Propanil poisoning, management and challenges faced by health professionals in Sri Lanka

Propanil, being a widely used herbicide in cultivation and a popular agent used for deliberate self-harm, seemingly has less attention from both the public and health sectors. It causes potentially life-threatening end-organ failure as well as death by inducing methaemoglibinaemia when ingested. While intravenous methylene blue remains the drug of choice for propanil poisoning, lack of adequate supplies and proper guidance hinder patient management. The guidelines and management options have been upgraded with the invention of the bedside colour chart but whether it has been used effectively is questionable. This review aims to discuss the clinical features of propanil poisoning, available management options and the challenges in a resource-poor setting.