Abstract
BackgroundIn Oslo, the majority of patients with acute poisoning are treated in primary care, at an emergency outpatient clinic with limited diagnostic and treatment resources. We describe the poisonings currently seen in this setting. We compare our findings with previous studies, with special concern for the appearance of new toxic agents, and changes in overall numbers and patterns of poisoning.MethodsObservational study. Patients above the age of 12 years presenting at Oslo Accident and Emergency Outpatient Clinic (Oslo Legevakt) with acute poisoning were included consecutively from October 2011 through September 2012. Physicians and nurses registered data on preset forms. Main outcome measures were toxic agents, age, sex, intention, referral and time of presentation.ResultsThere were 2923 episodes of acute poisoning in 2261 patients. Median age of the patients was 32 years, and 1430 (63 %) were males. The most frequent toxic agents were ethanol in 1684 (58 %) episodes, heroin in 542 (19 %), benzodiazepines in 521 (18 %), amphetamine in 275 (9 %), fire smoke in 192 (7 %), gamma-hydroxybutyrate (GHB) in 144 (5 %), and cannabis in 143 (5 %). In 904 (31 %) poisonings there were more than one toxic agent. In 493 episodes (17 %), the patient was hospitalised, and in 60 episodes (2 %) admitted to a psychiatric ward. Most poisonings, 2328 (80 %), were accidental overdoses with substances of abuse, 276 (9 %) were suicide attempts, and 312 (11 %) were accidents. Among ethanol poisonings in patients above the age of 26 years, 685/934 (73 %) were in males, and 339/934 (36 %) presented during weekends. However, among ethanol poisonings in patients under the age of 26 years, 221/451 (49 %) were in females, and 297/451 (66 %) presented during weekends.ConclusionsThe poisonings treated in this primary care setting were mostly due to accidental overdoses with ethanol or other substances of abuse. There is a disconcerting weekend drinking pattern among adolescents and young adults, with young females presenting as often as young males with ethanol poisoning.
Highlights
In Oslo, the majority of patients with acute poisoning are treated in primary care, at an emergency outpatient clinic with limited diagnostic and treatment resources
In Oslo, the majority of poisoned patients are treated in primary care, at the Oslo Accident and Emergency Outpatient Clinic (OAEOC, Oslo Legevakt)
In 216 (7 %) episodes, the patient declined participation, leaving 2923 cases of acute poisoning in 2261 patients included in the study
Summary
In Oslo, the majority of patients with acute poisoning are treated in primary care, at an emergency outpatient clinic with limited diagnostic and treatment resources. We compare our findings with previous studies, with special concern for the appearance of new toxic agents, and changes in overall numbers and patterns of poisoning. New drugs appear [2, 3], poisoning patterns for familiar substances change [4, 5], there are. Most patients with acute poisoning are treated as outpatients in hospital emergency departments. In Oslo, the majority of poisoned patients are treated in primary care, at the Oslo Accident and Emergency Outpatient Clinic (OAEOC, Oslo Legevakt). Previous studies in 2003 and 2008 have shown that treatment of acute poisoning at the OAEOC is safe, considering the low mortality during treatment and immediately after discharge [9, 10]
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