Introduction
Deliberate self poisoning (DSP) is a common presentation to an emergency department (ED), being an acute medical exacerbation of a chronic psychosocial disorder [1]. At Sir Charles Gairdner Hospital (SCGH) in Perth Western Australia, DSP and intoxication accounts for 4.6% of all ED presentations [2], the Austin Hospital in Melbourne, reported 650 presentations per year (2% of their ED presentations) [3]. 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 [4]. 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 [5].
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 [6]. 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.