Poisoning And Toxicological Emergencies – Current Trends And Practice

Poisoning And Toxicological Emergencies – Current Trends And Practice

Abstract

Poisoning is a common presentation to hospital acute medical units, and can produce a variety of clinical scenarios. This review discusses the epidemiology of poisoning, a framework for managing patients with drug toxicity and considerations in the diagnosis of toxicity with unknown substances. The commonest substances seen in toxicity in the UK – paracetamol, antidepressants, sedatives and opioids are discussed in more detail.
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Poisoning And Toxicological Emergencies – Current Trends And Practice

2nd March 2016
PMID: 21607204
Authors Affiliations
Edward Banham-Hall MB BS BSc MRCP Specialty Registrar in Acute Medicine Ipswich Hospital NHS Trust
Robert Mallinson MB ChB MRCP Consultant in Acute Medicine Ipswich Hospital NHS Trust
Nicola Trepte MBBS FRCP Consultant and Clinical Lead for Acute Medicine Department of Acute Medicine

Poisoning And Toxicological Emergencies – Current Trends And Practice

Cite this article as:

Banham-Hall E, Mallinson R, Trepte N. Poisoning and toxicological emergencies - current trends and practice. Acute Med. 2009;8(1):17-21. PMID: 21607204.

Poisoning And Toxicological Emergencies – Current Trends And Practice

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