[An epidemiological study of acute intoxications and provision of medical-cabinet antidotes]

A Bajo Bajo, M E Santos Pérez, F Sanz Ortega, N Zapico Alvarez, K T Okatsu, A García Pérez, R Borrás Beato
Anales de Medicina Interna: Organo Oficial de la Sociedad Española de Medicina Interna 1999, 16 (6): 285-9

OBJECTIVES: The aims of this work is to know first, the characteristics of the cases of acute intoxication seen in the emergency room of he "Hospital Clínico de Salamanca", Spain; and second, the existence of first-aid antidote kits, their location within the hospital, and their supplies in relation of the level of assistance being provided in hospitals in the region of "Castilla-León".

METHODS: All cases of acute intoxication attended in the Emergency Room in he "Hospital Clínico de Salamanca" during one year (from June 1993 through May 1994) were studied prospectively. A descriptive analysis of several variables was performed including age, sex, monthly distribution, causes, toxic substances involved, route of exposure, clinical manifestations, treatment, department in witch patients were admitted and clinical evolution. Additionally, a questionnaire was sent to physicians in charge of emergency services of hospital in "Castilla-León" regarding the existence, location an equipment of first-aid antidote units.

RESULTS: A total of 425 cases of acute intoxication were attended, representing 0.69% of all cases seen in the emergency room, during the mentioned period. The age range with the highest incidence was 20-30 years, representing 28.94% of the cases of acute intoxication. 51.3% of cases corresponded to male individuals, although in the 20-30 year range 63.11% were females. February was the month with the highest incidence. With regard to etiology, accidental exposure was the most common, representing 60.47% of cases, while among females 49.28% of cases of intoxication were self inflicted. The toxic substances most frequently involved were alcoholic drinks (23%) and benzodiazepines (17.16%). Recreation and opiate drugs represented 16.23% of the cases. The route of exposure was oral ingestion in 81% of cases and the most common clinical manifestation were of neurologic type which were present in 48% of patients attended. 25% of patients were admitted, representing 0.80% of admissions from the Emergency Room, with the intensive care unit and the Department of Psychiatry (32% of cases in each one) being the areas in which the highest number of patients were hospitalized. The number of patients that died was 2, which represents 0.47% of intoxicated patients attended. In 40% of hospital of the region there is a specific location within the Emergency Room for the first aid antidote drug kit. There is a good correlation between the levels of assistance of hospitals of Castilla-León and the supplies of the first aid antidote kit in the Emergency Room as well as in the Pharmacy Unit.

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