Toxicology

Introduction Poisoning is one of the commonest medical emergencies in the UK and accounts for 10%-20% of acute medical admissions. The most common causes of poisoning in the UK are outlined in Table 13.1. Assessing poisoned patients and managing them is an exciting challenge because they often have complex psychosocial issues, together with general medical problems, and have taken toxins in sizeable doses. They require the best of clinical skills to provide the best outcome. Sadly, poisoned patients do not always meet with the sympathies of admitting doctors because th? ~ay be perceived to have "self-inflicted illness." This is a morally unacceptable view. Self-poisoned patients are most likely to respond to a pragmatlc, non-judgemental approach. Often an overdose is taken at a time of stress, .e.g. due to exams or relationship difficulties. Patients often need a helpful ear, supportive medical care, and follow-up support. Some may need ongoing psychiatric evaluation and support. Some patients, such as those who have taken paracetamol, may need treatment with an antidote. However, in general, the antidotes in toxicology are few (Table 13.2.) and the outcome depends on the ability of the clinincian to deliver meticulous supportive care.