Deliberate Self-Poisoning Presenting to an Emergency Medicine Network in South-East Melbourne: A Descriptive Study

Abstract

Background. Deliberate self-poisoning (DSP) comprises a small but significant proportion of presentations to the emergency department (ED). However, the prevalence and patient characteristics of self-poisoning attendances to EDs in Victoria have not been recently characterised. Aim. To identify and compare the characteristics of adult patients presenting to the three EDs of Monash Health following DSP. Methods. Retrospective clinical audit of adult DSP attendances between 1st July 2009 and 30th June 2012. Results. A total of 3558 cases over three years were identified fulfilling the search criteria. The mean age of patients was 36.3 years with the largest numbers aged between 18 and 30 (38%). About 30% of patients were born overseas. Forty-eight percent were discharged home, 15% were admitted to ED short stay units, and 5% required ICU admission. The median ED length of stay was 359 minutes (IQR 231–607). The most frequently reported substances in DSP were benzodiazepines (36.6%), paracetamol (22.2%), and antipsychotics (12.1%). Exposure to more than one substance for the episode of DSP was common (47%). Conclusion. This information may help identify the trends in poisoning substances used for DSP in Victoria, which in turn may provide clinicians with information to provide more focused and targeted interventions.

Assessment of pattern and outcomes of pesticides poisoning in a tertiary care hospital

“…However, studies from the other nations like Iran, Tanzania, Australia and United Kingdom revealed contrary results to our study, as medicines (sedatives, analgesics and antidepressants) were the most implicated agents in deliberate poisoning. However, in Ethiopia, Brazil, Caribbean and Ecuador, the results were similar to ours showing that pesticides were the most implicated agents in poisoning .…”

Characteristics of Attempted Suicide Patients Presenting to a Greek Emergency Department

“…The most often used substances was benzodiazepines (36,6%), which is similar to previous studies ranging from 39%-61% [18,39] and the second most frequent substance was analgesic. This pattern was different from a study in the UK where the analgesic was responsible for the most selfpoisoning cases [9], a study in the USA where poisoning by unspecified drugs or medicinal substances accounted for the highest number of self-poisoning [10] and a studies from Korea where the ingestion of pesticides is the principal agent of selfpoison among patients over the age of 50 Year [17].…”

Adolescent deliberate self‐poisoning in South‐East Melbourne

“…The present study describes the characteristics of adolescents presenting to an Australian ED network with DSP. A previous study of adults, conducted in the same healthcare network, revealed that 0.7% of adult ED presentations were the result DSP . In comparison, we found that 2% of adolescent presentations to the same ED network were related to DSP.…”

“…This is consistent with previous studies of adolescent self‐poisoning. However, it differs from studies of adult overdose where benzodiazepines, as a group, are the most common substances ingested . This difference suggests that adolescents might have less access to prescription medications.…”

“…For adolescents presenting with DSP, more than half were discharged home from the ED; the primary treatment interventions were supportive; there were no deaths during the study period; and the need for critical interventions was small. This most likely reflects a lack of access to more ‘potentially toxic’ prescription medications such as antipsychotics, anticonvulsants and cyclic antidepressants …”