Deliberate self poisoning (DSP) is a common presentation to an emergency department (ED), being an acute medical exacerbation of a chronic psychosocial disorder. At Sir Charles Gairdner Hospital (SCGH) in Perth Western Australia, DSP and intoxication accounts for 4.6% of all ED presentations, the Austin Hospital in Melbourne, reported 650 presentations per year (2% of their ED presentations). In the UK, Kappur estimated an annual rate of presentation to a UK hospital of 310/100000 population and estimated 170 000 presentations to EDs in the UK. One American study estimated an annual rate of ED presentation of self harm in 7 – 24 years old at 225.3 per 100 000 population. With such a caseload it is important that there is a structured process to the management and disposition of cases, as Boyle and her colleagues have described in their review article on the management of the critically poisoned patient. As Boyle discussed resuscitation is an essential part of the management of the poisoned patient, and often this and good supportive care is all that is required in the patients management.
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