Suspected Poisoning Research Articles

Trends of Poisoning Cases Coming to a Tertiary Care Center in Lucknow: A Retrospective Observational Study

Introduction: The term “suspected poisoning” describes the potential exposure of a human or animal to a poisonous chemical, which might result in a variety of symptoms ranging from minor symptoms to severe consequences. The kind and quantity of the poison implicated may affect the symptoms. If poisoning is suspected, it’s crucial to get help right away so that the correct toxin can be identified and the proper management can be given.Aim: To monitor the epidemiological traits and clinical trends of poisoning cases at the emergency department of Dr. RMLIMS Lucknow.Methods: All 295 instances of acute poisoning were reported to the emergency department between April 2022 to March 2023. It is retrospective observational research of 12 months duration carried out in a tertiary care hospital. Data on the patient’s age, gender, kind of poisoning, length of hospital stay, and result were gathered from hospital medical records and examined.Result: The majority of victims have married housewives with poor socioeconomic and educational standingwho were between the ages of 31 and 40. Agriculture poisons and domestic poisons were the two most often used toxins. Most of the time, the general health at the time of presentation was unstable.Conclusion: Suspected poisoning is a serious medical emergency that might have life-altering effects on thevictims. Knowledge of the probable causes and symptoms of poisoning is crucial to ensure prompt diagnosis and treatment. Those who have been exposed to harmful chemicals can recover and prevent long-term harm with the proper measures.

Risk Assessment and Risk Management of Incidents of Suspected Poisoning

Abstract Poisoning in livestock, horses and wildlife may be localised or large events involving single or multiple animals and can have public health, economic or medicolegal, as well as animal welfare, implications. Investigation of these incidents is required to determine the cause, assess the risk to other animals and people and instigate an appropriate risk management plan. Investigations will involve clinical examination and history taking, site visits to determine possible sources of poisoning, post-mortem examination and collection of biological (both ante and post-mortem) and environmental samples (water, soil, feed, suspect plants). Interpretation of laboratory analyses and investigations may involve a multidisciplinary team in order to formulate and implement a risk management programme. Specialist advice should be sought early in the investigation in order to ensure appropriate sampling and correct actions are undertaken. Practitioners should be aware of where and how to report incidents, where to seek advice and have some awareness of common toxicological risks, particularly local or seasonal risks, to livestock and other animals. This case study outlines some of the steps that should be undertaken when handling a case of suspected poisoning in animals and highlights some of the possible circumstances and substances that may result in toxicosis. Information © The Author 2023

Suspected alimentary poisoning by aluminium phosphide in horses – a case report

In November 2018, a horse owner from the Czech Republic experienced the loss of two of his stallions in consequence of probable poisoning. The affected animals were kept in the stable only. The mares, which were grazing on pasture during the day, were not affected. All the animals were fed the same type of feed. The day before the animals became sick, between 15:00 to 19:00 h the stable was not secured against the entry of strangers. When the mares were brought back to the stable and all animals were closed and locked for the night, no signs of health issues were observed. In the following morning, the two stallions were found in lateral recumbency with seizure attacks. Despite symptomatic treatment (infusion with saline, flunixine meglumine, activated charcoal) and applications of myorelaxants, the symptoms persisted until the afternoon, and the owner agreed with euthanasia. Based on the clinical signs and pathological examination, poisoning by pesticides was suspected. The results of toxicological analyses revealed that carbofuran, metaldehyde, and strychnine were not responsible for the poisoning as they were not detected in the samples. The only positive finding was a high aluminium concentration in the stomach content, liver and kidney samples. Based on the observed symptoms and the high aluminium concentration, it was presumed that aluminium phosphide could be the source of poisoning. As there was no evidence of the possession of such product by the horse breeder and the stable stayed unsupervised for a few hours, intentional poisoning cannot be excluded.

Suspected veterinary poisoning cases: A retrospective toxicoepidemiology study (2009-2019) in south-eastern Italy

Suspected veterinary poisoning cases: A retrospective toxicoepidemiology study (2009-2019) in south-eastern Italy

Reductions in emergency department visits after primary healthcare use of the UK National Poisons Information Service

Background: Suspected poisoning is a common cause of hospital admission internationally. In the United Kingdom, the National Poisons Information Service (NPIS), a network of four poisons units, provides specialist advice to health professionals on the management of poisoning by telephone and via its online poisoning information and management database, TOXBASE®.Objective: To demonstrate the impact of NPIS telephone advice and TOXBASE® guidance on poisoning-related referrals to emergency departments (ED) from primary healthcare settings.Methods: A telephone survey of primary healthcare providers calling the NPIS and an online survey of TOXBASE® primary care users were conducted to evaluate the effect of these services on poisoning-related ED referrals. Enquirers were asked to indicate whether referral was needed before and after using these information sources.Results: The number of cases considered by enquirers appropriate for ED referral was reduced from 1178 (58.1%) before to 819 (40.4%) after the provision of telephone advice for 2028 cases (absolute reduction 17.7%, 95% CI 14.6, 20.7%) and from 410 (48.2%) before to 341 (40.1%) after consideration of TOXBASE® guidance for 851 cases (absolute reduction 8.1%, 95% CI 3.3, 12.9%). By extrapolating these figures over a full year, it is estimated that these services prevent approximately 41,000 ED referrals annually.Conclusions: The use of NPIS services significantly reduced ED referrals from primary healthcare services with resulting avoided healthcare costs exceeding the current annual NPIS budget. Further studies are needed to evaluate other potential benefits of accessing NPIS services.

Resource Utilization in Emergency Department Patients with Known or Suspected Poisoning

Previous work has shown poisoning-related emergency department (ED) visits are increasing, and these visits are resource-intensive. Little is known, however, about how resource utilization for patients with known or suspected poisoning differs from that of general ED patients. We reviewed 4years of operational data at a single ED. We identified visits due to known or suspected poisoning (index cases), and paired them with time-matched controls. In the primary analysis, we compared the groups with respect to a broad array of resource utilization characteristics. In a secondary analysis, we performed the same comparison after excluding patients ultimately transferred to a psychiatric facility. There were 405 index cases and 802 controls in the primary analysis, and 374 index cases and 741 controls in the secondary analysis. In the primary/secondary analyses, patients with known or suspected poisoning had longer ED lengths of stay in minutes (370 vs. 232/295 vs. 234), higher rates of laboratory results per patient (40.4 vs. 26.8/39.6 vs. 26.8), greater administration of intravenous medications and fluids per patient (2.0 vs. 1.6/2.1 vs. 1.6), higher rates of transfer to a psychiatric facility (7.7 vs. 0.2%/not applicable), and higher rates of both admission (40.2 vs. 32.8/43.6 vs. 33.1%) and admission to an advanced care bed (21.5 vs. 7.6/23.3 vs. 7.8%). Patients with known or suspected poisoning had lower rates of imaging per patient, for both plain radiographs (0.4 vs. 0.5/0.4 vs. 0.5) and advanced imaging studies (0.3 vs. 0.5/0.4 vs. 0.5). ED patients with known or suspected poisoning are more resource intensive than general ED patients. These results may have implications for both resource allocation (particularly for departments that might see a high volume of such patients) and ED operations management.

Suspected poisoning of domestic animals by pesticides

A retrospective study was carried out by reviewing all suspected cases of domestic animal poisoning attributed to pesticides, reported to the Milan Poison Control Centre (MPCC) between January 2011 and December 2013. During this period, pesticides were found to be responsible for 37.3% of all suspected poisoning enquiries received (815). The most commonly species involved was the dog (71.1% of calls) followed by the cat (15.8%), while a limited number of cases involved horses, goats and sheep. Most cases of exposure (47.1%) resulted in mild to moderate clinical signs. The outcome was reported in 59.9% of these cases, with death occurring in 10.4% of them. Insecticides (40.8%) proved to be the most common group of pesticides involved and exposure to pyrethrins–pyrethroids accounted for the majority of calls. According to the MPCC data, there has been a decrease in the number of suspected poisonings cases attributed to pesticides that have been banned by the EU, including aldicarb, carbofuran, endosulfan and paraquat. In contrast, there has been an increase of suspected poisoning cases attributed to the neonicotinoids, imidacloprid and acetamiprid, probably due to their widespread use in recent years. Cases of suspected poisoning that involved exposure to rodenticides accounted for 27.6% of calls received by the MPCC and anticoagulant rodenticides were the primary cause of calls, with many cases involving brodifacoum and bromadiolone. Herbicides were involved in 14.2% of calls related to pesticides and glyphosate was the main culprit in cases involving dogs, cats, horses, goats and sheep. As far as exposure to molluscicides (11.5%) and fungicides (5.9%), most of the cases involved dogs and the suspected poisoning agents were metaldehyde and copper compounds respectively. The data collected are useful in determining trends in poisoning episodes and identifying newly emerging toxicants, thus demonstrating the prevalence of pesticides as causative agents in animal poisonings.

A Meta-Analysis of the Reliability of the History in Suspected Poisoning

BackgroundManagement of acute poisoning depends on the reliability of history of the poisoning event. ObjectiveThe objective of this study was to perform a meta-analysis from published data to determine summary measures of reliability of history in suspected acute poisoning. MethodRelevant studies were selected from a search on the Medline database to perform a meta-analysis to calculate pooled estimates of κ statistic for agreement between history of poisoning and laboratory diagnosis. ResultsA total of seven articles were included in the meta-analysis. The κ statistic varied from 0.35 (95% confidence interval [CI] 0.135–0.558) for 3,4-methylenedioxy-N-methylamphetamine (MDMA, also known as ecstasy) to 0.69 (95% CI 0.648–0.733) for paracetamol. ConclusionsA history of paracetamol ingestion is moderately reliable, and further evaluation is required to make a clinical diagnosis of acute poisoning with street drugs.

Suspected poisoning of cattle by scarlet pimpernel (Lysimachia arvensis L.)

The ingestion of scarlet pimpernel (Lysimachia arvensis L.), also known as red chickweed, has been reported as a cause of death of cattle in Uruguay, and as the suspected cause of deaths of sheep in Australia. It has not previously been reported in association with deaths of cattle in Australia. We report the clinical and pathological findings from four cattle in western Victoria that died with a nephrosis suspected to be secondary to intoxication with scarlet pimpernel.

Electrocardiographic Predictors of Adverse Cardiovascular Events in Suspected Poisoning

Poisoning is the second leading cause of injury-related fatality in the USA and the leading cause of cardiac arrest in victims under 40 years of age. The study objective was to define the electrocardiographic (ECG) predictors of adverse cardiovascular events (ACVE) complicating suspected acute poisoning (SAP). This was a case-control study in adults at three tertiary-care hospitals and one regional Poison Control Center. We compared 34 cases of SAP complicated by ACVE to 101 consecutive control patients with uncomplicated SAP. The initial ECG was analyzed for rhythm, intervals, QT dispersion, ischemia, and infarction. ECGs were interpreted by a cardiologist, blinded to study hypothesis and case data. Subjects were 48% male, with mean age 42 +/- 19 years. In addition to clinical suspicion of poisoning in 100% of patients, routine toxicology screens were positive in 77%, most commonly for benzodiazepines, opioids, and/or acetaminophen. Neither the ventricular rate, the QRS duration, nor the presence of infarction predicted the risk of ACVE. However, the rhythm, QTc, QT dispersion, and presence of ischemia correlated with the risk of ACVE. Independent predictors of ACVE based on multivariable logistic regression were prolonged QTc, any non-sinus rhythm, ventricular ectopy, and ischemia. Recursive partitioning analysis identified very low risk criteria (94.1% sensitivity, 96.2% NPV) and high risk criteria (95% specificity). Among patients with SAP, the presence of QTc prolongation, QT dispersion, ventricular ectopy, any non-sinus rhythm, and evidence of ischemia on the initial ECG are strongly associated with ACVE.

Suspected poisoning and actual poisons found in chemico-toxicological emergency investigations (author's transl)

In almost half (46.5%) of 400 chemico-toxicological investigations suspected poisoning had been assumed without a specific poison being named. In 73% of these cases toxicologically important substances were demonstrated. In 19% of cases no poison could be demonstrated and in approximately 6% of cases poison ingestion could neither be ascertained nor ruled out. In 53.5% of emergency investigations suspected poisons could be named before the beginning of analysis. The information could be verified partially or completely in 78%. In 20% of these more poisonous substances were found than suspected and in 16.3% none of the suspected substances but completely different toxic ones were demonstrable. In 5.6% of cases suspected poison ingestion could not be verified.

Avian mortality events in the United States caused by anticholinesterase pesticides: a retrospective summary of National Wildlife Health Center records from 1980 to 2000.

We reviewed the U.S. Geological Survey National Wildlife Health Center (NWHC) mortality database from 1980 to 2000 to identify cases of poisoning caused by organophosphorus and carbamate pesticides. From the 35,022 cases from which one or more avian carcasses were submitted to the NWHC for necropsy, we identified 335 mortality events attributed to anticholinesterase poisoning, 119 of which have been included in earlier reports. Poisoning events were classified as confirmed (n = 205) when supported by findings of > or =50% inhibition of cholinesterase (ChE) activity in brain tissue and the detection of a specific pesticide in the gastrointestinal contents of one or more carcasses. Suspected poisonings (n = 130) were defined as cases where brain ChE activity was > or =50% inhibited or a specific pesticide was identified in gastrointestinal contents. The 335 avian mortality events occurred in 42 states. Washington, Virginia, and Ohio had the highest frequency of events, with 24 (7.2%), 21 (6.3%), and 20 (6.0%) events, respectively. A total of 8877 carcasses of 103 avian species in 12 orders was recovered. Because carcass counts underestimate total mortality, this represents the minimum actual mortality. Of 24 different pesticides identified, the most frequent were famphur (n = 59: 18%), carbofuran (n = 52; 15%), diazinon (n = 40; 12%), and fenthion (n = 17; 5.1%). Falconiformes were reported killed most frequently (49% of all die-offs) but Anseriformes were found dead in the greatest numbers (64% of 8877 found dead). The majority of birds reported killed by famphur were Passeriformes and Falconiformes, with the latter found dead in 90% of famphur-related poisoning events. Carbofuran and famphur were involved in mortality of the greatest variety of species (45 and 33, respectively). Most of the mortality events caused by diazinon involved waterfowl.

Suspected poisoning of domestic dogs by Macrolepiota molybdites

Macrolepiota molybdites poisoning is suspected as the cause of an intoxication in four German Shepherd dogs. There was very strong circumstantial evidence that the dogs had eaten this fungus and the symptoms encountered were similar to those described for human poisoning with this species. To our knowledge this is the first report of poisoning by Macrolepiota molybdites in dogs.

Suspected poisoning of two dogs

Suspected poisoning of two dogs

Suspected hydrocarbon poisoning of swans and guillemots

A case of sub-acute hydrocarbon poisoning of swans and several separate incidents of suspected chronic hydrocarbon poisoning of guillemots were investigated. The birds' tissues were saponified and extracted with pentane and analysed by gas chromatographymass spectrometry. The residue levels of pristane in the swan tissues and aliphatic hydrocarbons in the guillemots' livers are reported and discussed.

Suspected poisoning of camels by Trema tomentosa (poison peach)

Suspected poisoning of camels by Trema tomentosa (poison peach)

Suspected superphosphate poisoning in calves.

Suspected superphosphate poisoning in calves.

Suspected selenium poisoning in a horse

A case of selenium poisoning was suspected following the administration of 325 micromol selenium a day as sodium selenate (25 mg Se) for five consecutive days. The main signs were confined to changes in the integument which were loss of hair from the mane and tail, disintegration of the skin of the anus, lips, prepuce and scrotum, and separation of the hooves from the coronary corium. Periodic analyses of blood, hair and hoof parings from the sole correlated strongly with blood and identified horn and hair as important additional routes of excretion.

Suspected poisoning of sheep by Anagallis arvensis (scarlet pimpernel).

Suspected poisoning of sheep by Anagallis arvensis (scarlet pimpernel).

Suspected poisoning of cattle by Claviceps spp on water couch.

Australian Veterinary JournalVolume 62, Issue 12 p. 432-433 Suspected poisoning of cattle by Claviceps spp on water couch J W NOBLE, J W NOBLE Department of Primary Industries, P.O. Box 485, Biloela, Queensland 4715Search for more papers by this author J W NOBLE, J W NOBLE Department of Primary Industries, P.O. Box 485, Biloela, Queensland 4715Search for more papers by this author First published: December 1985 https://doi.org/10.1111/j.1751-0813.1985.tb14137.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume62, Issue12December 1985Pages 432-433 RelatedInformation