Changing epidemiology and management of deliberate self poisoning in Christchurch.
OBJECTIVE
To review the epidemiology and emergency management of deliberate self poisoning by substance ingestion in Christchurch for 1992, with comparison to 1989.


METHODS
A retrospective analysis of case records was conducted for the year 1992, and compared with published data from 1989.


RESULTS
There were 622 presentations (compared to 531 in 1989) of deliberate self poisoning by substance ingestion, representing 1.2% (cf 0.96%) of the total emergency department consultations. The female to male ratio was 1.5:1.0 (cf 2.1:1), with three quarters of patients being under the age of 35. The principle drugs ingested were antidepressants (24.4% cf 15.7%), hypnotic/anxiolytics 23.6% (benzodiazepines 18% cf 22.8% in 1989), paracetamol (16.9% cf 10.6%) and antipsychotics (16.1%, not reported 1989). Stomach emptying procedures were used in 27% of patients (cf 78%). Ipecacuanha was administered in 1% (cf 25%). Activated charcoal alone was used as the method of gastrointestinal decontamination in 46% (cf 0.4%). No attempt at decontamination was made for 27% of patients. Fifty nine percent (cf 66%) were admitted, 11% (cf 18%) to the intensive care unit. There were two inpatient deaths in both 1992 and 1989.


CONCLUSIONS
Antidepressants have become the most frequently misused medication, and misuse of paracetamol has increased. However, self poisoning remains a phenomenon of low morbidity and mortality. Stomach emptying procedures are used much less frequently, making for substantial savings of time, resources and patient discomfort.
Hall
A K
AK
Emergency Department, Christchurch Hospital.
Curry
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002606:Charcoal / Q000627:therapeutic use; D002648:Child; D002985:Clinical Protocols; D062787:Drug Overdose / Q000453:epidemiology* / Q000628:therapy*; D004632:Emergency Medical Services / Q000379:methods / Q000639:trends; D004636:Emergency Service, Hospital; D005260:Female; D005751:Gastric Lavage; D017052:Hospital Mortality; D006801:Humans; D007486:Ipecac / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000706:statistics & numerical data* / Q000639:trends; D014505:Urban Population
D002606:Charcoal; D007486:Ipecac