Enquiries to the New Zealand National Poisons Centre in 2018

Abstract

The New Zealand National Poisons Centre provides 24/7 freely accessible expert clinical assessment and management advice for poisonings through telephone consultations and its extensive online poisoning information database. Most calls in 2018 were from the general public and involved paediatric exposures which could be managed at home. Most telephone consultations with New Zealand National Poisons Centre clinical toxicologists and queries of the online database involved exposures to medications, particularly paracetamol.

Specialist medical toxicologist consultations provided by the New Zealand National Poisons Centre, 2018–2020

“…NPC enquiries typically involve young children (median age 3 years) with a "child exploratory" reason underlying the exposure. 18 In contrast, this study found that NPC medical toxicologist consultation exposures involved patients who were older with a median age of 25 years. Further, almost 40% of medical toxicologist-consulted records in this study involved intentional exposures, compared to a rate of only 5.5% observed in all NPC patient records in 2018.…”

“…Drugs primarily affecting the nervous system were the most commonly queried group of medicines in medical toxicologist consultations, similar to recent reports from Lebanon, 24 Singapore 25 and the United Kingdom (UK). 26 Paracetamol was the most frequent therapeutic substance in medical toxicologist consultations, similar to exposures reported to the NPC in general, 18 and in similar consultations of the UK's National Poisons Information Service (NPIS) in 2020/2021. 26 Of note, the Australia and New Zealand guidelines on management of paracetamol poisoning encourage contact with medical toxicologists or poisons centres in several clinical scenarios, as written guidelines cannot cover all possible variations of circum-stances.…”

“…Further, almost 40% of medical toxicologist-consulted records in this study involved intentional exposures, compared to a rate of only 5.5% observed in all NPC patient records in 2018. 18 An increase in rates of serious self-inflicted injuries including poisoning has been noted in Aotearoa New Zealand in recent years. 19,20 Intentional exposures often involve larger ingested doses not normally seen in unintentional exposures, multiple substances combined, undisclosed other substances and possibly delays in seeking treatment-which together introduce complexities in management and can result in serious morbidity and mortality.…”

Lessons From the Household Humidifier Disinfectant Tragedy (HHDT) With Focus on the Chemical Poisoning Surveillance System: Review and Recommendation

“… 41 By comparison, the main objectives of the UK TOXBASE ® and New Zealand TOXINZ are electronic textbooks on how to identify the main symptoms of patients with exposures/poisonings and how to treat them promptly, and provide basic toxicological information by chemical or product ingredient. 35 Acceptance of UK’s TOXBASE has reduced need for telephone advice, allowing resources to be redirected to improve its electronic database. 42 New Zealand’s National PCC team’s TOXINZ provides more than 120,000 documents offering a wide range of information on symptoms and treatment on many chemicals, pharmaceuticals, household products and plants.…”