Forensic analysis of acute fatal poisonings in the southern districts of Trinidad

A prospective autopsy study was undertaken at General Hospital in San Ferna ndo, Trinidad, to analyze deaths that occurred from poisoning during 1996 a nd 1997. During that period 105 deaths occurred from acute poisoning. The m ajor poisons used were: paraquat (80 cases), organophosphate/carbamate inse cticides (10 cases), and anti-psychotic drugs (6 cases). Much less frequent ly, battery acid, ETHREL[Ethephon: (2-chloroethyl)phosphonic acid], phenols , ethanol, kerosene and flavine were the agents of choice. Suicide accounte d for 99 (94.29%) deaths. Of these, 44.44% occurred in the 10-29 y-age-grou p. Ingestion of paraquat seems almost always fatal, since the large volumes ingested make treatment universally ineffective. Aspiration pneumonitis (1 00% of cases), and pneumothorax with pneumomediastinum (18.75% of cases), w ere remarkable autopsy findings in those dying from paraquat poisoning, whi le asphyxia due to respiratory paralysis was-the mode of death from pestici de ingestion. Efforts to prevent suicide by poisoning may be more useful th an treatment protocols.