THE CHANGING PROFILE OF POISONING AND ITS MANAGEMENT

To identify changes in treatment methods and types of drugs taken in o verdoses over a 10-year period we conducted a retrospective study in t he accident and emergency department of a large teaching hospital, The influence of a protocol to direct medical management was also studied , Results were compared with those of a 1984 survey at the same instit ution. 409 cases of accidental and deliberate poisoning were reviewed, In deliberate poisoning 52% of drugs taken were prescription drugs, 4 1.6% over-the-counter medications and the remaining 6.4% illicit drugs , Only 13% of patients had a stomach emptying procedure compared with 75.2% of patients in the previous survey. Charcoal was administered or offered in over 95% of cases. Medical management of overdoses in this centre changed drastically over 10 years. A department protocol had b een adhered to in the great majority of cases, and we recommend that a ll accident and emergency departments as well as medical and paediatri c teams establish similar protocols, Over-the-counter drugs are increa singly troublesome, especially paracetamol, which accounts for 28.8% o f drugs taken in deliberate overdose.