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Exploratory study of factors associated with adverse clinical features in patients presenting with non-fatal drug overdose/self-poisoning to the ambulance service
  1. Stella May Gwini1,
  2. Deborah Shaw2,
  3. Mohammad Iqbal2,
  4. Anne Spaight2,
  5. Aloysius Niroshan Siriwardena2,3
  1. 1Centre for Occupational and Environmental Health, Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2East Midlands Ambulance Service NHS Trust, Lincolnshire Divisional Headquarters, Cross O'Cliff Court, Bracebridge Heath, Lincoln, UK
  3. 3Faculty of Health, Life and Social Sciences, University of Lincoln, Lincoln, UK
  1. Correspondence to A Niroshan Siriwardena, Professor of Primary and Prehospital Health Care, Faculty of Health, Life and Social Sciences, University of Lincoln, Lincoln LN6 7TS, UK; nsiriwardena{at}


Aim To investigate the factors associated with adverse clinical features presented by drug overdose/self-poisoning patients and the treatments provided.

Methods Historical patient records collected over 3 months from ambulance crews attending non-fatal overdoses/self-poisoning incidents were reviewed. Logistic regression was used to investigate predictors of adverse clinical features (reduced consciousness, obstructed airway, hypotension or bradycardia, hypoglycaemia) and treatment.

Results Of 22 728 calls attended to over 3 months, 585 (rate 26/1000 calls) were classified as overdose or self-poisoning. In the 585 patients identified, paracetamol-containing drugs were most commonly involved (31.5%). At least one adverse clinical feature occurred in 103 (17.7%) patients, with higher odds in men and opiate overdose or illegal drugs. Older patients and patients with reduced consciousness were more likely to receive oxygen. The latter also had a greater chance of receiving saline.

Conclusion Non-fatal overdose/self-poisoning accounted for 2.6% of patients attended by an ambulance. Gender, illegal drugs or opiates were important predictors of adverse clinical features. The treatments most often provided to patients were oxygen and saline.

  • Overdose
  • poisoning
  • prehospital
  • paramedic
  • therapies
  • self-harm
  • drug overdose
  • self-poisoning
  • treatment
  • ambulance services
  • prehospital care
  • cross sectional study
  • mental health
  • nursing

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  • Funding The study was funded by Trent Research and Development Support Unit and East Midlands Ambulance Service NHS Trust.

  • Competing interests None.

  • Ethics approval This study was approved by Derbyshire Research Ethics Committee (Reference 08/H0401/122) and the Ethics Committee of the Centre for Clinical and Academic Workforce Innovation, University of Lincoln. Approval for Research Management and Governance was sought and gained from East Midlands Ambulance Service.

  • Provenance and peer review Not commissioned; externally peer reviewed.