ABSTRACT
Most cases of acute poisoning are acts of deliberate self-harm in the adult, but are usually accidental in children. Cases should initially be managed as medical emergencies and require substance identification, risk assessment, resuscitation, general supportive and specific treatment, with a period of observation. Advice in the UK is available from the National Poisons Information Service, which coordinates an internet and telephone service to assist in the diagnosis, treatment and management of all types of poisonings. Toxicity is related to underlying cardiac disease, co-ingestants, delay to treatment, increased age, and the specific calcium-channel blocker ingested. Staff treating patients exposed to organophosphates may develop mild headache, eye irritation and pulmonary symptoms secondary to the hydrocarbon solvent and not the organophosphate itself. These resolve with simple analgesia and by removing the staff from the exposure source.
