Background: In a previous study we reported that spO2 <85%, exposure > 2 hours, s. acetylcholinesterase < 1000 and GCS < 12 at admission were related with poorer prognosis in acute op poisoning. We aimed to develop evidence based protocol for management of acute op poisoning patients based on these findings.  

Methods:  Severity score was calculated from spO2 at room air, GCS, s. acetylcholinesterase and duration of exposure at admission to see if the scoring system holds and develop an evidence based protocol for treatment of op poisoning.

Results: Maximum and minimum scores were 8 and 4 respectively; score <6 indicated significantly worse prognosis. In the separate set of patients also significant difference in prognosis was seen between groups with score < 6 and ≥6.

Conclusion: Severity scoring system was validated for identifying cases who need aggressive management. An evidence based protocol is suggested for improving prognosis in these patients.