D. T. V. Naresh1, Shailendra D2, Subbaratnam Y3, Prasuna G4, K. Rajashekar5, Mary Rohini6
BACKGROUND: Poisoning with various substances is an important cause of death and disability worldwide. The types of poisons that are encountered in the emergency medicine departments encompass a wide range of substances. Apparently, geographic location, socio-demographic factors, ease of availability of poisons and many other cryptic factors contribute to the wide spectrum of substances that cause poisoning. Pesticides, drugs and chemicals are reported to be the most commonly used poisons in India. Management of poisoning is quite challenging for the health care professionals globally. Factors such as the uncertainty in the identification of allegedly consumed poison, varied clinical features and the need for timely access to specific information for treatment, complicates poisoning management. This study was therefore conducted to explore the clinical features, management and outcomes of poisoning cases reporting to a tertiary care centre in south India.
OBJECTIVE: To identify the spectrum of poisons and evaluate their clinical manifestations, medical management and clinical outcomes.
METHODOLOGY: All cases of poisoning that were reported at a tertiary care hospital in South India for a period of 18 months from January 1, 2013 to June 30, 2014 were included in this study. A data abstraction sheet was designed to document demographic details (age and gender), poison consumed, duration of stay in the hospital, clinical features, treatment administered, need for life support and patient outcomes.
RESULTS: A total of 145 poisoning cases were reported during the study period. Among them, 58.5% were males and 41.3% were females. Majority of victims were in the age group of 21-30 years. Intentional poisoning was observed in 86.2%, whereas the rest were accidental poisonings. Organophosphorus (OP) poisoning was the most common poisoning encountered in this study. It accounted for 25.5% of the total cases of poisoning. The nature of poison was undetermined in 8.9% of the cases. Apart from organophosphorus poisoning, significant proportion of poisoning comprised of several other substances like hair colours, home remedies for medical ailments and chemicals used in the household. Though, they were small in numbers independently, cumulatively they contributed to a significant proportion of poisoning cases. All of the poisoning cases had complete recovery.
CONCLUSION: Organophosphorus poisoning was the most common type of poisoning. Several chemicals like hair colours, phenyle, urea and drugs like norethisterone and thyroxine were used with suicidal intention. There were no casualties. Timely management of poisoning according to evidence based guidelines potentially minimises morbidity and mortality due to poisons and helps improve patient outcomes.
