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

A prospective autopsy study was undertaken at General Hospital in San Fernando, Trinidad, to analyze deaths that occurred from poisoning during 1996 and 1997. During that period 105 deaths occurred from acute poisoning. The major poisons used were: paraquat (80 cases), organophosphate/carbamate insecticides (10 cases), and anti-psychotic drugs (6 cases). Much less frequently, battery acid, ETHREL[Ethephon; (2-chloroethyl)phosphonic acid], phenols, ethanol, kerosene and flavine were the agents of choice. Suicide accounted for 99 (94.29%) deaths. Of these, 44.44% occurred in the 10-29 y-age-group. Ingestion of paraquat seems almost always fatal, since the large volumes ingested make treatment universally ineffective. Aspiration pneumonitis (100% of cases), and pneumothorax with pneumomediastinum (18.75% of cases), were remarkable autopsy findings in those dying from paraquat poisoning, while asphyxia due to respiratory paralysis was the mode of death from pesticide ingestion. Efforts to prevent suicide by poisoning may be more useful than treatment protocols.