Poisoning is a serious worldwide public health problem. Based on the World Health Organization data in 2012, almost 190,000 people died worldwide and the number of deaths due to poisoning in 2008 exceeded the number of deaths due to motor vehicular crashes; also, poisoning death rate nearly tripled worldwide. The number of patients presenting to the emergency departments with overdose had been increased both intentionally and accidentally. All the previous facts make toxicology an important field in emergency medicine. According to the American Association of Poison Control Centers (AAPCC) in the United States, over 2.1 million human exposure calls are reported in 2016. Management of intoxicated patients has a unique approach because of the challenge in diagnosis and treatment of overdose cases. This chapter focuses on general approaches for intoxicated patients and initial management and on how the history and physical examinations could help physicians to have a clue about the drugs that have been abused. Patients are most commonly poisoned via oral ingestion, but other routes could also cause intoxication including inhalation, insufflation, cutaneous and mucous membrane exposure, and injection.
Part of the book: Poisoning in the Modern World