The Poisoning Information Database Covers a Large Proportion of Real Poisoning Cases in Korea

The poisoning information database (PIDB) provides clinical toxicological information on commonly encountered toxic substances in Korea. The aim of this study was to estimate the coverage rate of the PIDB by comparing the database with the distribution of toxic substances that real poisoning patients presented to 20 emergency departments. Development of the PIDB started in 2007, and the number of toxic substances increased annually from 50 to 470 substances in 2014. We retrospectively reviewed the medical records of patients with toxic exposure who visited 20 emergency departments in Korea from January to December 2013. Identified toxic substances were classified as prescription drug, agricultural chemical, household product, animal or plant, herbal drug, or other. We calculated the coverage rate of the PIDB for both the number of poisoning cases and the kinds of toxic substances. A total of 10,887 cases of intoxication among 8,145 patients was collected. The 470 substances registered in the PIDB covered 89.3% of 8,891 identified cases related to poisoning, while the same substances only covered 45.3% of the 671 kinds of identified toxic substances. According to category, 211 prescription drugs, 58 agricultural chemicals, 28 household products, and 32 animals or plants were not covered by the PIDB. This study suggested that the PIDB covered a large proportion of real poisoning cases in Korea. However, the database should be continuously extended to provide information for even rare toxic substances.

Comparison between Emergency Patient Poisoning Cases and the Tox-Info System Database

PURPOSE: The Tox-Info system is a poisonous substance information database developed by the Korean National Institute of Food and Drug Safety Evaluation. The aim of this study was to estimate the coverage effectiveness of the Tox-Info system by comparing the toxic substances included in the database with the distribution of the toxic substances implicated in the cases of intoxicated patients presenting to emergency departments. The secondary aim of the study was to propose any additional substances that should be added to the database. METHODS: We retrospectively reviewed the medical records of patients suffering with toxic exposure who had visited any of 12 selected emergency departments in Korea from January 2010 to December 2011. The identified toxic substances were classified into groups including prescription drugs, agricultural chemicals, household products, animals or plants, herbal drugs, and others. We calculated the coverage rate of the Tox-Info database relative to the number of intoxication cases and the type of toxic substances involved. RESULTS: A total of 5,840 intoxicated patient records were collected. Their mean age was 46.6+/-20.5 years and 56.2% were female. Of the total intoxication cases, 87.8% of the identified toxic substances were included in the Tox-Info database, while only 41.6% of all of the types of identified toxic substances were included. Broken down by category, 122 prescription drugs, 15 agricultural chemicals, 12 household products, 14 animals or plants and 2 herbal drugs involved in poisoning cases were not included in the Tox-info database. CONCLUSION: This study demonstrated the clinical usefulness of the Tox-Info system. While 87.8% of the substances involved in the cases were included in the Tox-Info database, the database should be continuously updated in order to include even the most uncommon toxic substances.

Usefulness of Local Anesthesia for Urethral Catheterization

PURPOSE: Urethral catheterization is a commonly done, painful procedure, but few studies have evaluated the use of topical anesthesia prior to catheterization. This study was designed to assess the effect of topical anesthetics (2% lidocaine gel) prior to uretheral catheterization. METHODS: This study was a prospective, randomized, case-controlled trial conducted in an emergency department of a university teaching hospital. The 54 subjects were alert, cooperative male adults. Patients in the experimental group were catheterized after injection of topical lidocaine gel in their urethras, and a wait of 3 minutes. Patients in the control group were catheterized with a urethral catheter that was coated by plain lubricant. After each procedure, the patients indicated their subjective assessment of pain on a 100 mm visual analog scale (VAS). We assessed VAS at 4 times: during the procedure, at the end of the procedure, and at 3 and 6 hours after the procedure. SPSS 17.0 was used for statistical analysis. RESULTS: The 54 patients were evenly distributed between the 2 study groups. Mean age was 50 years (range 28-71) in the control group, and 54 years (range 27-70) in the experimental group. The mean reduction in VAS values in the experimental group was 27 mm during the procedure, and 23 mm at 6 hours after the procedure. CONCLUSION: Use of a topical lidocaine gel during urethral catheterization results in significant reduction in pain compared to topical lubricants. This benefit is provided both during the procedure as well as up to 6 hours after the procedure.