Scottish Intensive Care Society

ICM Induction programme ©

1. The scale of the poisoning problem and how it relates to ICU admissions

Poisoning is one of the commonest acute medical presentations in the UK. Discharge data

for hospitals in Scotland reveal the incidence of deliberate self-poisoning to be among the

highest in Europe (379.3/100 000 per year for women and 331.5/100 000 per year for men

over 1990-1999) [1].

Unfortunately the incidence of poisoning is increasing with time.

Most poisonings are managed in acute medical admissions units, emergency department

observation units or dedicated toxicology units. More ‘unwell’ patients, or those requiring

continuous monitoring may be managed in medical high dependency units. However, in

certain circumstances admission to an ICU is appropriate. Indeed most poisoned patients

have acutely reversible conditions that may potentially benefit from ICU intervention.

[1. Bateman DN, Bain M, Gorman D et al. Changes in paracetamol, antidepressants and

opioid poisoning in Scotland during the 1990s. QJM 2003; 96: 1-8.]

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