Evaluation of the Therapeutic Interventions Performed in Patients Before and During Referral to Poisoning Emergency Department in Isfahan Province

Poisoning is one of the most common medical emergencies. Essential measures in the management of a poisoned can be practiced in all medical centers in accordance with their facilities and the competency of the doctors while other precautions necessitate transferring of the patient to specialist centers; hence transfer of the poisoned patients to a specialist center with adequate medical equipments and proficient specialist doctors who are experienced in the groundwork of poisonings is concerned. The present study is conducted to determine the condition of transferring poisoned patients from medical centers to Noor Poisoning Center in Isfahan province of Iran. The present study is a descriptive-retrospective study. The studied population has been the patients who were transferred from medical centers to the poisoning center during a year. The sampling has been conducted in census method، and the researcher designed the questionnaire with regards to the available data in transfer forms which held questions about the preliminary measures taken in the management of the poisoned patient. the population involved 363 patients who were transferred to our referral center during one year. About 53% (15 of 32 cases) of the patients، who had required intubation، were not intubated prior to transfer to the poisoning emergency room. About 27% (98 cases) of the dispatched patients had unstable hemodynamics، and stabilization measures had been performed for 68% (25 cases) of the clinically unstable patients. Such measures were beneficial in 59% (14 cases) of these patients. About 13% (47 cases) of the patients were comatose and an appropriate prescription of coma cocktail had been done in 24% (11 cases) of them. Around 87% (267 of 306 cases) of the patients requiring gastric lavage had been lavaged which had been efficient in 62% (165 cases) of them. Charcoal had been only prescribed for 8% (15 of 196 cases) of the patients who required it. Special poison treatments had been administered in 63% (229 cases) of patients. In addition، 95% of the referring doctors were general practitioners who had not passed the poisoning course. The most common reason for transferring، according to the forms data، had been the lack of appropriate medical facilities (36% cases). Apparently، in order to reduce the problems of transferring poisoned patients، the most attention should be paid to increasing awareness of the physicians in general medicine course by including a poisoning course and also by emphasizing the presence of graduates in training poisoning programs. Moreover، there need to be more supervision on existence of the necessary equipments and medicines like coma cocktails and charcoal in medical centers.