Management overview for paraquat poisoning

Paraquat is an extremely toxic herbicide that causes multiorgan failure and pulmonary toxicity following ingestion. Repackaging of paraquat into containers, such as soft drink bottles, is a common source of accidental ingestion. Dermal or inhalational exposures have lower risks of toxicity.

If paraquat poisoning is suspected, particularly deliberate ingestions, urgently contact a clinical toxicologist or poisons information centre (13 11 26). The management priority for any paraquat ingestion is early treatment. Field first aid for paraquat ingestion is gastrointestinal decontamination with activated charcoal or, if not available, Fuller’s earth or soil. Do not give oxygen.

Patients require further management in hospital with acetylcysteine and corticosteroid therapy; however, even after early treatment the prognosis may be poor. Once the patient has multiorgan failure, management is palliative. There is no specific antidote for paraquat poisoning.