A triage for disposition of the poisoned patients with cardiovascular therapeutic agents attending to the Poison Control Center of Ain Shams University Hospitals (PCC ASUH)

Abstract

Background: According to the 2016 annual report of the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH), toxicity of cardiovascular drugs represented 7.8% of all intoxicated cases. There is a great variability in the disposition of the poisoned patients with cardiovascular therapeutic agents between poison control centers depending on the presence of triage guidelines, the compliance to these guidelines and the current poison control center practice. Objective: To compare the triage for disposition of the intoxicated patients with cardiovascular therapeutic agents in the Poison Control Center of Ain Shams University Hospitals with the American Association of Poison Control Centers (AAPCC) to improve the health care outcome. Patients and Methods: This study was a comparative cross sectional study, performed in the Poison Control Center of Ain Shams University Hospitals. The patients were divided into two groups; Retrospective group in which disposition was based on PSS and local Poison Control Center protocols, and prospective observational group using the American Association of Poison Control Centers Guidelines. Then comparison between the two groups was to determine the effect on patients disposition and outcome. Results: This study included 806 patient, beta blockers intoxication was the commonest cardiovascular drug poisoning (54.8%) .Retrospectively; Of the studied patients (37.2%) were observed in ER then discharged to home, (36.7%) were admitted to ICU, (8.37%) were admitted to inpatient unit, and (17.73%) were referred to another toxicology center. Prospectively; Most of poisoned cases (57.39%) observed in ER then discharged to home, (11.78%) of patients admitted to ICU, (27.82%) admitted to inpatient unit, and (3.01%) referred to another toxicology center, with no adverse effects appeared during follow up of intoxicated patients at PCC clinic. Conclusion: Application of the AAPCC triage method is able to reduce the unnecessary admissions of poisoned patients with cardiovascular therapeutic agents through increasing the percent of observed patients in ER and reducing the cost of ICU admission together with decreasing the need for referral to other health care facility which might pose a risk on the patient.