ABSTRACT
Poisoning emergency is a common occurrence which constitutes a significant source of aggregate morbidity, mortality, and health care expenditure. The aim of the present study was to clinically evaluate the ICU admitted poisoned cases as regard criteria of ICU admission, approach to treatment and discharge criteria during the period from 1-1-2008 to 31-12-2008. Data were collected from self designed admission clinical sheet which included all needed data. The present study revealed that the total poisoned cases that were admitted to Menoufiya poison control center [MPCC] were, 423 cases from 35550 total menoufiya hospitals admission during the year of the study i.e [1.18%] of which 86 cases have been admitted to ICU i.e. [20.33%] and they represented about [2.79%] of total hospital ICU admission [3073 cases]. Most of admitted poisoned cases throughout the year of the study were due to anticholinesterase poisoning 126 cases [29.78%] from those 34 cases were admitted to ICU i.e. [26.98%] from total ICU admitted poisoned cases. Regarding the admission criteria the present work represents that the patients who were admitted due to both hemodynamic instability and altered mental status were the commonest ones [61.63%], followed by altered mental status [16.3%], hemodynamic instability [13.9%] while those presenting with the three admission criteria were [8.1%]. There is a statistically significant relationship between type of poison and admission criteria where all digitalis poisoned cases were admitted with hemodynamic instability [100%] while a high proportion of anticholinesterase poisoned cases were admitted for both hemodynamic instability and altered mental status were [67.6%]. As regards the poisoning characteristics, the present work shows that suicidal cases who were admitted due to hemodynamic instability were [66.7%], ingestion of solution form of poison, represented in both homodynamic instability and altered mental status were [62.3%] and high percentage of patients that were transported by ambulance were admitted due to both haemodynamic instability and altered mental status [85.7%]. Regarding the discharge criteria from ICU, the present study revealed that the patients who were discharged due to death represented [19.76%] of cases. Discharge of patients as hemodynamic instable [in the form of no need for mechanical ventilation, normal ABG] were [26%], controlled arrhythmia [7.2%], shocked patients discharged with no need for inotropic drugs [5.8%]. The patient who were admitted to ICU due to altered mental status and didn't receive mechanical ventilation were discharge as fully conscious [alert and aware] and represented [76.8%] of ICU discharged cases. This study revealed that an ideal ICU must be available in each PCC [poison control center] and ICU admission and discharge criteria are an important part of clinical evaluation for acutely poisoned patients in emergency room