The incidence and management of severe drug overdose patients over a five-year period is presented, together with results and complications. Emphasis is placed on the importance of conservative measures with minimal need for more aggressive methods of treatment.
References
1.
AllanB. C. (1961): “The Role of Gastric Lavage in the Treatment of Patients Suffering from Barbiturate Overdose”, Med. J. Aust., 2, 513.
2.
BakerA. B. (1969): “Early Treatment of the Unconscious Patient Suffering from Drug Overdose”, Med. J. Aust., 1, 497.
3.
BloomerH. R. (1965): “Limited Usefulness of Alkaline Diuresis and Peritoneal Dialysis in Pentobarbitol Intoxication”, New Eng. J. Med., 272, 1309.
4.
BrownT. C. K., BakerG. A., DunlopM. E., and LoughnanP. M. (1973): “The Use of Sodium Bicarbonate in the Treatment of Tricyclic Antidepressants Arrhythmias”, Anaesth. Intens. Care, 1, 203.
5.
BurstonG. A. (1969): “Severe Self-Poisoning in Sunderland”, Brit. Med. J., 1, 679.
6.
CirksenaM. J., BastianR. C., MalloyJ. P., and BarryK. G. (1964): “Use of Mannitol in Exogenous and Endogenous Intoxication”, New Eng. J. Med., 270, 161.
7.
ClemmesenC., and LassenN. A. (1963): “Treatment of Circulatory Shock in Narcotic Poisoning with Special Reference to Complicating Pulmonary Oedema”, Dan. Med. Bull., 10, 100.
8.
ClemmesenC., and NilssonE. (1961): “Therapeutic Trends in the Treatment of Barbiturate Poisoning, The Scandinavian Method”, Clin. Pharmacol. Ther., 2, 220.
9.
CliftonB. S., MackeyK. H., and McLeodJ. G. (1965): “Barbiturate Poisoning”, Med. J. Aust., 1, 63.
DayE. A., and MorganE. B. (1974): “Accidental Hypothermia: Report of a Case Following Alcohol and Barbiturate Overdose”, Anaesth. Intens. Care, 2, 73.
12.
DinesD. E., BakerW. G., and ScantlandW. A. (1961): “Aspiration Pneumonitis: Mendelson's Syndrome”, J. Amer. Med. Ass., 176, 229.
13.
EckenhoffJ. E., and DamW. (1956): “Treatment of Barbiturate Poisoning With or Without Analeptics”, Amer. J. Med., 20, 912.
14.
EvansJ. G. (1967): “Deliberate Self-Poisoning in the Oxford Area”, Brit. J. of Preventive and Social Med., 21, 97.
15.
FergusonM. J., and GraceW. J. (1961): “The Conservative Management of Barbiturate Intoxication. Experience with 95 Unconscious Patients”, Ann. Intern. Med., 54, 726.
16.
FlegeJ. B. (1967): “Tracheosoesophageal Fistulae Caused by Cuffed Tracheostomy Tubes”, Ann. Surg., 166, 153.
17.
FreemanJ. W., BeattieR. R., and RyanC. A. (1970): “Management of Patients Unconscious from Drug Overdosage”, Med. J. Aust., 2, 1165.
18.
GeffinB., and PontoppidanH. (1969): “Reduction of Tracheal Damage by the Prestretching of Inflatable Cuffs”, Anaesthesia, 31, 462.
19.
HaddenJ., JohnsonK., SmithS., PriceL., and GiardinaE. (1969): “Acute Barbiturate Intoxication. Concepts of Management”, J. Amer. Med. Ass., 209, 893.
20.
HamelbergW., and BosomworthP. P. (1964): “Aspiration Pneumonitis. Experimental Studies and Clinical Observation”, Anesth. Anal., 43, 669.
21.
HarleyH. R. S. (1972): “Tracheoesophageal Fistula During Treatment by Tracheostomy and Intermittent Positive Pressure Ventilation”, Thorax., 27, 338.
22.
HarrisonG. A., and TonkinJ. P. (1965): “Laryngeal Complications of Prolonged Endotracheal Intubation”, Med. J. Aust., 2, 709.
23.
HarrisonG. A., and TonkinT. P. (1967): “Some Serious Laryngeal Complications of Prolonged Endotracheal Intubation”, Med. J. Aust., 1, 605.
24.
HeddesM., ErsogC. J., and SafarP. (1969): “Tracheoesophageal Fistulae Following Prolonged Artificial Ventilation Via Cuffed Tracheostomy Tubes“ Anaesthesia, 31, 281.
25.
HendersonL. W., and MerrillJ. P. (1966): “Treatment of Barbiturate Intoxication, with a Report of Recent Experience at Peter Bent Brigham Hospital”, Ann. Intern. Med., 64, 876.
26.
JoronG. E. (1961): “The Treatment of Acute Barbiturate Poisoning”, Applied Therapeutics, 3, 452.
27.
KamenJ. M., and WilkinsonC. J. (1971): “A New Low Pressure Cuff for Endotracheal Tubes”, Anaesthesia, 34, 482.
28.
LawsonA. A. H., and MitchellI. (1972): “Patients with Acute Poisoning Seen in a General Medical Unit (1960–71)”, Brit. Med. J., 4, 153.
29.
LawsonA. A. H., ProudfootA. J., BrownS. S., MacdonaldR. H., FrazerA. G., CameronJ. C., and MatthewH. (1969): “Forced Diuresis in the Treatment of Acute Salicytate Poisoning in Adults”, Quart. J. Med., 35, 31.
30.
Leading Article (1969): “Management of Unconscious Poisoned Patients”, Brit. Med. J., 2, 647.
31.
LindholmC. E. (1969): “Prolonged Endotracheal Intubation”, Acta Anaesth. Scand., 33.
32.
LintonA. L., LukeR. G., and BriggsJ. D. (1967): “Methods of Forced Diuresis and Its Application in Barbiturate Poisoning”, Lancet, 2, 397.
33.
LordR. (1967): “A Review of 280 Tracheostomies”, Aust. N.Z. J. Surg., 36, 192.
34.
MagovernG. J., ShivelyJ. G., FechtD., and ThevozF. (1972): “The Clinical and Experimental Evolution of a Controlled Pressure Intratracheal Cuff”, J. Thorac. Cardiovasc. Surg., 64, 747.
35.
MaherJ. F., SchreinerG. E., and WesterveltF. B. (1962): “Acute Glutethimide Intoxication. Clinical Experience (22 Patients) Compare to Acute Barbiturate Intoxication (62 Patients)”, Amer. J. Med., 33, 70.
36.
MaherJ. F., and SchreinerG. E. (1965): “The Clinical Dialysis of Poisons”, Trans. Amer. Soc. Artif. Intern. Org., 11, 349.
MatthewH. (1969): “Early Treatment of the Unconscious Patient Suffering from Drug Overdose”, Med. J. Aust., 1, 752.
39.
MatthewH., and LawsonA. A. H. (1966): “Acute Barbiturate Poisoning. A Review of Two Years’ Experience”, Quart. J. Med., 35, 539.
40.
MatthewH., and LawsonA. A. H. (1970): Treatment of Common Poisons, 2nd Ed., E. and S. Livingstone, Edinburgh.
41.
MatthewH., MackintoshT. F., TompsettS. L., and CameronJ. C. (1966): “Gastric Aspiration and Lavage in Acute Poisoning”, Brit. Med. J., 1, 1333.
42.
MatthewH., ProudfootA. J., BrownS. S., and AitkenR. C. B. (1969): “Acute Poisoning: Organization and Work Load of a Treatment Centre”, Brit. Med. J., 3, 489.
43.
MerrillJ. P. (1971): “Treatment of Drug Intoxication by Haemoperfusion”, New Eng. J. Med., 284, 911.
44.
MewerG. E., and LeeH. A. (1968): “Value of Forced Diuresis in Acute Barbiturate Poisoning”, Brit. Med. J., 2, 790.
45.
MilthersE. (1963): “Respiratory Embarrassment in Narcotic Poisoning: Diagnosis and Treatment Illustrated by Clinical Experience”, Dan. Med. Bull., 10, 109.
46.
MorganA. G., BennettJ. H., and PolakA. (1968): “Mannitol Retention During Diuretic Treatment of Barbiturate and Salicytate Overdosage”, Quart. J. Med., 37, 589.
47.
MulderD. S., and RubuschJ. L. (1969): “Complications of Tracheostomy. Relationship to Long Term Ventilatory Assistance”, J. Trauma, 9, 389.
48.
MulderD. S., RubuschJ. L., DenbenstenL., and ErhenhaftJ. E. (1972): “Tracheopleural Fistulae: A Complication of the Cuffed Tracheostomy Tube”, J. Thor. Cardiovas. Surg., 63, 416.
49.
MyschetzkyA. (1961): “The Significance of Megimide in the Treatment of Barbiturate Poisoning”, Dan. Med. Bull., 8, 33.
50.
MyschetzkyA., and LassenN. A. (1963): “Urea Induced Osmotic Diuresis and Alkalinization of Urine in Acute Barbiturate Intoxication”, J. Amer. Med. Ass., 185, 936.
51.
PedersenB. S., and PetersenP. N. (1965): “A Resuscitation Centre for Acute Poisoning: Experiences in the First Four Years”, Dan. Med. Ball., 12, 145.
52.
ReedC. E., DriggsM. F., and FotteC. C. (1952): “Acute Barbiturate Intoxication: A Study of 300 Cases on a Physiologic System of Classification of the Severity of the Intoxication”, Ann. Intern. Med., 37, 290.
53.
RibaudoC. A., and GraceW. J. (1971): “Pulmonary Aspiration”, Amer. J. Med., 50, 510.
54.
RichmanH., and AbramsonS. F. (1972): “Mendel-son's Syndrome. Diagnosis, Therapy and Prevention”, Am. J. Surg., 120, 531.
55.
RobinsonR. R., HayesC. P., and GunnellsJ. C. (1967): “Treatment of Acute Barbiturate Intoxication”, Mod. Treat., 4, 679.
56.
SavagesT. M., WardJ. D., SimpsonD. R., and CohenR. D. (1969): “Treatment of Severe Salicytate Poisoning by Forced Alkaline Diuresis”, Brit. Med. J., 1, 35.
57.
SchoenfeldM. R. (1964): “Acute Pulmonary Oedema Caused by Barbiturate Poisoning. A Consideration of its Genesis and Therapy”, Angiology, 15, 445.
58.
SetterJ. G., MaherJ. F., and SchreinerG. E. (1966): “Barbiturate Intoxication. Evaluation of Therapy Including Dialysis in a Large Series Selectively Referred Because of Severity”, Arch. Intern. Med., 117, 224.
59.
ShubinM., and WeilM. H. (1965): “The Mechanism of Shock Following Suicidal Doses of Barbiturates, Narcotics and Tranquilizer Drugs with Observations on the Effect of Treatment”, Amer. J. Med., 38, 853.
60.
ShubinM., and WeilM. H. (1971): “Shock Associated with Barbiturate Intoxication”, J. Amer. Med. Ass., 215, 263.
61.
SmithA. J. (1972): “Self-Poisoning with Drugs: A Worsening Situation”, Brit. Med. J., 4, 157.
62.
StanleyW. J. (1969): “Attempted Suicide and Suicide Gesture”, Brit. J. Preventive Social Med., 23, 190.
63.
StreetonJ. A., and MorganE. B. (1971): “Salbutamol in Status Asthamaticus and Severe Chronic Obstructive Bronchitis”, Postgrad. Med. J., 47 (Supplement, p. 125).
64.
StricklerJ. C. (1965): “Forced Diuresis in the Management of Barbiturate Intoxication”, Clin. Pharmacol. Ther., 6, 693.
65.
SunshineL., and HackettE. R. (1954): “Barbiturate Studies. Correlation Between Clinical Conditions and Blood Barbiturate Levels”, Amer. J. Clin. Path., 24, 1133.
66.
TonkinJ. P., and HarrisonG. A. (1966): “Effect on the Larynx of Prolonged Endotracheal Intubation”, Med. J. Aust., 2, 581.
67.
TullochJ. A. (1972): “Self-Poisoning. A 10 Year Review of Patients Admitted to Stracathro Hospital”, Scot. Med. J., 17, 278.
68.
WhitingE. G., BarrettO., and InmonT. W. (1965): “Treatment of Barbiturate Poisoning. The Use of Peritoneal Dialysis”, Calif. Med., 102, 367.
69.
WrightJ. T. (1965): “The Value of Barbiturate Estimation in the Diagnosis and Treatment of Barbiturate Intoxication”, Quart. J. Med., 24, 95.