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A7 “Near miss” poisonings: a national picture
  1. G Thomas,
  2. H Snooks
  1. Swansea University, Swansea, UK

Abstract

Introduction Non-fatal poisoning is one of the commonest reasons for general hospital admission in the UK. We know that following an episode of non-fatal poisoning people are at increased risk of suffering a fatal overdose within a short time period. Little is known about clinical, demographic and geographical epidemiology of non-fatal poisonings. In this paper we present findings from a national “snapshot” observational study of 999 calls and attendances for non-fatal poisonings in Wales.

Aims In order to better understand the clinical epidemiology of and information related to non-fatal poisonings we describe, at national level:

  1. information pathway for the identification and retrieval of data about non-fatal poisonings attended by emergency ambulance crews

  2. patterns of presentation of non-fatal poisonings for which 999 calls are made

Methods Observational data related to non-fatal poisonings in Wales were retrospectively collected for the period December 2007–February 2008 from:

  • ambulance call centre records (dispatch codes)

  • Patient Clinical Records (PCR) completed by attending ambulance crews.

Cases identified through dispatch data were matched with PCR data; clinical and demographic data were obtained from the PCRs.

Results A total of 92 331 999 calls were made during the study period of which 3923 were coded in the 999 call centre as overdose/poisoning (4.2%). During the same period 1827 PCR forms categorised as overdose by attending ambulance staff were identified through a manual process. 1287 of these matched with calls identified from call centre data (26.18%). Of the calls categorised by crews as overdose [Paracetamol (23.9%, 438/1827), antidepressants (15.5%, 285/1827) and benzodiazepines (14.4%, 264/1827)] were the most frequently taken drugs. Over half (1072/1827) had taken more than one substance, although this was not spread evenly among the drug groups. The mean age of cases was 34 years (SD 15.4) and cases were predominantly female (54.24%, 991/1827). Incidents were spread across Wales with concentrations in industrial urban south Wales, particularly of heroin overdoses. Cardiff: (16.5%, 302/1827) poisonings, (17.2%, 16/93) heroin poisonings; Swansea: (15.4%, 281/1827) poisonings, (25.8%, 24/93) heroin poisonings.

Conclusion We have reported new data related to patterns of presentation of non-fatal poisoning, allowing improvements in the management of this patient group. However, current 999 clinical and management information systems do not allow routine identification of these cases, limiting ability to monitor impact of changes in care provided.

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