Abstract
IntroductionAcetaminophen is one of the most common causes of poisoning among developed countries. The emergency department observation unit (EDOU) has been increasingly used in the management of various conditions to reduce hospitalisation but its efficacy in not well studied in management of poisoned patients. In this study, we aim to study the effectiveness of our EDOU in the management of acetaminophen overdosed patients.ResultsMedical records of patients admitted from the emergency department from 2012 to 2016 for acetaminophen overdose were reviewed. One hundred ninety-five patients presenting with acetaminophen overdose were admitted to the EDOU while 184 were admitted to the general ward. Of these, 27 patients admitted to EDOU did not meet the admission criteria for it while 71 patients who met EDOU criteria were admitted to the ward instead. For patients who fulfilled EDOU admission criteria, median length of stay for EDOU patients was 23 h (IQR 19–24) while that for those admitted to the ward was 66 h (IQR 62.5–88.3).ConclusionThe EDOU is a safe alternative to hospitalisation for patients presenting with acetaminophen poisoning. It is also associated with a shorter length of stay for such patients. Further studies need to be done to assess the cost-effectiveness of EDOU for management of patients presenting with acetaminophen overdose.
Highlights
Acetaminophen is one of the most common causes of poisoning among developed countries
From 1 January 2012 till 31 December 2016, a total of 195 patients were admitted from the emergency department (ED) to the emergency department observation unit (EDOU) for acetaminophen poisoning and 184 patients were admitted to the general ward (Fig. 1)
Of the 195 patients admitted to the EDOU for acetaminophen poisoning, 158 patients (81%) meets the admission criteria
Summary
Acetaminophen is one of the most common causes of poisoning among developed countries. Acetaminophen is one of the most common causes of poisoning in developed countries [1, 2]. In Singapore, it is one of the most common drugs that is overdosed by both children and adults [3,4,5]. It is a common cause of liver failure in Europe and North America, which is associated with significant morbidity and mortality [6]. The standard treatment protocol for acetaminophen overdose is a 21-h course of intravenous (IV) NAC infusion. A previous study found that most general ward admissions secondary to drug overdose
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