Factors associated with adverse clinical features in patients presenting with non-fatal self-poisoning

Gwini, Stella May and Shaw, Deborah and Iqbal, Mohammad and Spaight, Anne and Siriwardena, A. Niroshan (2011) Factors associated with adverse clinical features in patients presenting with non-fatal self-poisoning. Emergency Medicine Journal, 28 (3e). p. 5. ISSN 1472-0205

Documents
Factors associated with adverse clinical features in patients presenting with non-fatal self-poisoning
Published abstract
[img]
[Download]
Request a copy
[img] PDF
Gwini_Factors_associated_with_adverse_clinical_features_in_patients_presenting_with_nonfatal_poisoning_[abstract].EMJ_2011.pdf - Whole Document
Restricted to Repository staff only until 31 December 2099.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

56kB

Full text URL: http://emj.bmj.com/content/28/3/e1.5.abstract

Abstract

Background: Drug overdose or self poisoning is an important reason for an ambulance service response. We aimed to undertake a preliminary investigation into the pattern of drug overdose presenting to one ambulance service and factors associated with adverse clinical features and treatment.
Methods: We examined data from clinical records obtained by
ambulance crews attending non-fatal overdoses over 3 months. We produced descriptive statistics and used logistic regression to investigate predictors of adverse clinical features (reduced consciousness, obstructed airway, hypotensive and hypoglycaemia)and treatment.
Results: A total of 585 patients were identified over 3 months, giving a rate of 26 per 1000 ambulance requests. Paracetamol containing drugs were most commonly involved. About 8% of patients had taken an overdose of an illegal drug. Adverse clinical reactions occurred in 103 (17.7%) of patients. The odds of any adverse clinical feature was higher in men (OR 2.04; 95% CI 1.18 to 3.51) and overdose involving an opiate (OR 2.35; 95% CI 1.16 to 4.93) or an illegal drug (OR 2.51; 95% CI 1.05 to 5.96). The older the patient, the more likely they were to receive oxygen (OR 1.03; 95% CI 1.01 to 1.04). Patients with reduced consciousness also had a greater chance of receiving oxygen (OR 2.89; 95% CI 1.45 to 5.77) and/or saline (OR 8.00; 95% CI 3.32 to 19.28).
Conclusion: Non-fatal overdose or self poisoning accounts for 2.6% of patients attended by an ambulance. Gender, illegal or opioid containing drugs were important predictors of adverse clinical features. The treatments most often provided to patients were oxygen and saline. This provides an incite into the burden of overdose/poisoning as well as serve as a pilot for future research aimed at improving early management of overdose and poisoning.

Item Type:Article
Additional Information:Background: Drug overdose or self poisoning is an important reason for an ambulance service response. We aimed to undertake a preliminary investigation into the pattern of drug overdose presenting to one ambulance service and factors associated with adverse clinical features and treatment. Methods: We examined data from clinical records obtained by ambulance crews attending non-fatal overdoses over 3 months. We produced descriptive statistics and used logistic regression to investigate predictors of adverse clinical features (reduced consciousness, obstructed airway, hypotensive and hypoglycaemia)and treatment. Results: A total of 585 patients were identified over 3 months, giving a rate of 26 per 1000 ambulance requests. Paracetamol containing drugs were most commonly involved. About 8% of patients had taken an overdose of an illegal drug. Adverse clinical reactions occurred in 103 (17.7%) of patients. The odds of any adverse clinical feature was higher in men (OR 2.04; 95% CI 1.18 to 3.51) and overdose involving an opiate (OR 2.35; 95% CI 1.16 to 4.93) or an illegal drug (OR 2.51; 95% CI 1.05 to 5.96). The older the patient, the more likely they were to receive oxygen (OR 1.03; 95% CI 1.01 to 1.04). Patients with reduced consciousness also had a greater chance of receiving oxygen (OR 2.89; 95% CI 1.45 to 5.77) and/or saline (OR 8.00; 95% CI 3.32 to 19.28). Conclusion: Non-fatal overdose or self poisoning accounts for 2.6% of patients attended by an ambulance. Gender, illegal or opioid containing drugs were important predictors of adverse clinical features. The treatments most often provided to patients were oxygen and saline. This provides an incite into the burden of overdose/poisoning as well as serve as a pilot for future research aimed at improving early management of overdose and poisoning.
Keywords:prehospital, ambulance, paramedic, quality improvement, patient safety, overdose, poisoning
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:4199
Deposited By: Niro Siriwardena
Deposited On:17 Mar 2011 08:40
Last Modified:13 Mar 2013 08:57

Repository Staff Only: item control page