Document Type : Original Article
Authors
1
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Egypt
2
Public and Community Medicine Department, Faculty of Medicine, Tanta University, Egypt
3
Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Egypt
Abstract
Acute poisoning is a frequent cause of admission to emergency departments and intensive care units, as it is considered as an important medical emergency requiring early diagnosis and rapid initiation of therapy. The aim of the present study was to assess characteristics, and outcomes of acutely intoxicated patients who were admitted to ICU. Also, design a scoring system regarding priority for ICU admission. The present study was carried out on 40 patients who were admitted to intensive care unit of El Mansoura General Hospitals- Egypt during a period of 6 months. Personal, toxicological, and medical histories, clinical examination and routine investigations were recorded for each patient. At discharge; all patients were reassessed for determination of patients' outcome. The patients were mostly females, single; student aged less than 30 years and from rural areas. The majority of the patients (72.5%) were recovered, 22.5% were died and 5% were referred to hyperbaric oxygen therapy units after carbon monoxide intoxication. Many patients were presented by constricted pupil (45%), respiratory depression (42.5%), altered mental status (42.5%), tachycardia (47.5%), and nausea & vomiting (75%). The highest numbers of cases were poisoned by medicinal drugs (40%) followed by agricultural chemicals (35%). Statistically significant difference between occupation, toxicological amount & frequency, pulse rate, Glasgow coma score, PH & PCO2 and type of poison (zinc phosphide) and patient outcomes was observed. Although many of the patients' characteristics were significantly associated with patient outcome yet none of them was considered significant predictors for death. So, the suggested scoring system depended mainly on clinical data and simple rapid investigation that may be helpful for rapid assessment of the patients after further validation. We recommend the presence of a channel of communication between the general care centers and the poison control centers for consultation about the protocol of treatment of poisoned patients. Nationwide, a mechanism of communication between the poison centers must be done to benefit from the different expertise and to make a uniform protocol for treatment of poisoned cases to decrease the mortality rate and the burden on hospitals resources.
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