Acute poisoning: understanding 90% of cases in a nutshell

Abstract

The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.

Pattern of acute poisoning in teaching hospital, northwest Ethiopia

“…Irrespective of the time, gastric lavage is performed in this hospital, as the initial part of treatment. Overall in-hospital mortality rates are less than 0.5% which is similar with the present study (the mortality rate 0.43%) (Greene et al 2005), however the medical costs of poisoning treatment can be substantial, exerting a considerable burden on the national health care service in developed and developing countries ).…”

Epidemiology and Treatment of Severe Poisoning in the Intensive Care Unit: Lessons from a One-Year Prospective Observational Study

“…One to five percent of public hospital admissions worldwide are caused by unintentional or deliberate poisoning [1][2][3][4][5]. Early diagnosis and rapid initiation of appropriate therapy in ED and ICU are critical for lowering hospital morbidity and mortality in poisoned patients.…”

Risk Factors Associated with Prolonged Hospital Stay in Admitted Patients with Psychotropic Drug Overdose

“…Patients with DO in other countries are involved with analgesics such as acetaminophen, opioids such as heroin and psychostimulants such as cocaine [4,5], while patients with intentional drug overdose in Japan are usually involved with psychotropic drugs such as benzodiazepines, although there were no reports of epidemiology about patients with DO. Most episodes of DO in Japan are from psychotropic drugs and lead to presentation to emergency departments (ED) and admission to acute care hospitals.…”

“…The drugs such as benzodiazepines do not usually damage vital organs of patients, although they lower a level of their consciousness by suppressing central nervous systems [5]. Recent evidence-based recommendations for treatment of DO patients suggested respiratory support and tracheal intubation with mechanical ventilation for patients with respiratory suppression and no gastric lavage or ipecac emetics for most patients [9,10].…”