A risk assessment based approach to the management of acute poisoning

Daly, Frank; Little, Mark; Murray, Lindsay

doi:10.1136/emj.2005.030312

Cited by 45 publications

(51 citation statements)

References 24 publications

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“…We propose that the items listed in Tables 1, 2 and 3 represent the minimum criteria required for preparedness. A list of commonly required resources and items used for the treatment of acute poisoning was compiled from the published recommendations [3,6,10]. Each of these items is discussed below.…”

Section: Discussionmentioning

confidence: 99%

“…A list of commonly required resources used for the treatment of acute poisoning was compiled from the published recommendations [3,6,10]. Participants were asked to indicate which resources were available in their ED, such as equipment for decontamination, life support, and elimination enhancement instruments.…”

Section: Study Area and Sample Sizementioning

confidence: 99%

“…As intended in any treatment, a patient's life can be saved if the patient is diagnosed properly and receives appropriate treatment according to clinical guidelines and within a reasonable time (e.g. the treatment of patients diagnosed with paracetamol overdose with the antidote N-acetylcysteine within 8 h) [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

et al. 2011

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Acute poisoning is a common medical emergency in Malaysia. Life can be saved if the patient is diagnosed properly and receives the appropriate treatment such as gastrointestinal decontamination techniques and resources to increase poison elimination according to clinical guidelines at a reasonable time. The aims of this study were to determine the availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in accident and emergency departments in Malaysia, and to compare the availability of such facilities among various types of hospitals. A comparative, descriptive cross-sectional study was conducted using a structured questionnaire. Seventy-four (58.3%) out of the targeted 127 hospitals replied and completed the questionnaire. The availabilities of most items related to stabilization resources were far better in general hospitals compared to district hospitals with specialists and district hospitals without specialists. These items were mechanical ventilators (p = 0.011), non-invasive positive pressure ventilators (0.024), pacemakers (p = 0.019), and transcutaneous cardiac pacing (p < 0.001). The availability of decontamination resources varied substantially with hospital type. Nevertheless, these differences did not reach statistical significance in any of the cases, whereas sodium sulphate, sorbitol, and polyethylene glycol were almost never available. The availabilities of most items related to elimination enhancement resources were far better in general hospitals and district hospitals with specialists compared to district hospitals without specialists. These items were haemodialysis (p = 0.046), haemoperfusion (p = 0.002), haemofiltration (p = 0.002), acid diuresis (p = 0.04), peritoneal dialysis (p < 0.001), and exchange transfusion (p < 0.001). Most Malaysian hospitals have certain important immediate interventions such as gastrointestinal decontamination techniques and resources to increase poison elimination. The availabilities of most facilities were far better in the general hospitals. Coordination between the National Poison Centre in Malaysia and hospitals should be established regarding the emergency facilities for effective management of poisoning cases in each hospital in order to direct the poisoned patients to the hospital where the appropriate management resources is available.

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Section: Discussionmentioning

confidence: 99%

Section: Study Area and Sample Sizementioning

confidence: 99%

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Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

et al. 2011

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“…Gastric lavage largely has been abandoned in the management of poisoned patients with the possible exception of overdose with a life-threatening drug and early presentation of the patient in the course of the poisoning [72][73][74]. Serious aspirin poisoning is certainly a life threat and given the unique potential of enteric-coated aspirin to form concretions and remain in the stomach due to pylorospasm [22], it is reasonable to consider gastric lavage with a large-bore endogastric tube (36 French or larger) if substantial salicylate poisoning is suspected, and there is no likelihood of airway compromise [74][75][76].…”

Section: Gastric Decontaminationmentioning

confidence: 99%

Emergency Department Management of the Salicylate-Poisoned Patient

O’Malley

2007

Emergency Medicine Clinics of North America

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“…Data regarding the use of observation units for deliberate ingestion is sparse, and provides little practical information (10,11). These patients are typically precluded from traditional EDOUs due to concerns regarding potentially high-risk psychiatric behaviors.…”

Section: Introductionmentioning

confidence: 99%