Suicidal or homicidal poisoning with drugs over dosage is one of the common causes of morbidity and mortality in Asian countries. Acute poisoning accounts for an estimated 10-20% of acute medical admissions in United Kingdom.
When a patient with poisoning is bought to the ward, the following management steps are carried out.
· assessment of the danger
· gut decontamination using activated charcoal
· maintenance of fluid balance
· air way control
Gastric levage is important if could be performed within first 60 minutes of ingestion of poisons. In some of the developing countries gastric lavage is carried out even after 2 hours. This is an incorrect method. In those countries the procedure is carried out by non medical personell with no training. This should never be happened. It put the patient’s life in danger due to aspiration.
Gastric larvage should never be performed on patients who does not give consents to do so.
MANAGEMENT
The following should be done in patients who present with a history, signs and symptoms of poisoning.
I) General Management
a. Securing the airway, intubation,
b. Assessment of breathing, oxygen saturation, and arterial blood gas analysis
c. Circulation should be assed by measuring pulse rate, blood pressure, urinary output and peripheral perfusion
d. estimate S. electrolytes, S. glucose and other parameters
e. Challenge with glucose should be done to avoid irreversible brain injury due to hypoglycemia.
II) Specific Management
General Management involves the following steps.
B) Decontamination of body parts.
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