title: Limiting the use of gastrointestinal decontamination does not worsen the outcome from deliberate self-poisoning.
abstract: OBJECTIVE
  To review the current epidemiology of patients with deliberate self-poisoning presenting to Christchurch Emergency Department, and to compare this with 1996, 1992, and 1989 data.
  
  
  METHODS
  A retrospective analysis of computer and case records over the twelve-month period of 1999 was conducted and compared with published data from 1996,1992 and 1989.
  
  
  RESULTS
  There were 561 presentations of deliberate self-poisoning to Christchurch Hospital, representing 0.87% of total presentations (compared with 1.1% in 1996, 1.2% in 1992, and 1.0% in 1989). The female to male ratio was 2.2:1.0 (compared with 1.9:1.0, 1.5:1.0, and 2.1:1.0). The principal drugs ingested were antidepressants 30.8% (compared with 20.1%, 24.4%,15.7%), paracetamol 23.5% (compared with 16.7%, 16.9%, 10.6%), benzodiazepines 23.0% (compared with 11.1%, 23.6% 22.8%) and antipsychotics 17.8% (compared with 10.7%, 16.1%, not reported). Gastrointestinal decontamination was performed in only 14.4% of patients (compared with 61%, 73%, 61%). Activated charcoal was given alone in 13.2% (compared with 54%, 46%, 0.4%), activated charcoal and gastric lavage in 0.7% (7%, 26%, 53%), a whole bowel irrigation in 0.5% (not recorded in previous papers). 70.4% were admitted (compared with 69%, 59%, 64%), 7% to intensive care (10.2%, 10.6%, 18%). There were two deaths (compared with 6, 2 and 2).
  
  
  CONCLUSIONS
  Over the time periods studied the drugs ingested and admission rates remain similar, although a large proportion are now being observed in the emergency short stay ward, reducing admission rates to the ward and intensive care. Trends in gastrointestinal decontamination have changed dramatically over the four time periods, but there has been no worsening in the outcome of patients with deliberate self-poisoning.
authors.affiliation: Emergency Department, Christchurch Hospital. Michaela@cdhb.govt.nz
authors.forename: M
authors.initials: M
authors.lastname: Ardagh
authors.forename: D
authors.initials: D
authors.lastname: Flood
authors.forename: C
authors.initials: C
authors.lastname: Tait
mesh_terms: D000082:Acetaminophen / Q000506:poisoning; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000506:poisoning; D001569:Benzodiazepines / Q000506:poisoning; D016009:Chi-Square Distribution; D003666:Decontamination; D005260:Female; D005500:Follow-Up Studies; D005751:Gastric Lavage / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011041:Poisoning / Q000453:epidemiology* / Q000628:therapy*; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D001569:Benzodiazepines; D000082:Acetaminophen