequate volume replacement (but these are not specific to this complication).

Sodium bicarbonate is sometimes recommended, but current evidence for this is limited.[30]

Evaluation of metabolic acidosis

short term
medium

This may simply be due to aspiration of the solvent, but may also be caused by excessive secretions and impaired immunity.

Antibiotics are commonly used, but are probably of little value during intensive respiratory care.

Aspiration pneumonia

short term
low

Acute organophosphate poisoning can cause impaired memory and episodic memory for up to 6 weeks post-poisoning, though this appears to be diminished at 6 months.[33]

Nerve conduction studies may detect subclinical injuries and lead to earlier treatment to prevent severe symptomatic neuropathy.[34]

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