Limiting the use of gastrointestinal decontamination does not worsen the outcome from deliberate self-poisoning

Aim. To review the current epidemiology of patients with deliberate self-po isoning presenting to Christchurch Emergency Department, and to compare thi s with 1996, 1992, and 1989 data. Methods. A retrospective analysis of computer and case records over the twe lve-month period of 1999 was conducted and compared with published data fro m 1996, 1992 and 1989. Results. There were 561 presentations of deliberate self-poisoning to Chris tchurch Hospital, representing 0.87% of total presentations (compared with 1.1% in 1996, 1.2% in 1992, and 1.0% in 1989). The female to male ratio was 2.2:1.0 (compared with 1.9:1.0, 1.5:1.0, and 2.1:1.0). The principal drugs ingested were antidepressants 30.8% (compared with 20.1%,24.4%,15.7%), par acetamol 23.5% (compared with 16.7%, 16.9%, 10.6%), benzodiazepines 23.0% ( compared with 11.1%, 23.6% 22.8%) and antipsychotics 17.8% (compared with 1 0.7%, 16.1%, not reported). Gastrointestinal decontamination was performed in only 14.4% of patients (compared with 61%, 73%, 61%). Activated charcoal was given alone in 13.2% (compared with 54%, 46%, 0.4%), activated charcoa l and gastric lavage in 0.7% (7%, 26%, 53%), and whole bowel irrigation in 0.5% (not recorded in previous papers), 70.4% were admitted (compared with 69%, 59%, 64%), 7% to intensive care (10.2%, 10.6%, 18%). There were two de aths (compared with 6, 2 and 2). Conclusions. Over the time periods studied the drugs ingested and admission rates remain similar, although a large proportion are now being observed i n the emergency short stay ward, reducing admission rates to the ward and i ntensive care. Trends in gastrointestinal decontamination have changed dram atically over the four time periods, but there has been no worsening in the outcome of patients with deliberate self-poisoning.