The epidemiology and management of adult poisonings admitted to the short-stay ward of a large Scottish emergency department

• Published in: Scottish medical journal Vol. 58; no. 3; p. 149
• Main Authors: Teo, A I C, Cooper, J G
• Format: Journal Article
• Language: English
• Published: Scotland 01-08-2013
• Subjects: Acetaminophen - poisoning; Acetylcysteine - therapeutic use; Adolescent; Adult; Aged; Aged, 80 and over; Analgesics, Non-Narcotic - poisoning; Antidotes - therapeutic use; Central Nervous System Depressants - poisoning; Charcoal - therapeutic use; Drug Overdose - epidemiology; Drug Overdose - psychology; Drug Overdose - therapy; Emergency Service, Hospital; Ethanol - poisoning; Female; Follow-Up Studies; Free Radical Scavengers - therapeutic use; Hospitalization - statistics & numerical data; Humans; Length of Stay; Male; Mental Disorders; Middle Aged; Naloxone - therapeutic use; Narcotic Antagonists - therapeutic use; Patient Admission; Patient Discharge; Public Health; Retrospective Studies; Scotland - epidemiology; Self-Injurious Behavior - epidemiology; Self-Injurious Behavior - psychology; Self-Injurious Behavior - therapy; Scotland; alcohol; overdose; Poisonings; paracetamol; self-harm
• ISSN: 0036-9330
• DOI: 10.1177/0036933013496951

The emergency department of Aberdeen Royal Infirmary receives around 68,000 new adult admissions annually. All poisoning cases are admitted to a 14-bedded short-stay ward, except those admitted to intensive care or immediately discharged. This study aimed to analyse epidemiological trends and management of short-stay ward admissions for poisonings.
Adult (>13 years) poisoning presentations admitted to the emergency department short-stay ward of Aberdeen Royal Infirmary from 1 January-31 December 2009 were retrospectively reviewed using patient discharge summaries. During 2009, there were 1062 poisoning cases, of which repeat episodes were responsible for 15%. The mean age of presentation was 33.9 years (SD 14.4) and there was a female preponderance (62%). Almost half of poisonings were polypharmacy, alcohol was involved in 40% of cases and overdoses most commonly involved paracetamol (43%). Management involved basic observations only (66%), N-acetylcysteine (24%), naloxone (4%) and activated charcoal (1%). Liaison psychiatry reviewed 84% presentations and admitted 9% to the psychiatric unit.
The short-stay ward is important for acute management of poisonings and the data gained from this study should help to direct patient services appropriately.