English abstract
Background
Acute poisoning remains a significant paramount clinical emergency globally. The type of
poison to which an individual is exposed to varies all over the world and may even vary in
different regions of the same country depending on the socioeconomic factors and cultural
diversity. It is of a crucial importance to investigate and analyze the pattern and severity of
poisoning in order to manage poisoning cases. Accordingly, prompt initiation of appropriate
emergency care and supportive measures could be life-saving and could possibly reduce
morbidity and mortality.
Aim
To characterize acute poisoning, marine envenomation, venomous animal bites/stings, identify
the outcome of poisonings and analyze the pattern of management of acute poisoning cases
presenting to the emergency medical department in Sultan Qaboos University hospital (SQUH)
in the Emergency Medical Department (EMD).
Objectives
To analyze reported acute poisoning cases by EMD at SQUH for demographical information
and etiological patterns and to identify the nature of agents involved in acute poisoning.
To determine risk factors of prolonged hospital stay for acute poisoning cases.
To assess the adherence to the National Management Guidelines of Poisoning by Ministry of
Health (MOH).
Methods
This was a retrospective study done in the EMD of SQUH (a tertiary care hospital). The Study
included a total of 350 cases, out of which 336 patients of acute poisoning, 10 cases of marine
envenomation and 4 cases of venomous animal bites/stings. Data regarding demographics,
type, and mode of poisoning, comorbid illness, complications, system involvement, first aid
outside SQUH, initial treatment at the hospital, requirement of antidote, duration of
hospitalization, and outcome were obtained.
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Scoring system: Ministry of health of Oman (MOH) poisoning scoring system, that was adapted
from "Poisoning Severity Score" (PSS). It is a standardized scale for grading the severity of
poisoning to facilitate qualitative evaluation of morbidity due to poisoning, better identification
of real risks and comparability of data. As per MOH poisoning scoring system, severity
grading is classified to minor, moderate, and severe/fatal.
Results
Among the 350 patients included, females accounted for the majority of cases (56,3% versus
43.7%). Intentional exposures were seen more frequent (186, 53.1%). Most of the reported
poisoning cases were due to medicinal drugs exposures (247, 71%). Among medicinal drug
poisonings, multiple drugs intake was prominent (56, 16%), while among non-pharmaceutical
exposures, household products were common (57, 16.4%).
It was found that (67 ,19.1%) were treated conservatively without receiving any medical
intervention. Length of hospitalization was the highest in patients who were admitted to
psychiatry medicine and/ or Intensive care unit (ICU), those who developed multiple system
manifestations and among those who received antidotes.
There was one death (case fatality rate of 0.3), primarily from organophosphate pesticide
ingestion
Conclusion
Poisoning in the age group of ≤ 12 years is mainly unintentional and commonly due to
pharmaceutical agents while poisoning in older age groups is mainly intentional (self-harm).
Opioids were detected to cause high rates of delayed recoveries, whereas hydrocarbons, mainly
toluene was the most frequent non-pharmaceutical agent causing delayed recovery. Drugs
detected at high rates in poisonings, such as paracetamol should be used more cautiously.
