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Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology
BACKGROUND: Non-accidental non-fatal poisoning (NANFP) is associated with high risk of repeat episodes and fatality. This cross-sectional study aims to describe the data sources and epidemiology of non-fatal poisonings (NFPs) presenting to the emergency ambulance service. METHODS: We assessed incide...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013357/ https://www.ncbi.nlm.nih.gov/pubmed/27540098 http://dx.doi.org/10.1136/bmjopen-2016-011049 |
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author | John, Ann Okolie, Chukwudi Porter, Alison Moore, Chris Thomas, Gareth Whitfield, Richard Oretti, Rossana Snooks, Helen |
author_facet | John, Ann Okolie, Chukwudi Porter, Alison Moore, Chris Thomas, Gareth Whitfield, Richard Oretti, Rossana Snooks, Helen |
author_sort | John, Ann |
collection | PubMed |
description | BACKGROUND: Non-accidental non-fatal poisoning (NANFP) is associated with high risk of repeat episodes and fatality. This cross-sectional study aims to describe the data sources and epidemiology of non-fatal poisonings (NFPs) presenting to the emergency ambulance service. METHODS: We assessed incidents of NFP across Wales from electronic ambulance call centre records and paper records completed by attending ambulance crews, December 2007 to February 2008. We descriptively analysed data completed by attending crews. RESULTS: 92 331 calls were made to the ambulance call centre, of which 3923 (4.2%) were coded as ‘overdose’ or ‘poisoning’. During the same period, ambulance crews recorded 1827 attended NANFP incidents in those categories, of which 1287 (70.4%) had been identified in the call centre. 76.1% (1356/1782) were aged 15–44 years and 54.2% (991/1827) were female. 75.0% (1302/1753) of incidents occurred in areas from the lower 2 quintiles of deprivation in Wales. Substance taken was reported in 90% of cases (n=1639). Multiple ingestion was common (n=886, 54.1%). Psychotropic was the most frequently taken group of substances (n=585, 32.0%) and paracetamol (n=484, 26.5%) was the most frequently taken substance prehospital. Almost half of patients had taken alcohol alongside other substances (n=844, 46.2%). Naloxone was the most frequently administered treatment (n=137, 7.5%). Only 142/1827 (7.8%) patients were not transported to hospital, of whom 4 were recorded to have been given naloxone. CONCLUSIONS: We report new data on the epidemiology of NFP across substance types at national level, highlighting deficiencies in information systems and high levels of multiple ingestion. In order to develop policy and practice for this patient group prehospital and further along the care pathway, information systems need to be developed to allow accurate routine monitoring of volume, presentation and outcomes. |
format | Online Article Text |
id | pubmed-5013357 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-50133572016-09-12 Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology John, Ann Okolie, Chukwudi Porter, Alison Moore, Chris Thomas, Gareth Whitfield, Richard Oretti, Rossana Snooks, Helen BMJ Open Emergency Medicine BACKGROUND: Non-accidental non-fatal poisoning (NANFP) is associated with high risk of repeat episodes and fatality. This cross-sectional study aims to describe the data sources and epidemiology of non-fatal poisonings (NFPs) presenting to the emergency ambulance service. METHODS: We assessed incidents of NFP across Wales from electronic ambulance call centre records and paper records completed by attending ambulance crews, December 2007 to February 2008. We descriptively analysed data completed by attending crews. RESULTS: 92 331 calls were made to the ambulance call centre, of which 3923 (4.2%) were coded as ‘overdose’ or ‘poisoning’. During the same period, ambulance crews recorded 1827 attended NANFP incidents in those categories, of which 1287 (70.4%) had been identified in the call centre. 76.1% (1356/1782) were aged 15–44 years and 54.2% (991/1827) were female. 75.0% (1302/1753) of incidents occurred in areas from the lower 2 quintiles of deprivation in Wales. Substance taken was reported in 90% of cases (n=1639). Multiple ingestion was common (n=886, 54.1%). Psychotropic was the most frequently taken group of substances (n=585, 32.0%) and paracetamol (n=484, 26.5%) was the most frequently taken substance prehospital. Almost half of patients had taken alcohol alongside other substances (n=844, 46.2%). Naloxone was the most frequently administered treatment (n=137, 7.5%). Only 142/1827 (7.8%) patients were not transported to hospital, of whom 4 were recorded to have been given naloxone. CONCLUSIONS: We report new data on the epidemiology of NFP across substance types at national level, highlighting deficiencies in information systems and high levels of multiple ingestion. In order to develop policy and practice for this patient group prehospital and further along the care pathway, information systems need to be developed to allow accurate routine monitoring of volume, presentation and outcomes. BMJ Publishing Group 2016-08-18 /pmc/articles/PMC5013357/ /pubmed/27540098 http://dx.doi.org/10.1136/bmjopen-2016-011049 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Emergency Medicine John, Ann Okolie, Chukwudi Porter, Alison Moore, Chris Thomas, Gareth Whitfield, Richard Oretti, Rossana Snooks, Helen Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
title | Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
title_full | Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
title_fullStr | Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
title_full_unstemmed | Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
title_short | Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
title_sort | non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013357/ https://www.ncbi.nlm.nih.gov/pubmed/27540098 http://dx.doi.org/10.1136/bmjopen-2016-011049 |
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