ONE YEAR OF DELIBERATE SELF-POISONING PRESENTATIONS AT A WEST LONDON EMERGENCY DEPARTMENT

George Bailey, Fiona Wisniacki

Abstract


Aim

To provide an up-to-date assessment of the demographics, patient characteristics and substances involved in deliberate self-poisoning (DSP) presentations to a UK emergency department (ED).

Method

A retrospective observational study was undertaken at Ealing Hospital ED between 1st August 2011 and 31st July 2012. Scanned ED records were reviewed to collect data from potential DSP presentations.

Results

368 DSP presentations were identified, accounting for 0.9% of total ED attendances. The mean age was 34.2 years and the female : male ratio 1.85 : 1. All 12 patients under 16 years were female. 561 substances were used in total. Paracetamol was the most frequently used substance, taken by 150 (40.8%) patients (with the addition of compound analgesics). The next most frequent substances were NSAIDs (16.8% of patients), hypnotics and anxiolytics (15.2%), SSRIs (13.9%), compound analgesics (8.7%) and atypical antipsychotics (8.4%). 533 (95.0%) of the substances were medications listed in the BNF. Household cleaning products were the most common of five other groups. Specific treatments were administered to 77 (20.9%) patients. 122 (33.2%) patients required specialty admission.

Conclusion

DSP remains a common ED presentation and presents the challenge of managing both medical complications and psychiatric risks. Observational studies on DSP are an important source of information on trends in demographics and substances; this can inform future prevention strategies. A detailed assessment of DSP presentations is provided in this study. A national surveillance system or study is recommended to improve knowledge and a consensus on classification of substances would aid comparisons between studies.


Keywords


Poisoning ; deliberate self-poisoning ; deliberate self-harm ; toxicology

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References


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