PATTERN OF ACUTE POISONING ADMISSIONS IN THE MEDICAL INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL
Abstract
Poisonings comprise an important health issue and leading cause of hospital admission and mortalities in developing countries. This study aims to evaluate the incidence, drug utilization pattern and cost of intensive care associated with poisonings in a tertiary care center. Participants comprised of acute poisoning admissions to the Medical Intensive Care unit of A J Hospital & Research Center, Mangalore during 6 months period. Data regarding pattern of poisoning, basic demographics and drug utilisation were collected by retrospective review of patient records Prevalence of poisoning was 35.49 cases per 1,000 hospitalizations. Majority of poisoning cases were observed in the age group between 25-44 years (85%). Intentional self-poisoning to Organophosphorous compounds and drug over dosage by sedatives were the most common patterns of poisoning observed. Parameters related to drug utilization exhibited slight variations with the agent consumed. Mortality rate was less probably due to timely medical management. Prevailing treatment protocols require updating on proper guidelines for better management of poisoning. There is need for stringent pesticide regulation laws and counselling and training programs to reduce incidence of poisonings.
Keywords:
Poisonings, drug utilisation, pesticide, medical intensive care unit, drug over dosageDOI
https://doi.org/10.25004/IJPSDR.2014.060314References
1. Irwin SR, Rippe JM. Irwin and Rippe's Intensive Care Medicine. 7th ed. Lippincott Williams & Wilkins, 2008, pp: 1433-55.
2. World Health Organization. Guidelines for poison control Bulletin 2004; Geneva: World Health Organisation.
3. London L, Flisher AJ, Wesseling C, Mergler D, Kromhout H. Suicide and exposure to organophosphate insecticides: cause or effect? American Journal of Industrial Medicine 2005; 47:308-321
4. Konradsen F, Hoek W, Peiris P. Reaching for the bottle of pesticide- a cry for help. Self-inflicted poisonings in Sri Lanka. Soc Sci Med. 2006; 62:1710-1719.
5. Wickramasinghe K, Steele P, Dawson A, Dharmaratne D, Gunawardena A, Senarathna L. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka. Bull World Health Organ. 2009; 87:180-185.
6. Medicolegal Issues: Guidelines to Medical Officers. 2012 [Internet] available from http://indianarmy.nic.in/writereaddata/Documents/medico_legal.pdf
7. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet 1974; 81-84.
8. Chowdary AN, Sanyal D, Dutta SK, Weiss MG. Deliberate self-harm by ingestion of poisons on Sagar island in Sunderban delta. India. Int Med J. 2003; 10:85-91
9. Srinivas Rao CH, Venkateshwarlu V, Surender T, Eddleston M, Buckley NA. Pesticide poisoning in South India- opportunities for prevention and improved medical management. Trop Med Int Health 2005; 10:581-9.
10. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Hum Exp Toxicol 2007; 26:753-756
11. Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S, et al. Acute organophosphorus poisoning in university hospital emergency room patients. Int Med J. 2007; 46:965-969
12. Dash SK, Aluri SR, Mohanty MK, Patnaik KK, Mohanty S. Sociodemographic profile of poisoning cases. J Indian Acad. Forensic Med. 2005; 27:133-8.
13. Gargi J, Rai H, Chanana A, Rai G, Sharma G, Bagga IJ. Current trend of poisoning--a hospital profile. J Indian Med Assoc. 2006; 104:72-3
14. Vale JA, Meredith TJ. Poisoning diagnosis and treatment, Edn 1, Update books, London, 1981, pp. 142-152
15. Kale E, Mori A, Risha P, Hasham S, Mwambete K. A Retrospective Study of Poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania E. Journal of Public Health Frontier 2013; 1(2): 21-26.
1. Irwin SR, Rippe JM. Irwin and Rippe's Intensive Care Medicine. 7th ed. Lippincott Williams & Wilkins, 2008, pp: 1433-55.
2. World Health Organization. Guidelines for poison control Bulletin 2004; Geneva: World Health Organisation.
3. London L, Flisher AJ, Wesseling C, Mergler D, Kromhout H. Suicide and exposure to organophosphate insecticides: cause or effect? American Journal of Industrial Medicine 2005; 47:308-321
4. Konradsen F, Hoek W, Peiris P. Reaching for the bottle of pesticide- a cry for help. Self-inflicted poisonings in Sri Lanka. Soc Sci Med. 2006; 62:1710-1719.
5. Wickramasinghe K, Steele P, Dawson A, Dharmaratne D, Gunawardena A, Senarathna L. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka. Bull World Health Organ. 2009; 87:180-185.
6. Medicolegal Issues: Guidelines to Medical Officers. 2012 [Internet] available from http://indianarmy.nic.in/writereaddata/Documents/medico_legal.pdf
7. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet 1974; 81-84.
8. Chowdary AN, Sanyal D, Dutta SK, Weiss MG. Deliberate self-harm by ingestion of poisons on Sagar island in Sunderban delta. India. Int Med J. 2003; 10:85-91
9. Srinivas Rao CH, Venkateshwarlu V, Surender T, Eddleston M, Buckley NA. Pesticide poisoning in South India- opportunities for prevention and improved medical management. Trop Med Int Health 2005; 10:581-9.
10. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Hum Exp Toxicol 2007; 26:753-756
11. Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S, et al. Acute organophosphorus poisoning in university hospital emergency room patients. Int Med J. 2007; 46:965-969
12. Dash SK, Aluri SR, Mohanty MK, Patnaik KK, Mohanty S. Sociodemographic profile of poisoning cases. J Indian Acad. Forensic Med. 2005; 27:133-8.
13. Gargi J, Rai H, Chanana A, Rai G, Sharma G, Bagga IJ. Current trend of poisoning--a hospital profile. J Indian Med Assoc. 2006; 104:72-3
14. Vale JA, Meredith TJ. Poisoning diagnosis and treatment, Edn 1, Update books, London, 1981, pp. 142-152
15. Kale E, Mori A, Risha P, Hasham S, Mwambete K. A Retrospective Study of Poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania E. Journal of Public Health Frontier 2013; 1(2): 21-26.
2. World Health Organization. Guidelines for poison control Bulletin 2004; Geneva: World Health Organisation.
3. London L, Flisher AJ, Wesseling C, Mergler D, Kromhout H. Suicide and exposure to organophosphate insecticides: cause or effect? American Journal of Industrial Medicine 2005; 47:308-321
4. Konradsen F, Hoek W, Peiris P. Reaching for the bottle of pesticide- a cry for help. Self-inflicted poisonings in Sri Lanka. Soc Sci Med. 2006; 62:1710-1719.
5. Wickramasinghe K, Steele P, Dawson A, Dharmaratne D, Gunawardena A, Senarathna L. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka. Bull World Health Organ. 2009; 87:180-185.
6. Medicolegal Issues: Guidelines to Medical Officers. 2012 [Internet] available from http://indianarmy.nic.in/writereaddata/Documents/medico_legal.pdf
7. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet 1974; 81-84.
8. Chowdary AN, Sanyal D, Dutta SK, Weiss MG. Deliberate self-harm by ingestion of poisons on Sagar island in Sunderban delta. India. Int Med J. 2003; 10:85-91
9. Srinivas Rao CH, Venkateshwarlu V, Surender T, Eddleston M, Buckley NA. Pesticide poisoning in South India- opportunities for prevention and improved medical management. Trop Med Int Health 2005; 10:581-9.
10. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Hum Exp Toxicol 2007; 26:753-756
11. Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S, et al. Acute organophosphorus poisoning in university hospital emergency room patients. Int Med J. 2007; 46:965-969
12. Dash SK, Aluri SR, Mohanty MK, Patnaik KK, Mohanty S. Sociodemographic profile of poisoning cases. J Indian Acad. Forensic Med. 2005; 27:133-8.
13. Gargi J, Rai H, Chanana A, Rai G, Sharma G, Bagga IJ. Current trend of poisoning--a hospital profile. J Indian Med Assoc. 2006; 104:72-3
14. Vale JA, Meredith TJ. Poisoning diagnosis and treatment, Edn 1, Update books, London, 1981, pp. 142-152
15. Kale E, Mori A, Risha P, Hasham S, Mwambete K. A Retrospective Study of Poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania E. Journal of Public Health Frontier 2013; 1(2): 21-26.
1. Irwin SR, Rippe JM. Irwin and Rippe's Intensive Care Medicine. 7th ed. Lippincott Williams & Wilkins, 2008, pp: 1433-55.
2. World Health Organization. Guidelines for poison control Bulletin 2004; Geneva: World Health Organisation.
3. London L, Flisher AJ, Wesseling C, Mergler D, Kromhout H. Suicide and exposure to organophosphate insecticides: cause or effect? American Journal of Industrial Medicine 2005; 47:308-321
4. Konradsen F, Hoek W, Peiris P. Reaching for the bottle of pesticide- a cry for help. Self-inflicted poisonings in Sri Lanka. Soc Sci Med. 2006; 62:1710-1719.
5. Wickramasinghe K, Steele P, Dawson A, Dharmaratne D, Gunawardena A, Senarathna L. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka. Bull World Health Organ. 2009; 87:180-185.
6. Medicolegal Issues: Guidelines to Medical Officers. 2012 [Internet] available from http://indianarmy.nic.in/writereaddata/Documents/medico_legal.pdf
7. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet 1974; 81-84.
8. Chowdary AN, Sanyal D, Dutta SK, Weiss MG. Deliberate self-harm by ingestion of poisons on Sagar island in Sunderban delta. India. Int Med J. 2003; 10:85-91
9. Srinivas Rao CH, Venkateshwarlu V, Surender T, Eddleston M, Buckley NA. Pesticide poisoning in South India- opportunities for prevention and improved medical management. Trop Med Int Health 2005; 10:581-9.
10. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Hum Exp Toxicol 2007; 26:753-756
11. Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S, et al. Acute organophosphorus poisoning in university hospital emergency room patients. Int Med J. 2007; 46:965-969
12. Dash SK, Aluri SR, Mohanty MK, Patnaik KK, Mohanty S. Sociodemographic profile of poisoning cases. J Indian Acad. Forensic Med. 2005; 27:133-8.
13. Gargi J, Rai H, Chanana A, Rai G, Sharma G, Bagga IJ. Current trend of poisoning--a hospital profile. J Indian Med Assoc. 2006; 104:72-3
14. Vale JA, Meredith TJ. Poisoning diagnosis and treatment, Edn 1, Update books, London, 1981, pp. 142-152
15. Kale E, Mori A, Risha P, Hasham S, Mwambete K. A Retrospective Study of Poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania E. Journal of Public Health Frontier 2013; 1(2): 21-26.
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01-07-2014
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“PATTERN OF ACUTE POISONING ADMISSIONS IN THE MEDICAL INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 6, no. 3, July 2014, pp. 239-42, https://doi.org/10.25004/IJPSDR.2014.060314.
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How to Cite
“PATTERN OF ACUTE POISONING ADMISSIONS IN THE MEDICAL INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 6, no. 3, July 2014, pp. 239-42, https://doi.org/10.25004/IJPSDR.2014.060314.
