![]() ![]() Rare exceptions include patients poisoned with organophosphates, where health-care workers first need to protect themselves from the agent, and cyanide poisoning, where the antidote for cyanide is immediately required. All cases are managed as acute medical emergencies using an ABC approach regardless of the agent used. Poisoning should be considered in any patient exhibiting bizarre behaviour, a reduced conscious level, or unexplained metabolic, cardiovascular, or respiratory instability. 3 Initial approach to the poisoned patient The website provides easily accessible information on acute poisoning and its management. Toxbase, the UK online toxicology database, was established in 1998 and NPIS recommends it as the first point of contact for registered health-care professionals. GTPU ceased to be a provider to NPIS in November 2005 and operates independently with support from Guy's and St Thomas’ Foundation Trust. The NPIS was commissioned by the Health Protection Agency and consists of five regional centres that operate a 24 h information service to health-care staff on the diagnosis, treatment, and management of poisoning. The medications most commonly taken were acetaminophen, non-steroidal analgesics, and antidepressants. Drugs accounted for the majority, but industrial chemicals and household products were involved in a significant number. 1 A recent report indicated that 85% of poisonings occur in the home. The largest proportion of enquiries to the National Poisons Information Service (NPIS) and Guy's and St Thomas’ Poisons Unit (GTPU) are concerning pre-school children. Although the majority of poison-related deaths occur in the community, reduction of in-hospital morbidity and mortality remains an important challenge. Ipecac is no longer recommended in the treatment of acute poisoning.Īctivated charcoal should be given within 60 min of ingestion of poison but may have an effect for up to 2 h or longer post-ingestion.Īcetaminophen levels are mandatory in all cases of adult overdose.Īcute poisoning accounts for >100 000 hospital admissions per year in the UK with in excess of 4000 deaths reported in England and Wales per annum. Poisoning should be considered in any patient exhibiting bizarre behaviour, a reduced conscious level, or unexplained physiological instability. ![]() The mainstay treatment of poisoning is resuscitation and supportive care.
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