"improving intensive care in Scotland"


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 thehighest 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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