THE FREQUENCY OF UNSUSPECTED MINOR ILLNESS OR INJURY IN INTOXICATED PATIENTS

Objective: To determine the frequency of unsuspected minor illness or injury in a group of patients frequently seen in the ED for acute into xication. Methods: The medical records of the 20 patients seen most fr equently in the ED for acute intoxication in 1993 were reviewed for th e number of ED visits for intoxication, the number of associated docum ented episodes of minor trauma or illness, the extent of ED workup of discovered illness or injury, and patient disposition from the ED. Res ults: The 20 study patients were evaluated in the ED 1,858 times in 19 93 for acute intoxication, a mean of 92.5 visits/patient (+/-26.6). Th e most frequent injury was minor trauma above the neck, occurring a me an of 9 times (+/-3.6) in each of the study patients during 1993, Eval uation included repeated neurologic examinations and frequent radiogra phy of the cervical spine (n = 80), skull (n = 5), facial bones (n = 6 ), and mandible (n = 5). A limited number of head CT scans also were d one (n = 8). The most frequent minor illnesses were gastritis (n = 7), managed with hydration, and mild hypothermia (n = 6), managed with pa ssive rewarming. Conclusions: The incidence of unsuspected minor illne ss or injury in this patient group was substantial, While most unsuspe cted medical problems had little clinical significance, some were pote ntially dangerous, and some necessitated hospitalization (e.g., hypoth ermia, hematemesis, and respiratory depression).