Q J Med 2001; 94: 117-120
© 2001 Association of Physicians
Editorial |
Our poisoned patients
West Midlands Centre for Adverse Drug Reaction Reporting City Hospital Birmingham B18 7QH
Patients poison themselves, sometimes deliberately, sometimes unintentionally; or they are poisoned by others, who may or may not mean to do them harm. Self-poisoning is still a major problem throughout the world.1 The balance in England and Wales has changed over the last 25 years. In 1978, 4085 deaths from poisoning were recorded, of which 1265 (31%) were from barbiturate poisoning, and 22 (0.5%) from opiate poisoning.2 By 1998, when 3328 people died from poisoning, barbiturates accounted for 23 (0.7%) and opiates for 483 (15%)—and many more if deaths due to addiction are included.3
The principles of management of acute poisoning are well established: separate the poison and the patient (‘decontaminate’); institute general supportive measures; and administer specific antidotes if they are appropriate. The enthusiasm for aggressive decontamination by gastric lavage has waned in recent years. The dangers of aspiration pneumonia, paradoxically increased absorption, and mechanical trauma can no longer
References